Five-Star Quality Rating System

CMS Five-Star Quality Rating System

The Centers for Medicare & Medicaid Services (CMS) publish Five-Star rankings on its Nursing Home Compare (NHC) website.

PHCA MembersCMS_5-Star

The CMS Five-Star Quality Rating System is a significant piece of a nursing facility’s overall quality strategy. As financial, quality and operational models become more tightly integrated understanding the overall CMS Five-Star methodology and each element that comprises the five-star rating becomes an important component in telling your quality story.

In April 2019, CMS published the new Five-Star rankings on the Nursing Home Compare (NHC) website that reflect several significant updates to all three components of the system – survey, staffing and quality. A summary of the changes can be found here.

“The abrupt change in star ratings for nursing homes may be confusing to consumers, residents and their families. By moving the scoring ‘goal posts’ for just two components of the Five-Star system, more than 30 percent of nursing homes in Pennsylvania have lost one or more stars overnight—even though staffing levels and quality of care have remained consistent,” said PHCA President and CEO Zach Shamberg. Click here to read Zach’s entire statement.

On April 8, AHCA hosted a webinar that walked through these new changes. AHCA Members can access the recorded webinar and the following resources on the Five-Star ahcancalED website here:

  • Q&As from the AHCA Five-Star Webinar
  • Member toolkit containing the following items:
    • Suggested talking points
    • Template media statement
    • Template letter to families
    • Sample letter to payors/referral sources
  • Five-Star Technical Users’ Guide
  • CMS QSO Memo

AHCA has several tools to help members continue to improve. AHCA/NCAL’s LTC Trend Tracker here is a one-stop-shop that allows members to gain timely information and valuable insight about their own performance as well as the entire profession, including reports that capture Five-Star and Quality Measure (QM) rates.

Members may also refer to CMS Memorandum 19-08 NH for more information. Members are encouraged to review the agency’s updated Technical User’s Guide for additional details about these changes.

For any additional questions on the Five-Star ratings, please contact Chris Fisher, PHCA Director of Quality Initiatives.

Be sure to use AHCA’s members-only LTC Trend Tracker here to run reports that capture your Five-Star and Quality Measure (QM) rates.

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