Harmony Healthcare International (HHI) Blog

Five-Star ALERT: Sweet 16 Quality Measures Not So Sweet

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


FiveStarCalc.pngThe Five-Star system has been updated (July 2016) to include 5 new measures in the calculation of the Quality Measure portion of Five-Star. A Five-Star Preview Report is available to facilities through the CASPER reporting system. The new reports now include point assignments for each of the 16 Quality Measures that calculate into a facility Five-Star Rating. The initial release of the Five-Star Preview Report contained errors in calculation. 

Specifically, the cut points for star assignments for the claims based measures were incorrect

On August 4th, a revised Five-Star Preview Report was made available to providers. Harmony Healthcare International (HHI) encourages facilities to obtain their Five-Star Reports prior to the information being published on the CMS Nursing Home Compare website. 

CMS planned to update the Nursing Home Compare website with the new calculations on July 27th, but this did not occur!! Per the revised Five-Star Preview report, Nursing Home compare will be updated “in early August.” 

Click Here to Download  Your Free Five-Star Calculator

Key calculation changes that have the potential to impact your Quality Measures Five-Star computation include: 

  1. The ADL Quality Measure will no longer be based on State Cut Points. The same National cut points will be utilized for all facilities. Those facilities in Medicaid Case Mix States with a 6-month snap shot may be more likely to see changes to their ADL Quality Measures. 
  1. The look back period for Five-Star calculations will now be 1 year for the MDS based QMs versus 3 quarters. This may result in facilities having new measures in their calculations that have historically been reported on Nursing Home Compare as “Not Applicable”. The first reporting will include the last 3 Quarters of 2015 and the first quarter of 2016 for MDS based quality Measures and July 1st 2014 through June 30th 2015 for the claims based measures. 
  1. The computation for facilities that do not generate long and or short stay measures has significantly changed! For example, CMS will now use a computation method that will take an average of your facility’s Long Stay Measures to calculate Short Stay Measures versus utilizing a computation method based on the National Average. 
  1. The Minimum Data Submission requirements (number of MDSs needed to trigger the measure) to generate QMs for all measures will be reduced to 20 assessments in the year. This may result in additional measures being calculated if your facility has historically reported measures as “Not Applicable”. 

Facilities are encouraged to utilize their QIES system to obtain their July 2016 preview report prior to the public release on Nursing Home Compare. This new preview report will also include the point’s assignment for each QM to assist facilities in understanding the new calculations. 

These 5 new measures will be diluted to only impact the Five-Star calculations at 50% of their full value.  In January 2017 these 5 measures will count to their full 100%

Click Here to Request a Free Five-Star Quality Measure Analysis with 5 New Measures

 

To access your preview report, select the CASPER Reporting link located on the CMS QIES Systems for Providers page.  Once you are in the CASPER Reporting system, select the "Folders" button and access the Five Star Report in your "st LTC facid" folder where the st is the 2 character postal code of the state in which your facility is located, e.g., Massachusetts is represented by "MA".  The "facid" is the state assigned Facility ID of your facility.  

The Five-Star Help Line (800-839-9290) was available from July 25th through August 5th. Provider preview reports will continue to be available on a monthly basis in advance of public reporting and will include the dates and hours of the helpline availability.  Addressing an email to BetterCare@cms.hhs.gov is an alternative communication system to direct inquires.  

Harmony Healthcare International (HHI) is pleased to assist facilities in navigating through the updated Five-Star Quality Rating System. Harmony Healthcare International (HHI) will continue provide updates with information regarding the impact of these newly added QMs on the Five-Star Rating System as it becomes available. If you have questions or concerns, please contact Harmony Healthcare International by clicking here or calling our office at 1.800.530.4413. 


 
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Topics: Five-Star, Quality Measures

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