Five-Star Quality Rating System
October 2019 Update

In October 2019, several changes will be made to the Nursing Home Compare website and the Five-Star Quality Rating System. These changes will affect the health inspection and quality measure domains.
 
Rating changes for facilities that receive the abuse icon: To make it easier for consumers to identify facilities with instances of non-compliance related to abuse, starting in October 2019, the Centers for Medicare and Medicaid Services (CMS) is adding an icon to highlight facilities that meet either of the following criteria:

  1. Harm-level abuse citation in the most recent survey cycle: Facilities cited for abuse where residents were found to be harmed (Scope/Severity of G or higher) on the most recent standard survey or on a complaint survey within the past 12 months.
  2. Repeat abuse citations: Facilities cited for abuse where residents were found to be potentially harmed (Scope/Severity of D or higher) on the most recent standard survey or on a complaint survey within the past 12 months and on the previous (i.e., second most recent) standard survey or on a complaint survey in the prior 12 months (i.e., from 12 to 24 months ago).

Nursing homes that receive the abuse icon will have their health inspection rating capped at a maximum of two stars. Due to the methodology used to calculate the overall rating, the best overall quality rating a facility that has received the abuse icon can have is four stars.

Removal of quality measures related to pain: The CMS will be removing two quality measures (QMs) from the Nursing Home Compare website and the Five-Star Quality Rating System in October 2019. These measures are:

  • Percentage of short-stay residents who report moderate to severe pain.
  • Percentage of long-stay residents who report moderate to severe pain.

As a result of dropping these two measures, the cut-points for the long-stay, short-stay, and overall QM ratings will change starting in October. These changes will be made to maintain, as close as possible, the same distribution of short-stay and long-stay QM ratings as were posted on Nursing Home Compare in July 2019. The new cut-points are shown in the table below. Note that this table will replace Table 6 in the Technical Users’ Guide (TUG) starting after these changes are implemented in October 2019.

Point Ranges for the QM Ratings (as of October 2019)
Contact Kristopher Pattison at kristopher.pattison@actcpas.com or your trusted ACT representative to review these matters.