Five-Star

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’s, 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.

If you need any assistance with media inquiries or talking points, contact Eric Kiehl, PHCA Director of Communications at ekiehl@phca.org or 717-221-7935.

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.

Partner spotlight

With more than 50 years of experience, Essity Hygiene Products AB ("Essity") is the worldwide leader in the management of incontinence, providing products and services for individuals and healthcare organizations throughout 105 countries. Under the brand name TENA®, Essity provides a full range of absorbent products tailored to the distinct needs of men and women, including pantiliners, daytime and overnight pads, male guards, protective underwear, briefs, skin care products, and underpads. With the TENA® brand, Essity is at the forefront of developing products that minimize the impact of incontinence and improve the everyday lives of people living or working with bladder leakage or incontinence. TENA® products feature innovative technologies, such as comfortable QuickDry™ topsheets, super-absorbent Lock Away Core™, and Advanced Odor Protection, to ensure protection, comfort and discretion for wearers.

Learn more about our business partners
Find Care in PA

Nursing Homes, Assisted Living and Personal Care

  • Search by type of care, and by location
  • Map the results
  • Research the facilities