The Centers for Medicare and
Medicaid Services (CMS) Updates
Five-Star Users’ Guide

The CMS announced that the waiver for Payroll-Based Journal ( PBJ) submissions was rescinded on June 25, 2020, and the August 14 deadline has been reinstated for reporting of staffing PBJ info for 2020 Q2 (4/1 - 6/30). 
 
While Health Inspections remain frozen as per the previously released memo QSO-20-31-ALL , some additional information was included in the Five-Star Users’ Guide update that was posted to the CMS website July 29, 2020, which has some pertinent information on how the first quarter of 2020 PBJ staffing submissions (or lack thereof) has impacted the staffing ratings. For most providers, the previous star rating for the staffing will remain unchanged and be reflective of 2019 quarter 4 PBJ staffing submissions; however, for facilities that would have had staffing star declines related to the 2020 Q1 PBJ submission, these facilities will retain their prior rating and not drop. For any facilities who had a one star staffing rating related to either a late PBJ submission or four or more days in the quarter with no registered nurse (RN) hours, these facilities will get a reprieve and the new staffing ratings will be posted as “Not Available.” 
 
Similarly, due to the COVID-19 Minimum Data Set (MDS) submission requirement waiver, MDS-related Quality Measures (QMs) are being held constant for the July update, and associated QM points will be derived from CY 2019; however, the QM rating may still change, as the claims-based measures will be updated and points related to these measures can change.
 
Facilities should review the Five-Star report posted in their Certification and Survey Provider Enhanced Reports (CASPER) folders to review information posted with the July 2020 update to Medicare.gov. Any changes to the QM rating is related to one of the 5 claims-based measures.  Four of these five QMs relate to emergency room (ER) visits and Rehospitalization measures, and a decline in the rating may indicate the need for more focus in these areas.
For more information, contact your Arnett Carbis Toothman representative or email us at info@actcpas.com .