CMS rates nursing home quality and quality of other healthcare provider types using a star system and makes public this rating on its Care Compare website. The rating Nursing Home system is calculated based on ratings in three areas, inspections, staffing and 15 quality measures. Currently the staffing rating is based on two measures, RN and total nurse staffing hours per resident day (HPRD). CMS recently added four new staffing measures to the calculation of the nursing home staffing star rating for the July 2022 refresh including:
- Total nurse (registered nurse (RN), licensed practical nurse, and nurse aide) staffing hours per resident per day on weekends;
- Total nurse staff turnover within a given year;
- RN turnover within a given year; and
- Number of administrators who have left the nursing home within a given year.
Unlike the current methodology of plotting RN and total nurse staffing hours per resident day on a grid to determine the rating, the new calculation will be based on a point system. Each of the six measures will be converted into points based on a facility’s ranking compared to all other facilities in the country. The points for all six measures will then be tallied, and a staffing star rating will be assigned. A separate RN rating will not be calculated or reported.
Another change, unlike the current methodology that adds a star to the overall rating if the staffing rating is four or five stars and is greater than the health inspection rating, the methodology that will be used at the July refresh will only add a star to the overall rating if the staffing rating is five stars.
CMS posted a fact sheet that summarizes the methodology changes that will be used for July ratings. Details on how ratings will be calculated can be found in the updated Nursing Home Five-Star Quality Rating System Technical Users’ Guide.
