Additional Information on the 5 Star Changes

JULY 2016 - CMS reported last week that beginning on Wednesday, July 27, the new Five-Star data will be available to the public on its Nursing Home Compare (NHC). The ratings reflect the following key changes:

1. The addition of five new QMs; four of the five quality indicators focus on individuals admitted to a center for short-term rehabilitation following a hospital stay. The five new measures are:
• Percentage of short-stay residents who were successfully discharged back to the community (claims-based)
• Percentage of short-stay residents who have had an outpatient emergency department visit (claims-based)
• Percentage of short-stay residents who were rehospitalized after a nursing care center admission (claims-based)
• Percentage of short-stay residents who made improvements in function (MDS-based)
• Percentage of long-stay residents whose ability to move independently worsened (MDS-based)

2. In July 2016, the new measures will have 50 percent of the weight of the current measures.

3. In January 2017, they will have the same weight as the current measures.

4. The methodological changes include:
• Using four quarters of data rather than three for determining QM ratings.
• Reducing the minimum denominator for all measures (short-stay, long-stay, and claims-based) to 20 summed across four quarters.
• Revising the imputation methodology for QMs with low denominators meeting specific criteria. A facility's own available data will be used and the state average will be used to reach the minimum denominator.
• Using national cut points for assigning points for the ADL QM rather than state-specific thresholds.

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