The CMS has added five new measures that are being gradually factored into its nursing home star ratings intended to help consumers research and compare the quality of facilities. The new measures, primarily tied to the outcomes of short-stay residents, are based on both Medicare claims and data self-reported by nursing homes.
The calculations that determine nursing homes' quality ratings, which are posted on the CMS' website, Nursing Home Compare, will now include successful discharges, outpatient emergency department visits, nursing home admissions and improvement in function for short-term residents, or those who stay in nursing homes for up to 100 days.
Adding those metrics, which are based on both Medicare claims and nursing homes' own reporting, nearly doubled the number of measures on Nursing Home Compare tied to short-term stays, the CMS said. It also newly incorporated a measure that looked at the proportion of long-term residents whose independent mobility worsened.
“With this update, star ratings will provide an even more accurate reflection of the services that nursing homes provide,” said Dr. Patrick Conway, the CMS' deputy administrator and chief medical officer.
On Nursing Home Compare, institutions have been rated since 2008 on a scale of one to five stars, with five being the best. In addition to an overall quality rating, they also receive individual scores in the areas of health inspections, staffing and quality measures.
Scores are calculated using a variety of metrics, including rehospitalization rates and emergency room use. Some of the data are self-reported by nursing homes; other metrics are based on Medicare claims submitted by hospitals. They also are graded based on the results of health inspections.
The CMS previewed the newest quality measures on Nursing Home Compare beginning in April, but it was not until July that they were factored into nursing homes' star ratings. They are being phased in slowly, starting with half of their full value in July, and will be fully counted by January 2017.
The agency has been adding new quality metrics to Nursing Home Compare since it launched the star ratings in 2008. An investigation by the New York Times in 2014, found that the system nevertheless allowed for some low-quality nursing homes to acquire four or five stars.