CMS Announces 6 New Quality Measures Coming Soon to Nursing Home Compare

Members | March 08, 2016

The following article was written by Kathy Pellatt for LeadingAge New York and is used here with permission.

During an Open Door Forum held on March 3, The Centers for Medicare and Medicaid (CMS) announced imminent changes to Nursing Home Compare and the 5 Star Quality Rating System.

Next month, CMS will begin publicly reporting 6 new quality measures (QMs) to Nursing Home Compare. Four of these measures are short-stay measures (3 claims-based and 1 MDS-based) and 2 are MDS-based long-stay QMs. 

The new measures include: 

  1. Percentage of short-stay residents who were successfully discharged to the community (Claims-based).
  2. Percentage of short-stay residents who have had an outpatient emergency department visit (Claims- based).
  3. Percentage of short-stay residents who were re-hospitalized after a nursing home admission (Claims-based).
  4. Percentage of short-stay residents who made improvements in function (MDS-based).
  5. Percentage of long-stay residents whose ability to move independently worsened (MDS-based).
  6. Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based).

Beginning in July, 5 of the 6 new QMs will be phased into the CMS 5-star quality rating system over a 9 month period. The measure on anti-anxiety and hypnotic medication use will be left out of the 5-Star system due to concerns about specificity and appropriate thresholds for star ratings.

CMS has provided this slide presentation explaining the new QM specifications and the data used for each. 

Other resources that are pending:

 

  • Preview Reports: Beginning with the April update, each nursing home will receive data on the new QMs as part of the normal 5-Star Preview Report process. CMS officials stated that CMS will not be able to provide information about how the five new 5-Star QMs will impact each facility’s QM rating until it gets closer to July.
  • CASPER Reports and Manuals: The new QMs will “eventually” be incorporated into the CASPER quality measure reports, but CMS officials did not have a timeline available.  Likewise, they will soon update the MDS 3.0 Quality measures User Manual to provide the specifications for the MDS-based QMs and will most likely issue a separate manual for the claims-based measures.  In addition, CMS plans to update the 5-Star Quality Rating System Technical User’s Guide for the July launch.

 

LeadingAge New York staff are currently working to update the free member LeadingAge Quality Metrics Tools to reflect these latest changes to CMS Nursing Home Compare and the 5-star rating system. 

  • Nursing Home Quality Metrics which analyzes quality metrics such as 5-star ratings, staffing, quality measures, and deficiencies in skilled nursing facilities using the most current publicly reported Nursing Home Compare data; will include the six new measures in April (or as soon as we are able to download them from CMS) so providers will be able to see how they compare in these areas to various other benchmark groups that are meaningful to them.
  • The 5-Star Analysis, a report that is e-mailed on a quarterly basis to members and identifies specific areas where nursing homes should focus improvement efforts to increase their overall star rating, will include information and rates for the five new measures by July (or as soon as we are able to download them from CMS). 

 

Contact: Kathy Pellatt, kpellatt@leadingageny.org; 518-867-8848