In July 2022, CMS updated Five-Star Ratings on Care Compare to include staff turnover measures. The following six Payroll-Based Journal (PBJ) staffing measures now determine Five-Star Staffing ratings):
Hours per Resident Day Measures (HPRD)
1. Total nursing (RN, LPN/LVN, CNA/aide) HPRD
2. RN nursing HPRD
3. Total nursing (RN, LPN/LVN, CNA/aide) HPRD on the weekend *New*
Turnover Measures
4. Total nursing turnover *New*
5. RN Turnover *New*
6. Administrator Turnover *New*
Impact on Staffing and Overall Five-Star Ratings
Staffing star ratings are determined by points earned for performance on each of the six measures. The scoring thresholds and method are outlined by CMS in the
Five-Star Technical Manual. The latest Your Top-Line (2022-Q3), released on August 2 on
LTC Trend Tracker goes through how a center’s scoring on each measure leads to its new staffing rating.
Nationwide, 32 percent (4,824) of skilled nursing center had a lower staffing rating with this latest release and changes. The overall rating for 25 percent (3,780) of centers also decreased. A portion of the decrease in overall ratings can be attributed to a methodological change made by CMS in how the overall rating is calculated. Under the new method, only centers with 5 stars in staffing can add a star to their overall rating. Previously, 4-star staffing facilities could add an overall star.
To see the impact of these changes by state, region, or county, check out this
AHCA/NCAL research report and follow the steps in this
help guide to run the SNF Staffing Measures report on LTC Trend Tracker.