A few months back, the Centers for Medicare and Medicaid Services (CMS) announced stricter staffing penalties through the Five-Star Quality Rating system. These changes went into effect as planned and 36% of skilled nursing facilities saw a drop in their overall star ratings as a result.
From here on out, facilities that report four or more days with zero RN hours in a quarter will automatically receive a one-star rating on Nursing Home Compare, the industry’s consumer-facing site. Previously, this penalty threshold was set at seven days.
CMS explained the reason for the change is that research reveals that nurse staffing has the greatest impact on the quality of care nursing homes deliver. In their analysis of the relationship between staffing levels and outcomes, they found that as staffing levels increase, quality increases – and vice versa.
Providers must take action today to avoid earning a one-star staffing rating. That might include hiring more people and/or examining staff utilization to ensure proper coverage. As always, timely and accurate Payroll-Based Journal submissions should be a priority.
Other non-staffing changes announced in the memo include separate ratings for short- and long-stay measures and the lifting of the freeze on health inspection star ratings. Health inspections occurring on or after November 28, 2017 will be factored into each facility’s star rating.
Skilled Nursing News’ Alex Spanko sums up the negative effects that a poor star rating can have on a skilled nursing community’s business: “A building’s five-star rating on Nursing Home Compare, CMS’s website for nursing home residents and their families, can be vital in securing referrals from hospital partners and attracting potential patients organically; preferred provider networks, accountable care organizations (ACOs), and other new payment models also frequently enforce certain star-rating thresholds when looking for new designated skilled nursing partners.”
You can read the full memo HERE.