Revised CMS Five Star Technical Users’ Manual dated July 2016 Released

Karen Morris and Lisa Volk in Clinical & Quality

CMS has posted the updated Five Star Technical User's Guide: www.cms.gov/Medicare/...

Susan Battaglia, Chair of AHCA MDS/IMPACT Subcommittee shared the following quick highlights related to the changes:

The first page denotes the changes and “phase in” of the new measures.  The new measures will be awarded QM points between 10 and 50 (July 2016) versus 20 to 100(Jan 2017) with carrying only 50% of weight until January.  Note there have also been a few methodological changes.

These measures greatly expand the number of short-stay measures used on Nursing Home Compare and add important domains not covered by other measures. The five new QMs will be phased in between July 2016 and January 2017. In July 2016, they will have 50% the weight of the current measures. In January 2017, they will have the same weight as the current measures.

The methodological changes that will be introduced in July include:

  • Using four quarters of data rather than three for determining QM ratings.
  • Reducing the minimum denominator for all measures (short-stay, long-stay, and claims-based) to 20 summed across four quarters.
  • Revising the imputation methodology for QMs with low denominators meeting specific criteria. A facility’s own available data will be used and the state average will be used to reach the minimum denominator.
  • Using national cut points for assigning points for the ADL QM rather than state-specific thresholds.


NYSHFA CONTACT:

Karen Morris, RN, MS
Member Operational Support
518-462-4800 x20

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15