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LTC- 5 Star

LTC- 5 Star Quality Rating

QuestionAnswer
What is the CMS LTC Five Star Quality Rating System? It is a rating system that gives each nursing home a rating of between 1 & 5 stars. Ones with 5 stars are considered to have much above average quality. One star facilities have a quality much below average.
Where can you find the Compare information? It can be found at medicare.gov/care-compare
What purpose does the Five Start Program serve? To help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions.
True or False: The only rating available on the Compare Website is the overall score? False: The website tracks 4 sources and an overall score.
What are the 4 source categories tracked by CMS for this website? 1. Health inspections 2. Staffing 3. Quality measures 4. Abuse
Is there a guide that explains The Five Star Rating System? www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/usersguide.pdf Yes: The Five Star Rating System: Technical Users' Guide. It provides detailed information about the content & scoring of each domain, as well as the overall star rating.
In October of last year, 2019 the quality measures for pain were removed why? To avoid ANY inappropriately contribution to a providers decision to administer an opioid.
How is the Overall Quality Rating of 1-5 stars decided? An Overall Quality Rating is based on a nursing homes performance in 3 domains, each has it own rating.
What are those 3 domains? 1. Health Inspections 2. Staffing 3. Quality Measures
How are the Health Inspection domain determined? Based on outcome from state health inspections; on number, S/S of deficiencies identified during the 3 most recent annual inspection surveys. 36 months of findings from complaint investigations & # of revisits required for corrections.
How are the Staffing domain determined? 1)RN hours per resident per day & 2)total nurse staffing hrs/ resident /day. Other types of staff are not included in the staffing rating calculation.
How are the Quality Measures determined? Ratings are based on performance on 15 QM's. These include 9 long-stay & 6 short-stay measures. These also have separate rating for each quality of care measure so they can be judged individually.
Created by: Debra Bernier 1
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