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Five-Star Changes Go Live Today


All Medicare-certified skilled nursing facilities are subject to the Five-Star Quality Rating System and Nursing Home Compare, which were established, implemented, and maintained by the Centers for Medicare and Medicaid (CMS). Both programs use metrics to judge the quality of skilled nursing properties. Nursing Home Compare is a website where consumers can gather information about quality metrics for every eligible skilled nursing property to use for comparison shopping. Most of the quality metrics displayed on Nursing Home Compare are used as part of the input to establish a skilled nursing property’s Five-Star rating, with five-star facilities considered the highest quality.

Earlier this year, CMS announced that Nursing Home Compare would collect data and report on additional metrics. Most of those additional metrics will be included in the overall star rating score, but not all of them. The implementation date for this expansion of quality metrics reporting is July 27, 2016. You can read more about the new changes to the Five-Star rating system on the NIC blog here and here.

While these changes do not represent a major departure from business-as-usual for skilled nursing properties, they have generated discussion and attracted some scrutiny from the American Health Care Association (AHCA), which is a trade association representing nursing homes. AHCA believes that the new additional quality measures used by CMS in Nursing Home Compare and the Five-Star Quality Rating System ought to be certified by the National Quality Forum (NQF), as required by the IMPACT Act. NQF vets programs such as Five-Star, putting them through rigorous academic scrutiny to ensure the measures’ validity. The new measures that went into implementation on July 27 have not yet received a stamp of approval from NQF, which is why AHCA requested that CMS delay implementation of these new measures. In fact, NQF gave the new measures a vote of “encourage further development,” according to a public comment submitted by AHCA. The direct impact of these additional quality metrics data collection and reporting on skilled nursing operations will not likely be dramatic, but these new metrics are not the end of the road for changes to the Five-Star. In announcing this additional data collection earlier this year, CMS reiterated that Five-Star will continue to evolve, including more quality metrics data collection and reporting.

I will be following closely as further changes to Five-Star are proposed. Check back to the NIC blog to stay abreast of the many regulatory and reimbursement changes affecting skilled nursing properties.

Skilled Nursing Panel to Discuss CMS Initiatives

Learn more about CMS’ initiatives during “The Ever-Changing World of Skilled Nursing,” a session at the 2016 NIC Fall Conference.

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