![]() ![]() What to keep in mind when using quality measures The quality measures aren't benchmarks, thresholds, guidelines, or standards of care, and aren't appropriate for use in a lawsuit. We will provide further analysis of these announced changes in a future edition of Advantage. Five-Star Quality Rating System (QRS) has been developed by the Centers for Medicare & Medicaid Services (CMS) to assist consumers compare nursing homes. CMS combines the values of 17 quality measures (QMs) (a subset of the 30 QMs reported on Nursing Home Compare) to create three quality measures ratings: a short-stay quality measure rating, a long-stay quality measure rating, and an overall quality measure rating. The nursing homes topic has 2 different types of quality measures: short- and long-stay resident quality measures. Quality measures that are based on the resident assessments that make up the nursing home Minimum Data Set (MDS). ![]() This announcement ties back to previously-announced changes relating to the Quality Measure domain of the Five-Star system that CMS is implementing in order to incentivize quality improvement. “In addition to incentivizing continuous quality improvement, this action reduces the need to have larger adjustments to the thresholds in the future,” the memo notes. For example, if there is an average rate of improvement of 2%, the QM threshold would be raised 1%. The memo also advises providers that, beginning in April 2020, CMS will begin increasing quality measure (QM) thresholds by 50% of the average rate of improvement in QM score, and will do so every six months. Medicare Care Compare shows how often each home health agency used best practices when caring for its patients and whether patients improved in certain important areas of care. Percentage of long-stay residents who report moderate to severe pain.Percentage of short-stay residents who report moderate to severe pain.To support this, CMS will be removing two measures from Nursing Home Compare and the Five Star Quality Rating System this month: In a memo from its Quality, Safety Oversight Group, CMS noted the severity of the opioid crisis and explained that it wishes to avoid any potential scenario where performance on pain quality measures may inappropriately contribute to a decision to seek administration of an opioid. The Centers for Medicare & Medicaid Services (CMS) plans to remove two quality measures relating to pain from the Nursing Home Compare website and the Five Star Quality Rating System. CMS Removes Two Quality Measures Relating to Pain ![]()
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