Five-Star Preview: Not All Good News

The transition from Nursing Home Compare to Care Compare and unexpected Five Star Quality Rating updates brought disappointment to some Skilled Nursing Facilities.

Due to the public health emergency (PHE), the rating system's three domains had previously been held constant.  Centers for Medicare and Medicaid Services (CMS) announced that the Five Star Quality Rating system would resume all updates with the January 2021 refresh.  At the same time, CMS also released the new Care Compare site, which officially replaced Nursing Home Compare.


Key Impacts

Five Star Quality Rating updates are available at the new Care Compare site as of January 2021. What can facilities expect to see?

  • Some facilities will see their ratings improve, and others will see their ratings decrease on January 27th.
  • Some facilities will no longer be a Special Focus Facility (SFF), and the Consumer Alert Icon ("abuse icon") will be updated as well.
  • The Health Inspection domain will now reflect findings from the Focused Infection Control inspections.
  • Quality Measures domain will be updated based on the data collection period ending June 30th, 2020.

As each of the three domains updates, providers may see changes to their domain ratings and, overall, Five Star Quality Rating system rating.


Facilities should note that even though CMS waived the timeframes for submitting data, nursing homes have still been submitting MDS data. Since nursing homes have continued to submit MDS data, the data can be used to update claim-based and MDS-based quality measures without any issues. Facilities continuing to submit this data despite the PHE should come as no surprise, as this is the main source of revenue for most SNFs. The PHE and the waivers are extended for 90 days more as of January 7th.

What should facilities do now?  Now is the time to audit and make improvements in the facilities Quality Measures. Remember Quality Measures Domain will be updated again in April of 2021. This April update will give facilities time to audit MDS's to ensure accurate Quality Measures. Also, the facility can use this time to improve or implement new QAPI systems. Most facilities are focused on Covid-19 and vaccinating, but they cannot lose sight that an annual survey or infection control survey could happen at any time. The nursing home team should be kept survey ready to the best of the facility's ability during the pandemic


Download the updated Care Compare Five-star Quality Rating Technical User's Guide:

For assistance preparing for the Focused Infection Control survey or an MDS- Based QM audit:

For more information on Ref: QSO 21-06-NH: