DOH Releases 2018 NH Quality Pool Methodology

The Department of Health (DOH) has released the methodology for the 2018 Nursing Home Quality Initiative (NHQI), which reflects no changes from the 2017 version. DOH’s Dear Administrator Letter (DAL) and 2018 methodology document details the new methodology. However, DOH notes in the DAL that the Centers for Medicare and Medicaid Services’ (CMS) approach for calculating the Five-Star Quality Rating for Health Inspections is changing in 2018, and that this will have a bearing on the corresponding compliance measure in the NHQI.

Timely submission of vaccination and cost report data can affect up to 25 percent of a facility’s overall NHQI score. Facilities are reminded that:

• Employee influenza vaccination data must be submitted to the DOH Bureau of Immunization for the 2017-18 influenza season by May 1, 2018 to be eligible for five NHQI points under compliance and five additional Quality Measure points.
• The 2017 cost report must be completed, filed, and certified by the due date established by DOH to be eligible for five NHQI points under compliance and 10 additional points for the staffing hours per day and percentage of contract/agency staff quality measures. Each member facility should verify well before the due date that any individual(s) who would be responsible for certifying the cost report have active Health Commerce System (HCS) accounts.

Concerns remain about the protracted delays in making the NHQI payment adjustments, which have yet to be made for 2013-17 due to pending litigation.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866