The Nursing Home Compare website reports separate ratings for short-stay quality of resident care and long-stay quality of resident care in addition to an overall quality of resident care rating. There are also new point thresholds for the overall quality measure rating as well as the short-stay and long-stay ratings. The scoring rules for the quality measures were changed to give more weight to those measures with greater opportunity for improvement. In April 2019, the threshold for the number of days without an RN onsite in a quarter that triggers an automatic downgrade to one-star will be reduced from seven days to four days. Previously, facilities that reported seven or more days in a quarter with no registered nurse onsite are automatically assigned a one-star staffing rating. The threshold for the number of days without an RN onsite in a quarter that triggers an automatic downgrade to one-star will be reduced from seven days to four days.
The Five-Star staffing category will now be calculated by figuring the total staffing Hours Per Resident Day (HPRD) and RN Staffing HPRD, with CMS prioritizing RN staffing levels by rounding the Five-Star staffing toward the RN Staffing rating. The overall staffing rating is assigned based on the combination of the total staffing and RN staffing ratings. The method by which the RN staffing rating and the total nurse staffing rating are combined is changing to provide more emphasis on RN staffing. Specifically, results from the three most recent standard health inspections and 36 months of complaint inspections will be used to calculate the health inspection score and determine the health inspection rating. The methodology for the health inspection rating returned to what it was prior to February 2018. To read the entire blog, please click HERE. A recent blog post from provides a brief overview of the 2019 changes to Nursing Home Compare and the Five-Star Quality Rating System.
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