AAPACN 2025 Quality Virtual Conference Recording Bundle: Expert Track-3.1 Change in the Stars: How the Health Inspection Calculation Changes Will Impact Facilities

Video Transcription

Video Summary

The presentation, delivered by Tammy Cassidy at the APACN 2025 Quality Virtual Conference, addresses significant recent changes to the Nursing Home Five-Star Quality Rating System, particularly focusing on the health inspection star rating system as outlined in CMS QSO 2520NH. Key changes include dropping the third cycle of standard recertification surveys from the health inspection rating starting July 2025, with the rating now based solely on the two most recent standard surveys plus recent complaint surveys and revisits. This adjustment aims to better reflect current facility quality, as some older surveys previously included were up to 45 months old and might not accurately represent present care quality.<br /><br />The update also mandates posting aggregated chain-level performance data on Care Compare to enhance consumer transparency, and adds Medicare and Medicaid claims data to refine long-stay antipsychotic use measures starting October 2025. COVID-19 vaccination measures were removed from the main Care Compare profile but remain publicly available.<br /><br />The health inspection rating calculation now re-weights points, attributing 75% to the most recent survey and complaints within 12 months, and 25% to older data. Citations are scored by scope and severity, with higher points lowering star ratings. The system compares facilities within each state, resulting in varying cut points for star levels.<br /><br />Two case studies illustrated how the elimination of the third cycle can either improve or drastically reduce star ratings depending on survey outcomes. Facilities with recent serious citations can see notable rating drops, impacting reimbursement, insurer network inclusion, and public perception.<br /><br />Tammy emphasized survey preparation strategies: understanding survey processes, confident but measured responses, proactive correction of issues before surveys, continual quality auditing, and effective communication during surveys. Ultimately, the goal of the Five-Star system remains to help consumers make informed choices and drive quality improvement in nursing homes.

Keywords

Nursing Home Five-Star Quality Rating System

CMS QSO 2520NH

health inspection star rating

standard recertification surveys

Care Compare

Medicare and Medicaid claims data

long-stay antipsychotic use measures

COVID-19 vaccination measures

survey preparation strategies

quality improvement in nursing homes