Medicare & Medicaid News
Medicare makes Five Star Rating
System for nursing homes even tougher
Climb gets even steeper for nursing homes to reach a
five star rating
23, 2015 - The Centers for Medicare & Medicaid Services (CMS) says it
has strengthened the Five Star Quality Rating System for Nursing
Homes on the Nursing Home Compare website to “give families more
precise and meaningful information on quality when they consider
facilities for themselves or a loved one.” The changes appear to make
the hill even steeper to climb for nursing homes to reach the top
Beginning today, nursing home star
● Include use of antipsychotics
in calculation of the star ratings. These medications are often used for
diagnoses that do not warrant them. The two existing quality measures –
for short stay and long stay patients – will now be part of the
calculation for the quality measures star rating.
● Have improved calculations for
staffing levels. Research indicates that staffing is important to
overall quality in a nursing home.
● Reflect higher standards for
nursing homes to achieve a high rating on the quality measure dimension
on the website.
The announcement Friday by CMS,
says this also marks an important milestone to achieving the goal of
implementing further improvements to the Five Star system in
2015, as the
Administration announced last October.
Star ratings allow users to see
important differences in quality among nursing homes to help them make
better care decisions. CMS rates nursing homes on three categories:
results from onsite inspections by trained surveyors, performance on
certain quality measures, and levels of staffing. CMS uses these three
categories to offer an overall star rating, but consumers can see and
focus on any of the three individual categories.
“CMS is committed to improving
Nursing Home Compare and the Five Star Quality Rating System
to ensure they are the most trusted and easy-to-use resources we can
provide,” said Patrick Conway, M.D., CMS Deputy Administrator for
Innovation and Quality and Chief Medical Officer for CMS. “Consumers can
feel confident that Nursing Home Compare’s star ratings include measures
that matter most to nursing home residents and their families and
challenge nursing homes to continuously improve care.”
Since CMS standards for performance
on quality measures are increasing, many nursing homes will see a
decline in their quality measures star rating. By making this change,
Nursing Home Compare will include more meaningful distinctions in
performance for consumers and focus nursing homes on continuously
improving care focused on residents, families, and their caregivers.
About two thirds of nursing homes will see a decline in their quality
measures rating and about one third of nursing homes will experience a
decline in their Overall Five Star Rating.
For example, before the
recalibration, about 80 percent of nursing homes received either a 4 or
5-star rating on their quality measures. Now, about 49 percent of
nursing homes will receive a 4 or 5 stars on their quality measure
rating. Also, the number of nursing homes receiving one star for their
quality measures has increased from 8.5 percent to 13 percent after the
CMS is also focusing changes in
areas identified by consumers and other stakeholders as important. For
example, by the end of 2013 nursing homes achieved a 15 percent
reduction in the use of anti-psychotics compared to 2011 levels. As part
of the National Partnership to Improve Dementia Care, CMS is working
with the nursing home community, patients, families and other important
stakeholders to achieve a 30 percent reduction by the end of CY2016.
The Nursing Home Compare
website was launched in 1998, and CMS added the Five Star Quality
Rating System (“NH Compare 2.0”) in 2008. Nursing Home
Compare gets approximately 1.4 million visits per year and users
report high satisfaction with the site. More than 85 percent of users
have indicated that they found the information they were seeking. CMS
recommends that consumers rely on multiple factors – including star
ratings, visits and community reputation -- when selecting a nursing
To achieve better care, smarter
spending and healthier people, the Department of Health and Human
Services is focused on sharing information more broadly to providers,
consumers, and others to support better decisions while enforcing
patient privacy. The Five Star Quality Rating System for Nursing
Homes is part of an administration-wide effort to increase the
availability and accessibility of information on quality, utilization
and costs for effective, informed decision-making by consumers.
● Read a
fact sheet on
Nursing Home Compare 3.0 .
for nursing homes in
local areas, visit .
information on the
national partnership. pdf
information on the
Advancing Excellence campaign.
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