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The Growing Importance of the Five-Star Quality Rating System Staffing and Quality Measures

The Centers for Medicare and Medicaid Services (CMS) issued the Fiscal Year (FY) 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule on April 4th. In it, CMS proposes to add measures to the SNF Quality Reporting Program (QRP) and SNF Valued-Based Purchasing (VBP) Program. Both programs affect a SNF’s payments. QRP is a pay-for-reporting program, and VBP is a pay-for-performance program. CMS is proposing to add current Five-Star staffing and quality measures to the VBP Program. Those measures are Total Nursing Staff Turnover, Percent of Residents Experiencing One or More Falls with Major Injury, and Number of Hospitalizations per 1,000 Long Stay Resident Days. These measures, if finalized, will have a dual effect on a community’s business success, first by affecting its Five-Star ratings and second by affecting its bottom line. Since these measures are currently on the Five-Star and Nursing Home Trend Reports, communities can review their relative performance against the national benchmark to ascertain where their standings are now and study these measures in Quality Assurance and Performance Improvement (QAPI) if they are not already doing so. Also, LeadingAge NY offers free Five-Star consulting for members who are interested in a deep dive into their most recent report.

For questions or additional information on Five-Star consulting, please contact Susan Chenail.

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