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November 2014 Excerpt


Take Note of Two Recent CMS Announcements

1) New Goal for Antipsychotics Use

On September 19, 2014, CMS announced new goals for reducing antipsychotic prevalence in nursing homes. CMS is calling for a 25% decrease in antipsychotic use by the end of 2015, with a total 30% reduction by the end of 2016. As of the first quarter of 2014, Idaho ranks 30th in the nation and Washington ranks 18th for the prevalence of antipsychotics; the lower the ranking, the better.

Take action
How will your nursing home further reduce the use of antipsychotics? Qualis Health has compiled many free resources to help you continue this important work. 

2) Planned Changes to Five-Star Quality Rating System 

On October 6, 2014, CMS announced its plan to improve the Five-Star Quality Rating System. Effective January 2015, CMS will implement the following measures:

  • Nationwide Focused Survey Inspections: Following a pilot in fiscal year 2014, CMS and individual states will implement survey inspections focused on verifying performance on resident assessments and the data set that is used in quality measures for a sample of nursing homes nationwide.  The inspections are intended to enhance verification of both the staffing and quality measure information that is part of the Five-Star Quality Rating System.
  • Payroll-Based Staffing Reporting: CMS will implement a quarterly electronic reporting system that is auditable back to payrolls to verify staffing information. This new system will increase accuracy and timeliness of data, and allow for the calculation of quality measures for staff turnover, retention, types of staffing, and levels of different types of staffing. Implementation will be improved by funding provided in the recently enacted, bipartisan Improving Medicare Post-Acute Care Transformation Act (IMPACT) of 2014.
  • Additional Quality Measures: CMS will increase both the number and type of quality measures used in the Five-Star Quality Rating System. The first additional measure, starting January 2015, will be the extent to which antipsychotic medications are in use. Future additional measures will include claims-based data on rehospitalization and community discharge rates.
  • Timely and Complete Inspection Data: CMS will also strengthen requirements to ensure that states maintain a user-friendly website and complete inspections of nursing homes in a timely and accurate manner for inclusion in the rating system.
  • Improved Scoring Methodology: In 2015, CMS will revise the scoring methodology by which each facility’s quality measure rating is calculated.  The revised scoring methods will place more emphasis on data that is verified by independent sources, rather than data that is self-reported by nursing homes.