Recently, skilled nursing home providers have been focusing a lot on keeping their Five Star rating high on the nursing Home Compare website. In the beginning, there was the reason that the consumer would look at Home Compare website first when attempting to find a SNF for a loved one or themselves. Now the incentive has doubled due the increasing prevalence of CMS’ Centers for Medicare and Medicaid Innovation (CMMI) alternative payment (APM) models and other incentive payment programs. Because of APM’s, now SNFs have to try being an attractive partner in providing cost effective and quality care across the patient’s post-acute care (PAC) continuum, and being an attractive partner refers to having at least a 3-star rating on the Nursing Home Compare website.
Now six new quality measures were added to Nursing Home Compare, making for the largest addition of quality measures to the website since 2003. The new quality measures will not impact the five star rating immediately; however, they are bound to make providers’ jobs more complicated. Three of these six new quality measures are based on Medicare-claims data submitted by hospitals, which is significant because this is the first time CMS is including quality measures that are not based solely on data that are self-reported by nursing homes. These three quality measures measure the rate of rehospitalization, emergency room use, and community discharge among nursing home residents.
Here’s a peek at the 6 quality measures:
- Percentage of short-stay residents who were successfully discharged to the community (claims-based).
- Percentage of short-stay residents who have had an outpatient emergency department visit (claims-based).
- Percentage of short-stay residents who were re-hospitalized after a nursing home admission (claims-based).
- Percentage of short-stay residents who made improvements in function (MDS-based).
- Percentage of long-stay residents whose ability to move independently worsened (MDS-based).
- Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based).
Patrick Conway, the CMS Deputy Administrator and Chief Medical Officer said “These new quality measures broaden the set of quality measures already on the site so that patients, their family members, and caregivers have more meaningful information when they consider facilities”.
In July 2016, CMS will incorporate all of these measures, except for the antianxiety/hypnotic medication measure, into the calculation of the Nursing Home Five-Star Quality Ratings. CMS is not incorporating the antianxiety/hypnotic medication measure because it has been difficult to determine appropriate nursing home benchmarks for the acceptable use of these medications.
Now is the time for the therapy, nursing, physicians/NPP, and pharmacy to all work together in an inter-professional collaboration to improve patient care.
For the latest education on Identifying Resident Rehab Needs in Skilled Nursing Facilities, join our expert speaker Renee Kinder, in an informative session to understand skilled rehabilitation needs for residents in areas of speech, physical and occupational therapy and gather knowledge on how to utilize current MDS data in order to identify skilled rehab needs.
