Staffing Measure Rating Changes with the July 2022 Refresh (SNF)
In January 2022, the Centers for Medicare & Medicaid Services (CMS) began posting new weekend staffing and staff turnover measures on Care Compare (CMS memorandum QSO 22-08-NH). These measures will be included in Nursing Home Five Star Quality Rating System methodology starting with the July 2022 Care Compare refresh.
In addition to existing measures of registered nurse (RN) and total nurse hours per resident per day, the new staffing rating methodology will include the following measures:
- Total nurse staffing hours per resident per day weekends;
- Total nurse staff turnover within a given year;
- Registered nurse (RN) turnover with a given year; and
- Number of administrators who have left the nursing home within a given year.
Each nursing home’s performance on the staffing measures are converted to points, then summed and compared to thresholds to determine the staffing star rating. Additionally, to emphasize the importance of staffing, we will no longer add one star to the overall rating of nursing homes that have a four-star staffing rating. Rather, only nursing homes with a five-star staffing rating will be rewarded with an increase in their overall star rating.
Please note – the data utilized to determine the revisions to the 5 Star Staffing Measure is pulled from your submitted Payroll-Based Journal (PBJ) staffing data submitted quarterly to CMS. Be sure to review which positions and roles are included in your PBJ reporting to aid in answering questions regarding this newly posted measure. As an example, while Administrator Turnover is defined on Care Compare as the “number of Administrators who have left the nursing home,” the data utilized to determine this measure includes all individuals coded with Job Code 1 in submitted PBJ data which includes administrators and assistant administrators. The inclusion of assistant administrators in this measure may lead to higher than expected turnover rates and generate questions from the public.
Additional details regarding the staffing rating methodology are included in the Nursing Home Five-Star Quality Rating Technical Users’ Guide.