Health Inspection Changes
On 11/24/2017, in S&C 18-04-NH, CMS announced upcoming changes to the Health Inspection domain of the Five-Star Quality Rating System. In this memo, CMS announced that they will hold constant the current health inspection star ratings on the Nursing Home Compare (NHC) website for any surveys occurring between November 28, 2017 and November 27, 2018 and that the survey findings of facilities surveyed under the new LTC survey process will be published on NHC, but will not be incorporated into calculations for the Five-Star Quality Rating System for 12 months.
In addition to the announcement regarding freezing of the health inspection star rating, CMS also announced in the memo that in early 2018, the NHC health inspection star ratings will be based on the two most recent cycles of findings for standard health inspection surveys and the two most recent years of complaint inspections, rather than the 3 years of health inspection data that was previously used.
In response to this memo, last week CMS released the updated CMS Five Star Quality Rating System Technical User Guide outlining the updates to the Health Inspection domain and updated facility health inspection ratings on NHC based on the two most recent standard surveys prior to November 28, 2017, as well as deficiencies arising from complaint investigations during the two-year period prior to November 28, 2017.
In calculating the total weighted health inspection score:
- Rating Cycle 1: The most recent period is assigned a weighting factor of 60 percent.
- Rating Cycle 2: The previous period is weighted at 40 percent.
- Complaint inspections are assigned to a time period based on the 12-month period in which the complaint survey occurred.
- Complaint inspections that occurred between November 28, 2016 and November 27, 2017 receive a weighting factor of 60 percent;
- Complaint inspections that occurred between November 28, 2015 and November 27, 2016 have a weighting factor of 40 percent
Many providers health inspection rating changed as a result of this change in the methodology for calculating the rating.
CMS began posting standard surveys and complaint surveys that occurred on or after November 28, 2017 (under the new survey process) on the Nursing Home Compare website last week. Due to the current freeze of the Health Inspection domain of the Five-Star Quality Rating System, this data will not be used to calculate the health inspection rating during the twelve-month period beginning in February 2018.
Proactive Medical Review is here to Help.
Proactive Medical Review specializes in assisting facilities with Five-Star Rating Improvement plans and preparing providers for the new LTC Survey Process. Contact us today for more information regarding our proven Five-Star Improvement partnerships and survey preparedness projects.