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CMS Adds New Quality Measures to Star Rating System

Since 2008, the Center for Medicare and Medicaid Services has been rating nursing homes based on a five-star system. This type of system was put into place to allow consumers to make distinctions between care communities and therefore make an educated choice about which community to choose.  Some information reflected through these ratings are results coming from regular health inspections, amount and qualification level of staff members and measurements of patient quality.

The largest influencer on these star ratings is quality measurement, which is gathered through regularly updated clinical material. In 2014, the New York Times did an in-depth search at the categories making up these quality measurements. It was discovered that with the current list of measures, it was easy for any business to receive a rating of four or five stars. With this finding, the Center for Medicare and Medicaid Services took the opportunity to add more quality measures to ensure that an accurate representation of each care community was available for potential clients.

The new measures put in place focused on the outcome of short-term patients in each care community. Short-term patients are defined as patients who remain in a community for a total of 100 days or fewer. In the past, the treatment of these patients previously had little impact on the overall star ratings. With the recent additions, the quality measurements regarding short-term patients virtually doubled. New focus has been put on improved mobility and function, any readmissions to a hospital following care from a post-acute community, any emergency room visits while staying at a care community and successful discharges that took place within that 100-day time frame. Along with these additions, another measure was added to look at long-term patients. Attention was put on whether any long-term patients’ ability to get around on their own worsened during their stay. These categories give insight on whether a post-acute care community is taking good care of their patients.

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