The Centers for Medicare & Medicaid Services announced Monday that it will begin posting certain nursing home ownership information, as well as aggregated MDS data for all residents at a facility, both for the first time, and issue new guides for consumers, on the Nursing Home Compare website.
The agency also said it will unfreeze staffing level ratings to implement a previously announced new staffing level case-mix adjustment methodology, and tweak the way it calculates nursing home staffing turnover.
All of the changes will become live July 31, according to a CMS policy memo sent to state survey agency directors Monday.
Officials said they are posting more characteristics of nursing homes and their residents at data.cms.gov in a bid for greater transparency. That ownership data comes from the CMS-671 form, which includes survey and resident assessment data collected through the MDS.
The ownership information posted to the consumer-facing website will include things like the type of services a facility provides, (such as dedicated special care units and organized residents’ groups), type of ownership details (nonprofit, government-owned, multi-facility owned or leased) and resident census.
Currently, aggregate MDS health data is reported at the state and national level for each MDS question. By the end of the month, however, CMS will start posting it at the facility level as well.
Last September, CMS announced an update to the staffing level case-mix adjustment methodology used to calculate staffing star ratings on Nursing Home Care Compare. It froze staffing measures in April to help facilitate the transition to the new case-mix methodology.
“While CMS will maintain the same overall distribution of points for staffing measures, it is still possible for a facility’s staffing star rating to change,” CMS noted in its memo Monday.
To “minimize the potential disruption associated with the implementation of the new case-mix adjustment methodology,” starting July 31, CMS will revise the staffing rating thresholds to maintain the same overall distribution of points for affected staffing measures.
More information about the new methodology is provided in the Nursing Home Care Compare Five Star Technical Users’ Guide.
The agency said facility staffing ratings could be different due to various reasons, including:
• The updated staffing level case-mix adjustment methodology
• Changes in the number of staffing hours reported by facilities from one quarter to the next
• Updates to the staffing turnover methodology (noted below)
In April, CMS froze three staffing level measures:
• Adjusted RN Staffing (hours per resident per day)
• Adjusted Total Nurse Staffing (hours per resident per day)
• Adjusted Total Nurse Staffing on weekends (hours per resident per day)
In addition to updating the staffing level case-mix adjustment methodology, CMS also is revising the risk adjustment methodology for the claims-based quality measures to incorporate the most recent data available.
“The availability of this information aligns with our commitment to transparency and could incentivize facilities to enhance their quality standards. This is the first time this data has been released,” said the surveyor memo sent by Karen L. Tritz, director of CMS’s Survey & Operations Group, and David R. Wright, director of the agency’s Quality, Safety & Oversight Group.
They said operators and other stakeholders can send recommendations on how the data could be best structured to support their efforts to [email protected].
The staffing turnover tweak apparently corrected an oversight. Currently, employees on leave for 60 days or more are counted as departeds in the quality measure for nurse and administrator staffing turnover. To accommodate maternity and paternity leaves that could last longer, such as the allowed 12 weeks under the Family and Medical Leave Act’s (FMLA), regulators have pushed the 60-day ceiling to 90 days.
The new consumer guides will highlight minimum health and safety expectations in “consumer-friendly” terms, emphasize residents’ rights and make the information posted on Care Compare easier to interpret, officials said.
