Following Efforts by Casey, Wyden, and Cummings, CMS Adds New Quality Measures to Help Rate Nursing Homes

Members of Congress Raised Concern About Five Star Rating System, Now Government Regulator Introduces New Measures to Provide Seniors with Better Information

Washington, D.C. – (RealEstateRama) — Following a push last year by U.S. Senator Bob Casey (D-PA), Senate Finance Committee Ranking Member Ron Wyden (D-OR), and Representative Elijah E. Cummings (D-MD), Ranking Member of the House Committee on Oversight and Government Reform, the Centers for Medicare and Medicaid Services (CMS) announced the addition of six new quality measures to the Nursing Home Compare website, including, for the first time, measures of quality that are based on hospital provided data, such as the rehospitalization rate, emergency room usage and community discharge among nursing home residents.

In 2015, Casey and Wyden wrote to the Government Accountability Office (GAO) calling for a review of the rating system, and Cummings also joined the request. On August 26, 2014, Cummings sent a letter to CMS requesting a briefing to address concerns about the Five-Star rating system after a New York Times article revealed deficiencies in the rating system, and later that year CMS announced revisions to the scoring methodology for its rating system. GAO agreed in August 2015 to conduct a review of the federal government’s nursing home rating system.

“We owe our families the peace of mind in knowing that the rating system they’re using to make a critical decision about the future of their loved ones is accurate,” Sen. Casey said. “This system has the potential to make a substantial difference in the lives of vulnerable seniors and to help families locate the quality care that their loved ones deserve.” “Our most vulnerable citizens and their families deserve to receive the best quality of care. I commend CMS for taking additional steps to ensure that the ‘five star’ rating system is not misleading consumers about the quality of care that nursing homes provide,” said Rep. Cummings. “It is my hope that adding measures that aren’t based solely on nursing homes’ self-reported data will provide families with the reliable and accurate information they need to make the best nursing home decision for their loved one.”
The new quality measure, included below, will be incorporated in July 2016 by CMS:

1. Percentage of short-stay residents who were successfully discharged to the community (Medicare claims- and Minimum Data Set (MDS)-based)

2. Percentage of short-stay residents who have had an outpatient emergency department visit (Medicare claims- and MDS-based)

3. Percentage of short-stay residents who were rehospitalized after a nursing home admission (Medicare claims- and MDS-based)

4. Percentage of short-stay residents who made improvements in function (MDS-based)

5. Percentage of long-stay residents whose ability to move independently worsened (MDS-based)

6. Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based)

114th Congress