On June 22, 2018, the federal Centers for Medicare and Medicaid Services (CMS) announced via a subscription email blast additional skilled nursing facility (SNF) information that it plans to make available to the public through Nursing Home Compare and other government websites. Additional information about the email blast can be obtained from email@example.com. Some of this enhanced information will also be included in the calculation of the SNF’s Five Star Rating.
New Quality Measure:
Since 2015, CMS has collected data about the percentage of short stay residents who were re-hospitalized after their SNF admission. CMS is now adding the same quality measure for long-stay residents. Key dates:
- July 2018 – long-stay resident hospitalization rates will be posted in each SNF’s individualized confidential “Nursing Home Compare Five-Star Ratings of Nursing Homes Provider Rating Report.”
- October 2018 – the long-stay hospitalization measure will be posted on the Nursing Home Compare website.
- Spring 2019 – CMS will include the long-stay hospitalization measure in the Five Star Rating calculation.
Payroll-Based Journal Data:
Since 2017, firstname.lastname@example.org has contained payroll-based data about the number of nursing hours actually worked per day in SNFs. Starting in July 2018, CMS will report hours actually worked by non-nursing staff as well. It will also distinguish hours worked by direct and contracted staff.
On July 7, 2018, the New York Times published an article claiming that the new Payroll-Based Journal data demonstrate that SNFs have fewer nursing staff than previously reported under the old reporting method. “Most nursing homes had fewer nurses and caretaking staff than they had reported to the government for years, according to new federal data, bolstering the long-held suspicions of many families that staffing levels were often inadequate. The records for the first time reveal frequent and significant fluctuations in day-to-day staffing, with particularly large shortfalls on weekends.” This negative publicity surrounding SNF staffing levels may enhance consumers’ interest in the additional data that CMS plans to report. Additionally, CMS is now using the Payroll-Based Journal data to calculate SNFs’ Five Star Rating, which many consumers use as evidence of a particular SNF’s suitability for their needs.
Lifting the Health Inspection Rating Freeze
In order to accommodate the learning curve occasioned by its new SNF survey protocols and implementation of phase 2 of its comprehensive changes to the SNF Requirements for Participation in late 2017, CMS temporarily froze the health inspection domain of the Five Star Quality Rating. CMS announced a timetable for lifting the freeze.
- Spring 2019 – CMS will resume health inspection rating calculations.
- October 2019 – CMS will resume posting the State and national average number of citations per inspection.
CMS promises to provide more details about the end of the freeze in subsequent communications.
As it has for some time, CMS continues to use public transparency about SNF quality measures and staffing as both a carrot and a stick to incentivize SNFs to improve the quality of its care and to engage sufficient and appropriate staff. To the extent appropriate, SNFs may want to use the newly-publicized data to adjust operations to improve their Five Star Rating and public image.