DOH Reviews NH Quality Pool Results, Proposes Change
At a meeting of the Nursing Home Quality Initiative (NHQI) Workgroup on March 7th, the Department of Health (DOH) reviewed the results of the 2015 NHQI and proposed a change to the staffing hours measure for 2016. DOH also proposed to create a new “Honor Roll” to recognize nursing homes that attained the top quintile across the first three years of the NHQI. Meanwhile, the payment adjustments for the 2013-15 NHQI results are still on hold.
The only change DOH is proposing to make to the NHQI methodology for 2016 is to replace the CMS 5-star staffing hours measure (which is based on a two-week snapshot) with an annualized staffing hours measure taken from Medicaid cost reports and adjusted for case-mix and predicted staffing hours using the MDS. DOH reported during the meeting that based on a comparison of the 2014 cost report staffing to the CMS 5-Star methodology, this new measure would have resulted in an improved or unchanged staffing rating for 78.9 percent of facilities, with a lower rating for the remaining 21.1 percent. The annualized staffing hours measure was reported to facilities in the 2015 results for benchmarking purposes only, but was not used in the scoring of the 2015 NHQI.
Another staffing measure that was reported to facilities for information only in 2015 was the percent of staff turnover, based on cost report data. However, due to questions about the validity of the source data and the results, this measure is not proposed for inclusion in the 2016 NHQI scoring.
LeadingAge New York and its Nursing Facility Cabinet will be closely reviewing the 2015 results and proposed 2016 change, and the Association will be submitting comments. Members with comments or questions on the proposed change or other aspects of the NHQI should contact us. A copy of DOH’s March 7th presentation to the NHQI Workgroup is posted here for your review.
Concerns were raised during the Workgroup meeting on delays in making associated payment adjustments. DOH officials indicated that unresolved litigation challenging implementation of the NHQI has delayed the payments, which the federal government had already approved for 2013 and 2014.
Facilities are reminded that the 2015 cost report must be completed, filed and certified by July 15, 2016 (for calendar year filers) to be eligible for 5 NHQI points under compliance and 10 additional points under the existing and proposed quality measures. Each member facility should verify well before the July 15th due date that any individual(s) who would be responsible for certifying the cost report have active Health Commerce System accounts.
Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866