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CMS Extends and Expands Nursing Home Compare Freeze

In a memo released on June 25th, the Centers for Medicare and Medicaid Services (CMS) announced changes to the Five-Star Quality Rating System calculation methodology for the staffing and quality measure domains.

CMS suspended standard inspections to focus on preventing the spread of COVID-19. As of the April 2020 quarterly refresh, the health inspection domain star rating was held constant and based on inspections prior to March 4, 2020. This freeze has been extended for the July 2020 quarterly refresh. Currently, there is no plan to lift the health inspection freeze.

The freeze has been expanded to include the staffing measures and star rating. During the Public Health Emergency (PHE), CMS waived the requirement for nursing homes to submit staffing data through the Payroll-Based Journal (PBJ) system. Because of the waiver, staffing data that would have been used to calculate the staffing domain for the July 2020 quarterly refresh has been affected. Therefore, the staffing measures and star rating will not be updated and will be held constant based on data from quarter 4 (October to December) 2019. This could negatively impact nursing homes assigned the one-star penalty from the April 2020 quarterly refresh. Because these facilities do not have the opportunity to correct or improve their star rating, CMS is removing the rating downgrade for these facilities and temporarily suppressing their staffing measures and star rating.

The blanket waiver for PBJ submission has been lifted, and facilities must resume their PBJ submissions beginning with the April to June 2020 quarterly data, with a submission deadline of Aug. 14, 2020. That data will be used to calculate the staffing domain for the October 2020 quarterly refresh.

During the PHE, CMS also issued waivers related to the completion and submission of Minimum Data Set (MDS) information impacting assessments after Jan. 1, 2020 and therefore affecting the calculation of some quality measures for the July 2020 quarterly refresh. Calculation of the quality measures will be based on data ending Dec. 31, 2019. Some measures will stay the same, and some will be updated based on the data collection periods for each quality measure. Measures whose data collection period included quarter 4 (October to December) 2019 for the April 2020 quarterly refresh will remain constant. Measures whose data collection period ended prior to Dec. 31, 2019 for the April 2020 quarterly refresh will be updated. Consequently, the quality measure star rating will not be held constant.

Contact: Susan Chenail, schenail@leadingageny.org, 518-867-8383 ext. 116