Update on CMS July 5-Star Ratings and the LeadingAge 5-Star Analysis
Although providers already received their CMS 5-star preview reports a week ago, CMS has delayed the release of the July 5-star ratings on the Nursing Home Compare website, originally scheduled for July 27th. Unofficially, they are now anticipating an Aug. 5th release for the new 5-star data.
The LeadingAge Five Star Analysis, disseminated to members on a quarterly basis, will also be delayed until the release of the CMS data and because of the following changes in the methodology of the Quality Measure (QM) domain of the Five Star Ratings. Once CMS makes the data available, a new version of the Five Star Analysis will need to be developed to reflect the changes, and then we can disseminate the report.
Summary of the changes:
Beginning with the upcoming release of the Nursing Home Five Star Ratings on Nursing Home Compare, CMS is making several changes to the QM domain of the Five-Star Nursing Home Quality Rating System. These include the addition of five of the six new measures that were first reported on Nursing Home Compare in April 2016 as well as several methodological changes. The five new measures being incorporated into the QM domain of the Five-Star System are:
- Percentage of short-stay residents who were successfully discharged to the community (claims-based)
- Percentage of short-stay residents who have had an outpatient emergency department visit (claims-based)
- Percentage of short-stay residents who were re-hospitalized after a nursing home admission (claims-based)
- Percentage of short-stay residents who made improvements in function (MDS-based)
- Percentage of long-stay residents whose ability to move independently worsened (MDS-based)
These five QMs will be phased in between this upcoming release and January 2017. In this first release, they will have 50% the weight of the current measures. In January 2017, they will have the same weight as the current measures.
The methodological changes that will be introduced with the upcoming release include:
- Using four quarters of data rather than three for determining QM ratings.
- Reducing the minimum denominator for all measures (short-stay, long-stay, and claims-based) to 20 summed across four quarters.
- Revising the imputation methodology for QMs with low denominators meeting specific criteria. A facility's own available data will be used, and the state average will be used to reach the minimum denominator.
- Using national cut points for assigning points for the ADL QM rather than state-specific thresholds.
These changes are described in more detail in the Quality Measure Domain section of the updated manual.
Contact: Kathy Pellatt, kpellatt@leadingageny.org, 518-867-8848