Nursing Home 2013 Quality Pool Score Sheets Now Available

Last week, DOH advised nursing homes that facility-specific 2013 Quality Pool result sheets were posted for download on the Health Commerce System (HCS).  DOH also posted an accompanying Dear Administrator letter and documents describing the methodology and providing guidance on interpreting the facility results.  The following types of facilities are excluded from the Quality Pool and therefore will not have a one-page report posted on the HCS:  Non-Medicaid facilities, CMS-designated Special Focus Facilities, Specialty Facilities, Continuing Care Retirement Communities and Transitional Care Units. 

Because the distribution methodology is dependent on the Medicaid revenue of the all quality pool recipients, it is difficult to estimate award amounts.  We estimate that Medicaid rates for all homes will be adjusted down by roughly one percent back to 1/1/2013 to collect the $50 million that will be distributed to quality pool recipients.  DOH hopes to make adjustments and payments prior to the end of the calendar year, although CMS approval is still pending.            

DOH has informed us that they will be issuing a press release regarding the quality pool results and providing public access to individual facility data.  This may lead to press attention, questions and confusion due to potential discrepancies with the CMS 5-Star system.   LeadingAge NY distributed some suggested talking points to assist members with inquiries.  It is not yet clear when the state will issue the press release.  We have expressed concern to DOH about some of the scoring (specifically how the disqualifier for fraud and abuse findings is being applied) and will keep members posted of developments. 

Contact:  Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841