CMS Releases released an updated Technical User’s Guide to the Nursing Home Five-Star system

The Centers for Medicare & Medicaid Services (CMS) has released an updated Technical User's Guide to the Nursing Home Five-Star system. The document details how the Payroll-Based Journal (PBJ) staff turnover measures released publicly on Care Compare in January 2022 will be included in Five-Star Staffing ratings starting with the July 2022 ratings update later this month. 
A total of six staffing measures will determine Staffing star ratings. CMS is adding the following four measures to the two already in use (total nursing and RN nursing hours per resident day [HPRD]):
  • Total nursing (RN, LPN/LVN, CNA/aide) HPRD on the weekend
  • Total nursing turnover
  • RN Turnover
  • Administrator Turnover
Facilities will earn points for their performance on all six measures. The sum of those points will determine their staffing star rating. This method is similar to how the Quality star rating is determined using multiple measures. The point thresholds for individual staffing measures and the staffing star rating can be found in the newly updated technical guide. 
In addition to changing the Staffing star calculation, CMS is altering how the staffing star rating will impact a facility's Overall Five-Star rating. Effective in July 2022, only facilities with a five star Staffing rating will gain a star in their Overall rating. Previously, four and five star Staffing facilities could receive this increase. Facilities will still lose an Overall star if their Staffing rating is one star.
AHCA/NCAL members can view their historical performance on all six of the staffing measures on
LTC Trend Tracker right now. Additionally, providers should soon be able to access their Five-Star rating preview reports in the CASPER QIES system to see their rating with the latest data before the July 2022 refresh occurs at the end of the month.

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