The Centers for Medicare and Medicaid Services (CMS) made changes to the 5-star rating system for nursing homes. The ratings are based on three measures: onsite inspections, quality measures, and staffing levels. CMS introduced strengthened quality measures to more accurately assess quality and standardize measures for post-acute care. Nearly a third of nursing homes will now receive lower scores under the toughened standards, with only 49% receiving the top two ratings of 4 or 5 stars compared to previously 80%. Changes taking effect in 2015 include factoring the use of anti-psychotic drugs and improved calculations for staffing levels.

1. UNDERSTANDING CMS
5-STAR RATING SYSTEM
CHANGES
This Slideshare is from Colonial, part of Community First Solutions.
This slide share
first appeared on
www.YourTimeBC.org

2. CMS 5-STAR RATING
SYSTEM CHANGES
Centers for Medicare and Medicaid
(CMS) added the Five Star Quality
Rating System to the Nursing Home
Compare Website in December of 2008.
The ratings are based on three separate
measures, each of which has its own
5-star rating.

3. THE MEASURES
1. Onsite Inspections: Conducted by objective surveyors
from State Public Health and CMS, nursing homes are
compared against each other and can gain a higher
rating if they improve relative to other facilities in their
market area.
2. Quality Measures: Based on quality measures like
prevalence of pressure ulcers and falls, and use of
restraints, providers can increase their rating regardless
of other facilities in their market area.
3. Staffing Levels: Based on total staffing hours for RNs,
LPNs and CNAs, as well as RN hours per day per resident.

4. The Centers for Medicare and Medicaid (CMS) are
introducing strengthened quality measures for nursing
homes in an attempt to more accurately look at quality
in facilities and to standardize and improve measures for
all levels of post-acute care.
Nearly 1/3 of nursing homes
that participate in the rating will
receive lower scores as a result.

5. BEFORE AND AFTER
Before the change:
Nearly 80% of facilities
receive a 4 or 5 star indicating
above average or well above
average quality.
After the change:
Only 49% of nursing homes
will receive a 4 or 5 star rating.

6. CHANGES AS
OF FEBRUARY, 2015
• Ratings will now include the use of anti-
psychotics for both short and long term stay
residents. These drugs can cause serious risks
for older adults, especially those with Dementia.
• CMS will implement improved calculations for
staffing levels.

7. The average government inspection score—the
most heavily weighted assessment category—
remained 2.81 stars, according to USA Today.
Despite the tougher standards, CMS still recommends families rely
on more than just the ratings. Visits, levels of care, and community
reputation are also important when selecting retirement living.

8. Colonial’s two Continuing
Care Retirement
Communities, Berkeley
Square and Westover, have both
maintained their 5-star rating despite
the toughened CMS standards.
Come see what it’s like to live at a 5-star rated
facility. Schedule a personal tour at your convenience
or learn about upcoming Lunch & Tours by calling
(513) 896-8080.
Community First Solutions is the non-profit parent company of Colonial,
Community Behavioral Health, Community First Pharmacy and Partners in Prime.