CMS is
announcing the following updates related to Nursing Home Compare and Payroll-Based
Journal data:
Long-Stay Hospitalization Quality Measure:
CMS continues to focus on reducing hospitalizations to improve
the health and safety of nursing home residents. Hospitalizations are
expensive, disruptive, and place residents at risk for an increased decline
in health. Over the last several years, CMS has launched initiatives aimed at
reducing hospitalizations, such as the Skilled Nursing Facility Value Based Purchasing program
and the Initiative to Reduce Avoidable Hospitalizations among
Nursing Facility Residents. In 2015, CMS added a quality measure to the Nursing Home Compare website and Five Star Quality
Rating System which reported the percentage of short-stay residents who were
re-hospitalized. Posting this quality measure was aimed at informing
stakeholders about the rates of re-hospitalizations for each nursing home,
and incentivizing nursing homes to implement interventions to reduce these
instances and improve quality. Similarly, CMS will begin posting rates of
hospitalizations of long-stay residents for the same objectives. In July
2018, CMS will provide rates of hospitalizations for long-stay residents in
each facility’s confidential “Nursing Home Compare Five-Star Ratings of
Nursing Homes Provider Rating Report.” In October 2018, the long-stay
hospitalization measure will be posted on the Nursing Home Compare website as
a long-stay quality measure. In the spring of 2019, this quality measure will
be included in the Five Star Quality Rating System. Additionally, in
July 2018 we will update the other claims-based quality measures reported on
the Nursing Home Compare website.
Payroll-Based Journal Data
In 2017, CMS began posting the number of hours worked by
nursing staff submitted through the Payroll-Based Journal (PBJ) system on data.cms.gov (see S&C memorandum 17-45-NH). To increase
transparency, we will begin posting the number of hours worked by other staff
(i.e., non-nursing) in July 2018. Facilities are required to submit hours for
all other staff as listed in Table 1 of the PBJ Policy Manual. We will also distinguish
between hours submitted for direct employees and contract staff. We encourage
stakeholders to use this information to learn how different categories of
staff can improve quality and outcomes for residents. The information will be
posted on data.cms.gov and will include the total
number of hours submitted for each staff category. As a reminder, CMS
recently announced the use of PBJ data to calculate staffing measures and
facilities' star ratings (see QSO memorandum 18-17-NH).
Health Inspection Rating Freeze
In February 2018, CMS implemented a temporary “freeze" of
the health inspection domain of the Nursing Home Five Star Quality Rating
System by holding each facility's health inspection rating constant for
approximately one year. During the freeze, inspections conducted after
November 28, 2017, are not included in facility’s star ratings calculation.
This action is part of CMS’s implementation of a new inspection process and
Phase Two of the revised Requirements for Participation for Long Term Care
Facilities (see S&C memorandum 18-04-NH). In October
2019, we will resume posting the average number of citations per inspection
for each state and nationally. CMS is monitoring outcomes of the new
inspection process and plans to resume health inspection rating calculations
(i.e., end the freeze) in the spring of 2019. CMS will communicate more
details about this prior to its implementation.
For questions related to this information, please email bettercare@cms.hhs.gov.
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Friday, June 22, 2018
CMS is announcing the following updates related to Nursing Home Compare and Payroll-Based Journal data:
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