New Five-Star ratings on the Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare website will serve to confuse consumers by deflating the number of stars many skilled nursing facilities receive, distorting the high quality of care being provided at centers across the country, according to the American Health Care Association (AHCA) in response to the changes implemented by CMS on April 24.
In a statement, AHCA Senior Vice President of Quality and Regulatory Affairs David Gifford, MD, says the “abrupt change in star ratings” for nursing centers may be confusing to consumers, residents, and their families.
“By moving the scoring ‘goal posts’ for two components of the Five-Star system, CMS will cause more than 30 percent of nursing centers nationwide to lose one or more stars overnight, even though nothing changed in staffing levels and in quality of care, which is still being practiced and delivered every day,” he says.
Gifford noted that since the launch of the profession’s metric-based Quality Initiative in 2012, nursing centers have made significant improvements in the quality of care residents receive.
He also said “While the Five-Star system can be a helpful tool, consumers should not rely on it exclusively when choosing a nursing center for themselves or a loved one. As changes are made in the future, we look forward to continuing to work with CMS to ensure that additional Five-Star changes are less confusing.”
At issue are the many alterations to the Five-Star ratings installed by CMS, which are intended to help consumers evaluate skilled nursing care centers. The star ratings are based on three components: survey data, staffing information, and quality metrics. These components are reported by a Minimum Data Set (MDS) and claims-based system.
The CMS changes include updated thresholds for assigning stars (or moving the “goal posts” back) for both the staffing and quality components of the system, which will cause a 47 percent of all nursing centers to lose stars in their Quality ratings. In addition, 33 percent will lose stars in their Staffing ratings, and some 36 percent will lose stars in their Overall ratings, according to data by AHCA.
A further impact of the new way CMS is assessing the star ratings is that the disruption may impact access to resident care since managed care organizations and hospital discharge networks often require nursing centers to maintain their star ratings.