Quality Measures & 5 Star Rating


Five Star Quality Rating:  In December 2008 the Centers for Medicare & Medicaid services enhanced the Nursing Home Compare website to include a rating system that would be easy for consumers to understand.  The rating system is based on a star system, similar to what is seen when rating fine hotels or restaurants.

Each facility is assigned four star ratings.  Three clinical domains (Health Inspections, Staffing, and Quality Measures) are combined to create an overall star rating for the facility.  Star ratings range from one star (much below average) to five stars (much above average).

Facilities are incentivized through market-based competition to improve their own 5 Star Quality Rating in order to be competitive with their peers.  Harmony Healthcare International (HHI) strongly believes that providing high quality clinical care will lead to a more competitive overall star rating.

Potential Risks to Providers:

  • Increased number of state survey citations, depending on severity, can negatively impact facility admissions and cause severe monetary penalties.

  • Inadequate staffing levels may lead to subpar quality of care, higher incident occurrence and increased risk of clinical complications.

  • Inaccurate coding of the MDS 3.0 assessment will lead to inaccurate representation of facility quality. 

How can Harmony Healthcare International (HHI) help?

The Health Inspections Star Rating is based on outcomes from State Health Inspection Survey.  Overall rating is based on the number, scope, and severity of deficiencies identified during the most recent annual inspection surveys, as well as substantiated findings from the most recent 36 months of complaint investigations.  HHI offers Mock Regulatory/State Survey to assist facilities in identifying areas for improvement prior to annual survey, which will lead to decreased number of citations during survey and citations of lesser severity.

The Staffing star rating is based on nursing home staffing levels and uses two measures.  RN hours per resident day and total nursing staffing hours per day are equally weighted, and are case-mix adjusted based on the distribution of MDS 3.0 assessments by RUG group.  HHI offers Staffing Analysis for clients to ensure that staffing is at its optimal level, as well as staff mentoring programs and staff development programs to aid current staff to preform work tasks efficiently and accurately.  HHI also offers Talent Management to aid facilities in placing ideal candidates into open positions.

The Quality Measure star rating is based on 9 of the 18 Quality Measures that are currently posted on the Nursing Home Compare website, and are derived from MDS 3.0 data.  These include 7 long stay and two short stay measures.  Quality Measure accuracy is solely dependent on MDS 3.0 assessment accuracy. HHI offers three distinct levels of MDS training, ranging from beginner to expert coding guidance.  HHI site visits include in-depth audit of the medical record to assure that the coding on the MDS 3.0 assessment is fully supported by medical record documentation.  Staff is provided with education, oversight, and examples of supportive medical record documentation.

Free Resources - Case Mix by State, Federal Rates, RUGs Analysis & More!