The Centers for Medicare & Medicaid Services (CMS) released memo QSO-24-14-NH on July 1 detailing updates to the staffing domain coming with the July 31 Care Compare refresh. These updates include changes to the staffing domain based on case mix methodology and turnover measure specifications. CMS also announced that they will begin posting facility-level Minimum Data Set (MDS) data on the CMS data site beginning with the July refresh and will update consumer guides on the Care Compare site.

Staffing Domain Updates

Staffing level measures were frozen in April 2024 to allow for an update to case mix methodology based on the October 2024 MDS transition from Section G to Section GG. With the July refresh, staffing level measures will be unfrozen and will be calculated based on the updated case mix methodology. CMS will maintain overall star-rating distribution within the domain but warns that some nursing homes may still see a change in star rating due to a variety of factors including the updated case mix methodology, changes in reporting from quarter to quarter, or a just announced change to staff turnover measure specifications.

Staff turnover measures are calculated by identifying gaps in days worked. Currently, a gap in days worked of 60 days or more is considered turnover but with the July refresh, CMS has announced that the turnover threshold will be updated to 90 days. This means that staff with gaps in days worked of 90 days or less will not be counted as turnover. LeadingAge celebrates this change for which we have previously heavily advocated.

Updates to Data Site

CMS announces that, as a measure of transparency, facility-level MDS data and other data included on the form CMS-671 will be published at data.cms.gov beginning with the July refresh. Posting this data, which is often used in research and policy, gives public access to facility-level data that was previously difficult and sometimes costly to obtain.