LeadingAge NY, LeadingAge Address Concerns About Nursing Home Staffing Data
With the changeover in staffing ratings on Nursing Home Compare from facility-reported information on the Form CMS-671 to Payroll-Based Journal (PBJ) data, many facilities were showing lower staffing levels than under the previous reporting system. A July 13th article in Kaiser Health News concluded that the PBJ data provide evidence that the Five-Star rating system often exaggerated staffing levels and rarely identified the periods of thin staffing that were common. Senator Ron Wyden (D-OR), ranking member of the Senate Finance Committee, expressed concern about the Kaiser report, which was also published in The New York Times. In his letter to the Centers for Medicare and Medicaid Services (CMS), he noted that “the new payroll data contradicts the self-reported data…”.
Shortly thereafter, the Office of Inspector General of the Department of Health and Human Services announced that it would be examining nursing staffing levels reported by facilities to the Payroll-Based Journal and CMS's efforts to ensure data accuracy and improve resident quality of care by both enforcing minimum requirements and incentivizing high quality staffing above minimum requirements.
LeadingAge NY carefully analyzed the methodology used by Kaiser Health News to arrive at its conclusions about changes in reported staffing levels from the previous system to the new one. Our letter to CMS Administrator Seema Verma documents several concerns with the Kaiser analysis and any conclusions drawn from it. LeadingAge National cited our letter in a recent statement to the House Energy and Commerce Committee Subcommittee on Oversight and Investigations, which held a hearing on Sept. 6th on nursing home quality and resident safety.
As members are aware, the loss of a star in the Five-Star system can have major consequences for a nursing home, its residents, and staff. Several other parties, including payors and other providers, are using Five-Star ratings to determine which nursing homes they will have relationships with. This underscores the importance of proper reporting, error correction, and accurate analyses by providers, government agencies, and researchers.
Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866