April 2024 Staffing Five-Star Projections now available in LTC Trend Tracker

In April 2024, CMS will implement adjustments to the five-star staffing scoring methodology, specifically targeting missing turnover data. Under this adjustment, missing turnover rates will incur the lowest possible score (e.g., 5 out of 50 points), rather than recalibrating the scoring to render missing data neutral.
Remaining penalties related to Payroll-Based Journal (PBJ) will persist, including an automatic downgrade to a 1-star staffing rating for failure to submit PBJ data or having four or more days without registered nurse hours.
For comprehensive details, refer to the CMS Five-Star Technical Manual and CMS's memo (QSO-23-21NH) issued in September 2023.
While the majority of centers are not anticipated to be significantly affected by this scoring alteration, approximately 10 percent may experience a decrease. Calculating the three PBJ-based turnover measures (Total Nurse, RN, and Administrator) necessitates six consecutive quarters of PBJ data. Most centers (68%) exhibit non-missing rates for all three measures, while around 10 percent lack data for all three as of the January 31, 2024, release of CMS Care Compare.
Through analysis conducted by the AHCA/NCAL Research Department utilizing the latest available data, it was determined that 90% of centers observed no change in their staffing star ratings. Nine percent experienced a downgrade of one star, and one percent saw a decrease of two stars.
To assess the potential impact of these changes on your center, access the latest Your Top-Line publication in LTC Trend Tracker (2024-Q1).
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