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Changes to Five-Star Quality Rating System at July 2024 Refresh

(July 9, 2024) The Centers for Medicare and Medicaid Services (CMS) has released a memo, QSO-24-14-NH, that outlines the July 2024 updates to the Five-Star Quality Rating System.

Staffing level measures (hours per resident day) for total nurse, registered nurse (RN), and total nurse on weekends will be unfrozen and recalculated using a new methodology for case mix. Resource Utilization Group (RUG)-IV will be replaced with the 25 Patient-Driven Payment Model (PDPM) nursing categories. Staffing level measures will use Payroll-Based Journal (PBJ) data from Quarter 1 2024.

Turnover measures for total nurse, RN, and Administrators would use a 90-day employment gap instead of a 60-day employment gap to identify if turnover occurred. This is directly related to CMS’s consideration of the Family Leave Act and the availability of 12 weeks leave. This change ensures that the employees who use their 12 weeks leave will not be counted as turnover. Turnover measures will use PBJ data from Quarter 4 2022, Quarters 1-4 2023, and Quarter 1 2024.

A new Five-Star Technical Users’ Guide will be posted at or around the July 31, 2024 Care Compare refresh. Other updates include posting aggregated facility level Minimum Data Set (MDS) data and data from the CMS-671 form on the data.cms.gov site.

Contact: Susan Chenail, schenail@leadingageny.org, 518-867-8383 ext. 116