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CMS created the Five-Star (5-Star) Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily. The Five-Star Quality Rating System Technical Users' Guide provides in-depth descriptions of the ratings and the methods used to calculate them. Updated twice in October 2019.
October 2019 Revisions
In October 2019, several changes were made to the Nursing Home Compare website and the Five-Star Quality Rating System. These changes affected the health inspection and quality measure domains. This section provides details on these changes.
Ratings changes for facilities that receive the abuse icon: To make it easier for consumers to identify facilities with instances of non-compliance related to abuse, starting in October 2019, CMS added an icon to highlight facilities that meet either of the following criteria:
Nursing homes that receive the abuse icon have their health inspection rating capped at a maximum of two stars. Due to the methodology used to calculate the overall rating, the best overall quality rating a facility that receives the abuse icon can have is four stars.
Removal of quality measures related to pain: CMS removed two quality measures (QMs) from the Nursing Home Compare website and the Five-Star Quality Rating System in October 2019. These measures are:
As a result of dropping these two measures, the cut-points for the long-stay, short-stay, and overall QM ratings changed. These changes were made to maintain, as close as possible, the same distribution of short-stay and long-stay QM ratings as were posted on Nursing Home Compare in July 2019.
This Chartbook on Patient Safety includes a section with results from the National Nursing Home Survey on Patient Safety:
National Healthcare Quality and Disparities Report
This Patient Safety chartbook is part of a family of documents and tools that support the National Healthcare Quality and Disparities Report (QDR). The QDR includes annual reports to Congress mandated in the Healthcare Research and Quality Act of 1999 (P.L. 106-129). This chartbook includes a summary of trends across measures of patient safety from the QDR and figures illustrating select measures of patient safety. A PowerPoint version is also available that users can download for presentations.
The October 2019 Nursing Home Compare Refresh, including quality measure results based on SNF QRP data submitted to CMS, is now available. For this refresh SNF QRP assessment-based measures performance scores will be based upon data submitted to CMS between Q1 2018 – Q4 2018 (1/01/18 – 12/31/18); claims-based measures performance scores will be based upon SNF Prospective Payment System (PPS) claims dated between Q4 2016 and Q3 2018 (10/01/16 – 9/30/18).
CMS will no longer refresh the measure Percentage of Residents/Patients with Pressure Ulcers that are New or Worsened (NQF #0678), under the SNF QRP. The October refresh, as well as all subsequent refreshes of this quality measure data will be solely related to the CMS Nursing Home 5-Star Ratings.
We are implementing the annual refresh of the SNF QRP claims-based measures during the October 2019 refresh of NH Compare. The annual refresh will include updates to the Medicare Spending per Beneficiary (MSPB) and Discharge to Community (DTC) measures. As previously announced, we have updated the methodology used to assign provider performance categories to the DTC measure. Additionally, this refresh includes the inaugural posting of provider performance scores for the Potentially Preventable Readmissions (PPR) measure, which were previously suppressed.
CMS has established a Dementia Care Resources page to provide information that was previously housed at the National Nursing Home Quality Improvement Campaign. Additional resources are available through the QIO program.
· C. Infection Control Objectives for a Personnel Health Service
· D. Elements of a Personnel Health Service for Infection Control
· H. Emergency-Response Personnel
· J. The Americans With Disabilities Act
The updated recommendations are aimed at the leaders and staff of Occupational Health Services (OHS) and the administrators and leaders of healthcare organizations (HCO) and are intended to facilitate the provision of occupational infection prevention and control (IPC) services to HCP and prevent the spread of infections between HCP and others. Additional updates to the 1998 Guideline are underway and will be published in the future. Updates in Part I include:
· a broader range of elements necessary for providing occupational IPC services to HCP;
· applicability to the wider range of healthcare settings where patient care is now delivered, including hospital-based, long-term care, and outpatient settings such as ambulatory and home healthcare; and
· expanded guidance on policies and procedures for occupational IPC services and strategies for delivering occupational IPC services to HCP.
New topics include:
· administrative support and resource allocation for OHS by senior leaders and management,
· service oversight by OHS leadership, and
· use of performance measures to track occupational IPC services and guide quality improvement initiatives.
Unrecognized spread of germs from healthcare personnel (HCP) contamination occurs every day in healthcare settings, posing a risk to patients and HCP alike. Recent Ebola virus outbreaks demonstrated that the potential for transmission of any pathogen in healthcare settings poses an immediate and serious threat.
Preventing the spread of germs in healthcare is essential to protecting the health of patients and HCP. This International Infection Prevention Week, the CDC Prevention Epicenters Program is pleased to announce a groundbreaking new journal supplement, “Personal Protective Equipment for Preventing Contact Transmission of Pathogens: Innovations from CDC’s Prevention Epicenters Program,” composed of 14 in-depth studies, published in this month’s Clinical Infectious Diseases. This research provides insights from recent personal protective equipment (PPE) work in U.S. healthcare settings. It provides evidence to improve routine use of PPE, and to prevent contact transmission of Ebola and other infectious diseases in healthcare settings.
All healthcare settings can benefit from improvements in PPE use and design. PPE plays an important role in preventing the spread of infectious diseases in healthcare settings, but its optimal design and use need to be informed by dedicated research to achieve the reliability and effectiveness needed to protect patients and HCP.
Adverse events and poor health outcomes are continuing challenges for nursing home residents and staff. Research has shown that many resident harms are avoidable and may be caused by situations in which residents do not receive needed care, often called omissions of care. Omissions of care research in nursing home settings is limited and definitions of omissions of care vary. Therefore, AHRQ has developed a definition of omissions of care for nursing homes intended to be meaningful to stakeholders, including residents and caregivers, and actionable for research or improving quality of care.
These apply to all four QRP programs, including the SNF QRP:
Coalition Reaches Consensus on Recommendations to Prevent Secondary Fractures in Adults 65+ with Osteoporosis
Recommendations target all health care professionals who participate in the care of older adults at risk for osteoporotic fractures
BOSTON (October 2, 2019) - A multistakeholder coalition assembled by the American Society for Bone and Mineral Research (ASBMR) has issued clinical recommendations for the optimal prevention of secondary fracture among people aged 65 years and older with a hip or vertebral fracture - the most serious complication associated with osteoporosis. Douglas P. Kiel, M.D., M.P.H., Director of the Musculoskeletal Research Center in the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife and Professor of Medicine at Harvard Medical School, is senior author on the report and served as co-leader of the project. The recommendations were published last month in the Journal of Bone and Mineral Research to coincide with the annual meeting of the ASBMR where Dr. Kiel was honored with the 2019 Esteemed Frederic C. Bartter Award. This prestigious award is bestowed upon an ASBMR member in recognition of outstanding clinical investigation in disorders of bone and mineral metabolism.
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