April 2024 Staffing Five-Star Projections Added to LTC Trend Tracker

CMS; PBJ; Long Term Care; Five-Star Rating System

In April 2024, CMS will adjust the five-star staffing scoring methodology to penalize missing turnover data. Missing turnover rates will be scored at the lowest points possible (e.g. 5 out of 50 points) instead of rebasing the scoring to allow missing data to be neutral. 
Other Payroll-Based Journal (PBJ)-related Five-Star penalties remain, such as an automatic 1-star staffing rating for not submitting PBJ data or having four or more days with no registered nurse hours. 

Most centers are not projected to be impacted by this scoring change, but 10 percent could see a decrease. The three PBJ-based turnover measures (Total Nurse, RN, and Administrator) require six consecutive quarters of PBJ data to be calculated. Most centers (68%) have non-missing rates for all three, while about 10 percent are missing all three in the January 31, 2024, release of CMS Care Compare.  

The AHCA/NCAL Research Department modeled the April 2024 scoring changes on the latest available data and found that 90% of centers had no change in their staffing star ratings, nine percent of ratings decreased by one star and one percent by two stars.  

Access the latest Your Top-Line publication in LTC Trend Tracker (2024-Q1, released on February 13) to see the projected impact of these changes for your center.