CMS Releases Updated Five-Star Technical Users’ Guide

The Centers for Medicare and Medicaid Services (CMS) released an updated Nursing Home Five-Star Quality Rating System Technical Users’ Guide on Sept. 21, 2023.

Changes to the rating system that will be effective with the April 2024 refresh include:

Updating the staffing level case-mix adjustment methodology;
Freezing (i.e., holding constant) four of the quality measures used in the rating system (related to replacing Section G items with Section GG);
Freezing (i.e., holding constant) the staffing level measures for three months during the transition;
Revising the staffing rating methodology so providers that fail to submit staffing data or submit erroneous data receive the lowest score possible for corresponding staffing turnover measures.

Changes to the rating system that will be effective with the July 2024 refresh include:

Changing the staffing case-mix adjustment methodology to a model based on the Patient-Driven Payment Model (PDPM);
Posting staffing level measures that use this methodology.

Details related to the updated case-mix adjustment for staffing can be found in the Technical Users’ Guide on pages 34-36.

Please refer to CMS memorandum QSO-23-21-NH for more information about these upcoming updates to staffing and quality measures.

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