Long-Term Care Survey Alert

Staffing remains a matter of concern.

If the Nursing Home Compare 5-Star Quality Rating System is a source of some serious hand-wringing for you, you’ll be pleased to know that nursing homes overall are improving their ratings.

The Centers for Medicare & Medicaid Services (CMS) issued the official three-year report by ABT Associates on June 7, detailing the rating mechanisms and progress that nursing homes made in their star ratings from the Five-Star Quality Rating System’s implementation in December 2008 through December 2011. ABT found that overall, nursing homes improved in the three major domain areas:

1. Inspections

2. Staffing

3. Quality Measures (QMs)

Fewer Inspection Deficiencies, Better Survey Scores

In the first domain area, the Five-Star system draws nursing home data from three indicators of poor survey performance: actual harm; immediate jeopardy (IJ); and substandard quality of care (SQC). Although all three survey indicators were less common in the most recent surveys, 1-Star facilities didn’t perform so well — they actually experienced an increase in instances of these three indicators in recent surveys, noted Evvie Munley, senior health policy analyst for Washington, D.C.-based Leading Age, in a July 2 announcement.

For-Profits Lag Behind in Staffing Ratings

Although 1-Star facilities decreased staffing over the three-year period, 4- and 5-Star facilities increased staffing slightly. ABT discovered that the biggest changes in staffing were due to increases in reported levels of RN staffing.

Data also showed that non-profit and government-owned nursing homes received higher staffing ratings than for-profit nursing homes, Munley pointed out. Nearly twice as many non-profit nursing homes received 5-Star ratings for staffing than for-profits. In fact, less than 5 percent of for-profit nursing homes received five stars.

Nursing Homes Shine in QM Domain

“Due to the transition from the MDS 2.0 to the MDS 3.0 and the ‘freezing’ of the QM domain March 2011 to July 2012, fewer analyses of the QM component are included,” Munley said. But CMS plans to release a new rating based on QMs generated from MDS 3.0 assessments conducted in 2012.

Nevertheless, 1-Star nursing homes decreased dramatically in the QM domain, while 4- and 5-Star ratings became more common. Facilities with a 1-Star QM rating decreased from 20 percent to 11 percent, and facilities receiving 4- or 5-Star ratings increased from 34.1 percent to 46.9 percent.

Link: To view Nursing Home Compare 5-Star Quality Rating System: Year 3 Report, go to www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandCompliance/Downloads/FSQRS-Report.pdf.