Skilled Nursing

CMS Five Star Rating Changes in Effect

On March 5th, CMS announced that it would be making changes to how the Nursing Home Compare site calculates its Five Star Ratings. These changes went into effect last month (April 24, 2019) and threaten to impact a significant number of nursing facilities’ ratings. According to Kaiser Health News, 1,638 nursing homes received a one-star rating, mostly due to the providers inability to meet the four day registered nurse requirement.

Changes to the site include:

  • Ending the freeze on Health Inspection Star Ratings. CMS has resumed the traditional method of calculating health inspection scores by using three cycles of inspections occurring on or after November 28, 2017.
  • Introducing separate ratings on short- and long-stay measures to reflect the quality of care for the two subpopulations
  • Adjustments for the thresholds for staffing ratings. The threshold for the number of days without a registered nurse (RN) onsite that triggers an automatic downgrade to one star was reduced from seven days to four days.

Read more about the details of the changes in CMS Memo QSO-19-08-NH. For in-depth descriptions of the ratings and the methods used to calculate them, read the Five-Star Users’ Guide April 2019.