MDS Alert

Current information may not be incorporated into your rating until later this year.

Right before the Long Term Care Survey Process overhaul that went into effect Nov. 28, 2018, David R. Wright, director of the Survey and Certification Group at the Centers for Medicare and Medicaid Services (CMS), announced that survey results would not immediately be compiled into SNFs' Five-Star ratings.

But if you've been surveyed since the new regulations went into effect, you should know that certain information surveyors collect is made public to potential residents. For more on the new Long Term Care Survey Process, see TCI's MDS Alert Volume 15 Number 12.

Here are the specifics about which information will be made available and how, from the CMS website:

"The new inspection process began on November 28, 2017. Because of the large number of nursing homes, it will take approximately a year for most nursing homes to be inspected under the new process. As each nursing home is inspected under the new process, a summary of the findings and the full reports from the new inspection process will be available on Nursing Home Compare. However, for approximately one year, the findings from the new inspections won't be used to calculate each nursing home's star rating. Instead, ratings will be calculated using results from surveys that occurred before November 28, 2017. Therefore, the ratings may not reflect the most recent assessment of compliance and quality that exists in a given facility. Results from inspections done under the old process will also continue to be available on Nursing Home Compare."

Health Inspection Scores are Public

The information surveyors make public on Nursing Home Compare includes health inspections, fire safety, emergency preparedness, staffing, quality of resident care, and penalties.

CMS currently calculates a health inspection score for a nursing home in two ways:

• "On citations identified in each nursing home's 2 most recent health inspections that occurred before implementation of a new Long-Term Care survey process on November 28, 2017.
• "On citations identified from the most recent 2 years of complaint and facility reported incident inspections during this same time period."

The health inspection score is compiled through the assignation of points for each citation levied, depending on the severity of the issue and whether its widespread. The total points are then compiled - the lower the health inspection score, the better the facility fared on its inspection.

CMS says that that their evaluations and scoring place more emphasis on the more recent inspections, and uses the following criteria to determine the facility's star rating:

• "The top 10% of nursing homes with the lowest health inspection scores in each state get a health inspection rating of 5 stars.
• "The middle 70% of nursing homes get a rating of 2, 3, or 4 stars, with an almost equal number of nursing homes in each rating category.
• "The bottom 20% get a 1 star rating."

However: Due to the new survey process, information from health inspections conducted since the new regulations went into effect on Nov. 28, 2017, won't be included in the star ratings until later this year. Though the information won't be included in the star rating yet, CMS says it will share information, including the date of the survey, the number of citations identified during the new health inspection process, and the level of harm and number of residents affected, on Nursing Home Compare.

Resource: Find the February 2018 Five-Star Technical User's Guide here: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/Certificationand­Complianc/Downloads/usersguide.pdf.