As the coronavirus pandemic continues to impact the US, the skilled nursing industry must consider how the current environment will affect The Five-Star Quality Rating System for years to come.  CMS has taken major actions to try to counteract the long-ranging effects that the coronavirus pandemic could have on the Five-Star Quality Star Rating Program.

Here are the Top 5 Important Facts 5-Star Rating During COVID-19 Pandemic:

#5.  Staffing Measures and Rating- CMS waived the requirements at 42 CFR 483.70(q), which required nursing home providers to submit staffing data through the Payroll-Based Journal (PBJ) system. Because of the waiver, many facilities did not submit staffing data by the May 15, 2020 deadline. CMS will not be able to update the PBJ staffing measures and staffing domain star ratings at the regularly scheduled update in July 2020. Therefore, staffing measures and ratings will be held constant and based on data submitted for October – December 2019.

#4. Staffing Rating One-Star Staffing Downgrade- CMS recognizes that the waiver of the requirement prevented some facilities from improving their rating from their previous quarter’s submission. Specifically, facilities whose staffing rating was automatically downgraded to one-star due to missing the deadline for the previous submission, or for reporting four or more days in the quarter with no registered nurse. Therefore, CMS will remove the one-star staffing rating downgrade, and instead, these facilities will have their ratings temporarily suppressed. Their staffing ratings will show “Not Available” for July, August, and September 2020.

#3. Quality Measure Ratings- Similar to the staffing data waiver, CMS waived requirements at 42 CFR 483.20 related to the timelines for completing and submitting resident minimum data set (MDS) information. Therefore, beginning July 29,2020 quality measures based on the data collection period ending December 31, 2019 will be held constant. Quality measures that were based on a data collection period prior to December 31, 2019 (e.g., ending September 30, 2019); however, will continue to be updated until the underlying data reaches December 31, 2019.

#2. Health Inspection Ratings- Since the Nursing Home Compare (NHC) refresh in April 2020 and until further notice, the health inspection domain of the rating system is being held constant to include only data from surveys that occurred on or before March 3, 2020. Results of health inspections conducted on or after March 4, 2020, will be posted publicly, but not be used to calculate a nursing home's health inspection star ratings.

#1. “Focused Inspections” during COVID-19 Outbreak- The plan called for focused inspections on urgent patient safety threats and infection control. These targeted inspections allow CMS to focus inspections on the most urgent situations, so the agency can get the information it needs to ensure safety, while not getting in the way of patient care.  Health inspections conducted on or after March 4, 2020, will be posted publicly, but not be used to calculate a nursing home’s health inspection star ratings. The surveys occurring on or after March 4, 2020 will be posted through a link on the front page of the Nursing Home Compare website as the survey data are finalized and uploaded.

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