The latest 5 Star Reports were emailed out to members last week. This contains the latest analysis for your organization.
Last week’s AU article regarding the Medicaid Rate Incentives contained a link to the 5 Star Technical Manual. This manual contains a wealth of information for providers on how the 5 Star Rating is calculated.
The 5 Star specification was updated for July 2018 and the 2 changes have been incorporated into the 5 Star Reports as of this afternoon. Here are the 2 changes to the 5 Star Manual:
- Health Inspection
Providers with two or more health inspections on or after November 28, 2017 Results (dates, counts and lists of citations) from the three most recent health inspections are displayed on
Nursing Home Compare, regardless of whether these surveys took place before or after November 28, 2017. For example:
- For providers with one survey conducted on or after November 28, 2017, the posted results from the three most recent health inspections would include:
- One survey conducted after November 28, 2017; and
- two surveys conducted prior to November 28, 2018
For nursing homes that have had two surveys on or after November 28, 2017, the rating will still be based on the last two surveys conducted prior to November 28, 2017. However, since the results from the three most recent surveys are posted, the results from the oldest survey will not be displayed on the main website. For example:
- For providers with two surveys conducted on or after November 28, 2017, the posted results from the three most recent health inspections would include:
- Two surveys conducted after November 28, 2017; and
- one survey conducted prior to November 28, 2018.
In other words, the oldest survey will still be used to calculate a home’s rating, but the results from that survey will not be displayed on the main website. Interested users can find these earlier survey results in the health inspection files that are available at https://data.medicare.gov/data/nursing-home-compare.
- Staffing
As of July 2018, there are the following exceptions to the scoring rules described above for assigning the staffing rating and RN staffing rating.
- Providers that fail to submit any staffing data by the required deadline will receive a one-star rating for overall staffing and RN staffing for the quarter.
- Providers that submit staffing data indicating that there were seven or more days in the quarter with no RN staffing (job codes 5-7) but on which there were one or more residents in the facility will receive a one-star rating for overall staffing and RN staffing for the quarter.
- CMS conducts audits of nursing homes to verify the data submitted and to ensure accuracy. Facilities that fail to respond to these audits and those for which the audit identifies significant discrepancies between the hours reported and the hours verified will receive a one-star rating for overall staffing and RN staffing for three months from the time at which the deadline to respond to audit requests passes or discrepancies are identified.
