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CMS Posts Updated Five-Star Quality Rating Program Technical User’s Guide

The updated Nursing Home Care Compare Technical Users' Guide has been posted on the Centers for Medicare and Medicaid Services' (CMS') Five Star Quality Rating System Page.  
Effective with the January 2025 refresh (expected on January 29th), CMS will unfreeze four quality measures (QMs) that were frozen beginning with the April 2024 refresh. These measures were updated to accommodate recent changes to the Minimum Data Set (MDS). Please refer to the CMS Memorandum QSO-25-01-NH for more information about these updates. 
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The impacts to these QMs are as follows:  
  • Percentage of Skilled Nursing Facility (SNF) Residents Who Are At or Above an Expected Ability to Care for Themselves and Move Around at Discharge (i.e., the Discharge Function Score measure) will replace Percentage of Residents Who Made Improvements in Function (short-stay).  
  • The percentage of Residents Whose Need for Help with Activities of Daily Living Has Increased (long-stay) will be respecified.  
  • Percentage of Residents Whose Ability to Walk Independently Worsened (long-stay) will be respecified.  
  • Percentage of Residents with Pressure Ulcers will replace Percentage of High-Risk Residents with Pressure Ulcers (long-stay).  
To address these changes in measure specifications, the scoring cut points for each of these four measures were recalculated to achieve an even distribution across scores. Also, to minimize the potential disruption associated with these changes, the QM rating cut points were adjusted to maintain the same overall distribution.
 
Individual centers will be able to see the impact of these changes in mid-January in their iQIES Five-Star Preview Reports. Center-level data, along with benchmark rates, will also be available in LTC Trend Tracker and Your Top-Line soon after the January 2025 refresh.
 
 
Staff Contact: mcarland@mehca.org
 

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