CMS Moves Forward with Quality Measure Rating Threshold Changes (SNF)

On Monday, March 21, 2022 the Centers for Medicare & Medicaid Services (CMS) shared they will be moving forward to adjust the quality measure (QM) rating thresholds with the upcoming April 2022 database refresh. This move had previously been put on hold secondary to the COVID pandemic. 

In March 2019, CMS released QSO-19-08-NH, outlining plans to update the QM rating thresholds every six months. The plan included an increase to the existing threshold by 50% of the average rate of improvement in QM rating scores. For instance, if an average national rate of improvement of 2% is noted in a given QM rating, the threshold for that rating will be increased by 1%. Similar to setting new thresholds, CMS intent is to reduce the need for larger adjustments in the future, while incentivizing continuous quality improvement activity at the facility level. 

CMS also has indicated it will update the Five-Star Quality Rating System Technical Users Guide with the updated QM rating thresholds and formulas when the April 2022 refresh is complete.