✔ Review Star Ratings info and prepare for plan for inclusion on microsites and website#In-Process
Completed by Betsy S.
- Assigned to
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Betsy S.
Greg A.
- Due on
- Notes
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Hi Betsy and Greg,
RR: 3/22
The client shared this information with us this morning with this note:
"Checking in to hear your thoughts on the 5-star ratings and how we highlight it on the microsites (for the 5-stars) and how we will address it on the main site. Thanks for your thoughts."
It appears she sent this to Kathy in February.
How should we proceed with including this information? We will want to go back and tackle Batch 1, and then include it on Batches 2-4.
We also want to include it on the website, Greg.
Content of email is:
There are no changes this month for the Five Star Ratings from the previous month. For March 2019, GCHC remains at 4.48 out of 5 stars as an average. Tremendous job to all of you!Please see the information from the Provider Rating Report below. There will be SIGNIFICANT CHANGES to all of the ratings in April, 2019.- The health inspection rating will “thaw” and allow the Phase 2 RoP Surveys to be in the calculation and will return to the 3-standard surveys/36-months of complaints view for the health inspection rating. (Since November 2017, the health inspection star rating has been frozen and only had the previous 2 years of standard surveys and 24 months of complaints.)
- The QMs are changing considerably to rebase all measures, have a separate long-stay and short-stay QM rating that will give an overall QM rating, remove the restraint QM, add the long-stay rehospitalization QM and the long-stay ER Visit QM, and the high risk pressure ulcers QM will include unstageable pressure ulcers. LOTS of changes and I anticipate fluctuation with everyone QMs.
- The Staffing rating will be updated using the current national staffing levels and the RN/overall staffing rating will be reduced to 1-star if there are 4 or more days with NO reported RN hours (previous number was 7 or more). Furthermore, CMS will no longer suppress star ratings for centers with 5 or more residents and no nursing hours reported (Discharge MDS completion is extremely important as well as the MDS 3.0 Roster Audits for PBJ Census to get residents off the census who no longer reside in the center).
This Provider Rating Report shows the number of days with no RN hours and number of days with no nursing hours.If you would like to see your center’s report, please notify me or Tracie Fairman.
March, 2019 Provider Rating Report:The March 2019 Five-Star ratings provided above will be displayed for your nursing home on the Nursing Home Compare (NHC) website on March 27, 2019. The Quality Measure (QM) Rating that will be posted is based on MDS 3.0 quality measures using data from the fourth quarter of 2017 and the first, second and third quarters of 2018, re-hospitalization and emergency department claims-based quality measures using data from 7/1/2017 through 6/30/2018 and the community discharge claims-based quality measure using data from 4/1/2017 through 3/31/2018. The Staffing and RN Staffing Ratings are based on Payroll-based journal staffing data reported for the third calendar quarter of 2018.
HelplineThe Five-Star Helpline will operate Monday - Friday, March 25 - March 29, 2019. Hours of operation will be from 9 am - 5 pm ET, 8 am - 4 pm CT, 7 am - 3 pm MT, and 6 am - 2 pm PT. The Helpline number is 1-800-839-9290. The Helpline will be available again for two weeks, April 22 - May 3, 2019. During other times, direct inquiries to BetterCare@cms.hhs.gov as Helpline staff help respond to e-mail inquiries when the telephone Helpline is not operational.
Important NewsProvided below is an overview of the changes that will occur with the April 2019 Nursing Home Compare (NHC) refresh. For specific details please see the April 2019 Five-Star Quality Rating Technical Users' Guide located at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/Five-Star-Users-Guide-April-2019.pdfAdditionally, more detailed information on the April 2019 changes can be found in the CMS memorandum: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QSO19-08-NH.pdf
Health Inspection Changes for April 2019:
The health inspection rating will begin to incorporate surveys that occurred on or after 11/28/2017. The rating will be based on three cycles of survey data. Cycle 1 will be weighted 1/2, cycle 2 weighted 1/3, and cycle 3 weighted 1/6. It is not possible to predict the health inspection star rating in advance as the total weighted health inspection score for each facility will be compared to the state distribution in April 2019.Staffing Changes for April 2019:1. The national staffing star rating cut points will be updated.2. The staffing and RN staffing ratings will be set to one star if there are four or more days without RN staffing hours on days when there are residents in a facility (previously this occurred when there were seven or more days without RN staffing hours).3. Staffing ratings are no longer being suppressed for nursing homes that have five or more days with residents and no nurse staffing hours reported.4. The term "expected hours" will be replaced with the term "case-mix hours" in the staffing rating calculations. The case-mix hours are based on the RUG-IV levels of the residents using the same methodology previously used for the expected hours calculation.Quality Measure (QM) Changes for April 2019:1. NHC will report separate ratings for short-stay residents' quality of care and long-stay residents' quality of care in addition to an overall quality of care rating.2. There will be a total of 17 QMs used in the calculation of the Five-Star QM rating with 10 long-stay and seven short-stay QMs.3. The scoring rules for the quality measures are changing to give more weight to measures with greater opportunity for improvement. Some measures will have a maximum score of 150 points while the maximum number of points for other measures will be 100.4. There will be new thresholds for the quality measure rating. The thresholds are being adjusted based on the improvement in QMs that has occurred since July 2016, which is the last time that the measure thresholds were adjusted.5. The long-stay claims-based QM, number of hospitalizations per 1,000 long-stay resident days, will be added to the Five-Star QM rating calculation.6. A new long-stay claims-based QM, number of outpatient emergency department visits per 1,000 long-stay resident days, will be added to the Five-Star QM rating calculation.7. The short-stay MDS-based QM, percentage of residents with pressure ulcers that are new or worsened, will be replaced with the SNF QRP QM, percentage of SNF residents with pressure ulcers that are new or worsened, in the Five-Star QM rating calculation.8. The short-stay claims-based QM, percentage of residents who were successfully discharged to the community, will be replaced with the SNF QRP QM, rate of successful return to home and community from a SNF, in the Five-Star QM rating calculation.9. The long-stay QM, percentage of residents who were physically restrained, will no longer be included in the Five-Star QM calculation. Note that this measure willcontinue to be displayed on NHC.10. The long-stay QM, percentage of high-risk residents with pressure ulcers, will include unstageable pressure ulcers.Special Focus Facility (SFF) Changes for April 2019:SFF star ratings will not be displayed on NHC for any domain. A yellow warning sign will be displayed instead of the overall rating and "Not Available" will be displayed in place of the ratings for all other domains.User Guides and Manual Updates:Below is a list of Users' Guides and Manuals that will be updated by April 2019 (links to each provided in the References section of this report):1. Five-Star Quality Rating Technical Users' Guide2. MDS 3.0 Quality Measures User's Manual3. Nursing Home Compare Claims-Based Quality Measure Technical Specificationscc:
Michelle
Celeste
Roya
I am utterly confused and unsure of what my part in this is. It seems to me that it all could be moot if laypeople are not savvy about what these numbers mean and why.
I feel like we need to meet on this before I can be of any use. I lack the necessary information to be able to make heads or tails of this.
Please advise.
cc:
I neglected (accidentally!) to make you aware of an important aspect to all this Ratings System stuff. Here goes...
All that detail that initially had me confused is entirely pertaining to the SIGNIFICANT changes in the Five Star system coming in April. Basically, some of the key ratings categories have been "frozen" and are about to "thaw" next month. This means that the ratings may change noticeably, precipitously, significantly come next month. This raises two concerns:
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