Nursing Homes-- Prep up Your Quality Measures to Get That Five-Star Quality Rating!

3.3 million Americans are expected to live in the nation's nearly 16,000 nursing homes in 2014. The patient and their family deserve to get the best possible service, but the question is how?







DURHAM, N.C., March 24, 2014 /PRNewswire-iReach/ -- CMS created Five-Star Quality Rating System with the aim to help patients, their families, and caregivers compare nursing homes more easily. According to recent reports, a substantial number of nursing homes improved their overall Five-Star Quality Rating in past years. Although, one third of nursing facilities preserved the same overall Five-Star rating, but there was an overall improvement in the ratings. Besides, the facilities with a one-star overall rating decreased from 23% to 16% over the past years, and the proportion with a four- or five-star overall rating increased from 35% to 43%. The rating is solely based on scores in three domains— health inspections, staffing and quality measures. These ratings will allow the patient and their family to judge the quality of care provided by the nursing homes—enabling them to avail the best possible care for their loved ones.


The CMS run website Nursing Home Compare provides the user with necessary information regarding the ratings of all the nursing homes. The information available on the website is the result of regular health inspections carried out by state agencies. Based on that data, CMS assigns overall ratings of one to five stars to all nursing homes other than a few too new for meaningful data to be available. Because of the increase in inspection and surveys, the provider needs to be extra vigilant and be in sync with the three domains to get that perfect rating.

Potential Risks to Providers:

  • There is huge increase in the number of state surveys, depending on severity, this can negatively impact facility admissions and cause severe penalties.
  • Inadequate staffing may lead to poor quality of care, higher incident occurrence and increased risk of clinical complications.
  • Inaccurate coding of the MDS 3.0 assessment will lead to erroneous representation of facility quality.

In this entire rating gamut, the Quality Measures stands out like a sore thumb. The significance of Quality Measure cannot be denied, as it is fundamental to the overall quality assurance and quality improvement activities. The star rating is based on 9 of the 18 Quality Measures that are currently posted on the Nursing Home Compare website, and are derived from MDS 3.0 data; Quality Measure accuracy is solely dependent on MDS 3.0 assessment accuracy. It is significant for the facility to comprehend the methodology behind the calculation of the quality measures, to understand the difference between short and long-stay measures. Insights on global knowledge of how to use the QM data for quality care provision, quality assurance and quality improvement, as well as survey preparedness will help the facility to prepare for the survey in a better way. Success with MDS 3.0 requires an interdisciplinary process. Many of the tool's definitions and instructions have changed in the recent years; it has become vital for the facility staff to pay close attention to these.

A majority of people over age 65 will require some type of long-term care services during their lifetime, and the safety and health of the patient is important than all other considerations. The interdisciplinary teams in every facility need to aware of the MDS assessment, Quality Measures and assessment to receive that perfect rating from the CMS.

There is a series of informative webinars on Quality Measure, MDS.3 changes and how to implement them in your practice by expert Keri Hart at To attend these webinars please visit,

AudioEducator brings the most compelling list of audio conferences on wide array of healthcare topics—medical coding, billing to CPT changes, E/M Modifiers to OIG work plan, Affordable Care Act to ERISA, RAC updates to fee schedule, Electronic Health Record system to ICD 10 transition, HIPAA and more. Get trained from the comfort of your home or office without spending a penny on travel. Pick a format of your choice for training— live conference/On Demand/ CD/ PDF transcripts and start learning.

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