Increased Transparency and the Inclusion of Consumer Satisfaction Data Recommended for Nursing Home Compare and the Five-Star Quality Rating System

The Government Accountability Office recently recommended that the Centers for Medicare and Medicaid Services make changes to the Nursing Home Compare website to be more user-friendly for potential residents and their families and loved ones. Most notable among the recommended changes is the inclusion of a consumer satisfaction component. Other Federal Compare websites, such as Hospital Compare, already include consumer satisfaction survey results on their websites, and the results are weighted heavily in the Five-Star Rating System. The long-term care industry can expect a shift toward the inclusion of more patient reported data on the public reporting websites and Star Rating Systems.

The GAO report can be found here.



Deficiencies, fines, and audits are on the rise – are you ready?

An interim final rule, effective September 6, 2016, issued by the Department of Health and Human Services increased the maximum per day civil money penalty amount from $10,000 to $20,628. CMP amounts have not been increased since 1987; the change is intended to reflect inflation and the continued deterrent effect of CMPs.

Adjustments will be made to the CMP amounts on an annual basis.



Maximizing your Nursing Home Compare Five-Star Rating is more important than ever. 

The Federal government is transitioning the US healthcare system from a fee-for-service system to a pay-for-value system. One important mechanism for doing this is alternative payment models (APMs) or Accountable Care Organizations (ACOs). The post-acute and long-term care systems are important aspects of this. Providers, including hospitals and physicians are paying more attention to the ratings of the facilities they discharge patients to, so that they are not penalized for readmissions and other quality of care metrics. In fact, nursing homes that drop below three stars on their Overall Rating on Nursing Home Compare cannot participate in certain payment models, such as the Next Generation ACO, which includes a waiver for the three overnight-rule.