Changes to the 5 Star Rating

Angie SzumlinskiUncategorized

Last week CMS announced changes to the Five-Star Quality Rating System that take effect on February 20, 2015. The changes will likely impact a number of our member skilled nursing facilities' ratings, resulting in a loss of one or two stars. 

CMS released a preview of each center's new ratings on Friday, February 13. Information on how you can access your preview data is included below. 

The changes announced will impact how CMS assigns stars for both the Staffing and Quality Measure components, which may impact a center's Overall rating. They also will add two new measures to the Quality Measure component: the short-stay antipsychotic measure and the long-stay antipsychotic measure that CMS has been using on Nursing Home Compare for the past several years. 

Following is a summary of the changes to the Five-Star components:

  • Overall
    Five-Star rating
    • No changes to
      methodology but changes to Staffing and Quality Measure (QM) components
      will impact your overall rating
  • Survey component
    • No changes
  • Staffing component
    • Changed how 3-
      and 4-Star ratings are determined on Staffing component.
      • Centers that
        have a 3-Star rating on both their RN and Direct Care Staffing will no
        longer receive 4 Stars but will now receive a 3-Star rating.
      • This also may
        impact a Center's Overall rating since a 4- or 5-Star rating on the
        Staffing component added one star to your Overall rating.
  • Quality Measure component
    • Added two new Quality Measures to the current nine QMs
      • Short-Stay use of antipsychotics
      • Long-Stay use of antipsychotics
    • Re-scaled the cut points for each star level on the Quality Measure component.  The new cut points are included in the new Technical Users' Guide (February 2015).
      • This will result in many members losing one or two stars on the Quality Measure component.  Since the QM component contributes to the Overall rating, a sizable number of centers may also lose a star on their Overall rating.

Instructions for Accessing Five-Star Preview Reports

The February 2015 Five-Star Preview Report, reveals the effect of recalculation on your center's Five-Star rating, is available through the Quality Improvement Evaluation System (QIES) and CASPER as of Friday, February 13. Given the significance of these changes, and the potential for many of our members to lose a star as a result of the new calculations, we strongly encourage you to access your preview report as soon as possible to determine if your ratings will be affected. 

You may access your Five-Star Preview Report online through the Quality Improvement Evaluation System (QIES). CMS uses the QIES for many purposes including MDS submission and access to CASPER reporting. Note that QIES is a secure access service and requires a user name and password in order to review information that has been posted by CMS. Your MDS Coordinator will have your facility's login information.

  1. After logging into QIES, select the CASPER Reporting link located on your MDS State Welcome page.
  2. Once in the CASPER Reporting system, click on the “Folders” button and access the Five-Star Report in your “st LTC facid” folder, where “st” is the 2-character postal code of the state in which your facility is located and “facid” is the state-assigned Facility ID of your facility.

If you need assistance in accessing your Five-Star preview data, call the QIES Help Desk at 800.339.9313.

We will continue to keep you posted as new information becomes available.