CMS Set to Launch Five-Star Quality Rating System
December 18

VHCA (12/12/2008)

On December 18, the Centers for Medicare & Medicaid Services (CMS) will launch its Five-Star Quality Rating System on Nursing Home Compare resource page within Medicare.gov.  Last Friday, CMS Acting Administrator Kerry Weems and other CMS officials briefed AHCA and others on design, methodology and preliminary analyses related to the launch of its Five-Star Quality Rating System next week.  The CMS briefing presentation and a FAQ document which Care Providers of Minnesota shared with AHCA  together provide information on the Five-Star Rating program.

Each facility will receive notification in its QUIES or MDS mailbox listing its individual Five-Star rating that CMS will post as early as December 15 and no later than December 17.  Providers are urged to alert their MDS personnel to begin looking for the information in the MDS box starting Monday.  The rating system is a major revision to the Nursing Home Compare website and is based on facility performance in three areas: Health Inspections, Quality Measures and Staffing.  According to CMS, the rating system takes transparency to another level. 

The Health Inspection rating is based on the three most recent annual inspections, all complaint inspections in the last three years, and the number and Scope & Severity of deficiencies. 

The Quality Measure rating will be based on seven Long-Stay prevalence measures (ADL change; mobility change; high risk pressure ulcers; long term catheters; physical restraints; urinary tract infections and pain) and three Short-Stay Prevalence measures (delirium, pain and pressure ulcers) for the three most recent quarters of available data reported on the resident assessment. 

Staffing data will be based on the average number of hours of care by RNs, LPNs and CNAs per resident per day, adjusted for case-mix based on Resource Utilization Groupings (RUGs). 

Nursing Home Compare will display the star ratings for each of the three performance measures alongside an Overall Rating.  The survey rating forms the base "star" rating with stars being added or subtracted depending upon a facility's star rating for QMs and staffing respectively. 

On December 16, CMS will open a Five-Star Helpline to answer technical questions from providers who call 800.839.9290; consumers can call 1.800.MEDICARE for questions about the Five-Star Rating System.  CMS officials emphasized in its briefing to AHCA that this helpline is intended to answer questions about the program - not appeals to change a facility's rating.  Additional information will be posted to CMS' website on December 18 in the form of a Technical Users Guide.  USA Today, which will run a front-page story to coincide with the launch of Five-Star on December 18, has interviewed AHCA and additional media attention is anticipated following Mr. Weems' press briefing on the Five-Star rating system next Thursday.  AHCA continues to review the materials provided to date, and is developing additional resources for members that will be posted to AHCA's webpage as more information becomes available.  AHCA is currently in the process of developing a series of talking points for use by providers in anticipation of calls from the media, families and consumers.  We will distribute those talking points once they become available.