Tuesday, March 15, 2016

Five-Star: What You Need to Know and Do to Prepare Now

David Gifford, MD, MPH and Lyn Bentley, MSW

On March 3, CMS announced the addition of new quality measures (QMs) to Nursing Home Compare (NHC) and the Five-Star Quality Rating System. The new measures are a part of the agency’s effort to track and encourage improvements in skilled nursing care centers for short-stay and long-stay patients and residents. These new additions also build on what CMS announced in February of 2015.

There are six new measures: four short-stay and two long-stay. The new short-stay measures are discharge back to the community, emergency room use, rehospitalizations, and improvement in function. Three of the four are aligned with the AHCA Quality Initiative. The new long-stay measures are decline in mobility and the use of hypnotics/anxiolytics.

So what does this mean for nursing centers? By the end of April, all six of the new measures will be added to NHC and accessible to the public. And in July, all but one measure - hypnotics/anxiolytics - will be added to Five-Star. CMS has not yet announced how the new QMs will impact the overall star rating.

In preparation for these new additions, we encourage member centers to take the following steps now.

1. Register for free to access members-only Five-Star resources on ahcancalED. Current resources include the March 4th AHCA members-only webinar, the questions and answers from that webinar, and specifics on the new measurements. To access the resources on the site, you must 1) log in using your AHCA username and password and 2) register to download the Five-Star materials. Contact educate@ahca.org if you need any assistance.

2. Watch AHCA’s recorded members-only webinar from March 4th. Our presentation walks through the new updates in greater detail.

3. Be sure your MDS coordinator is aware of the new updates. One week before the measures are added to NHC at the end of April, she/he will be able to access the QIES System to preview the new data. Instructions on how to access the report can be found on the ahcancalED site here.

4. Start counting and tracking the number of residents and patients who are experiencing each of the QMs (e.g., discharge back to the community, emergency room use, rehospitalizations) by using Advancing Excellence’s free tracking tools.

5. Review and familiarize yourself with the specifics of the new measures. And don’t forget to include your staff in this process.

6. Go to AHCA’s LTC Trend Tracker(SM), a free, members-only online tool, to run your Discharge to Community and Hospitalization Rate reports. Once you have your report, look to see if you are above or below the national average to get a sense of how you are doing. Based on what you learn, set a goal to perform at least two-three points better than the average. Contact help@ltctrendtracker.com if you need any assistance.

7. Visit the AHCA Quality Initiative website to access additional resources to improve your discharges back to the community and reduce hospital readmissions.

We will inform members of any new updates over the next few weeks. Stay tuned.

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