Understanding How Nursing Homes are Rated

Nursing homes vary in the quality of care and services they provide to their residents. Reviewing health inspection results, staffing data and quality measures are three important ways to measure nursing home quality. These results are used by the federal and state government, customers, employees and bundled payment/ACO alliances. The Five Star rating report can be used to determine the current facility status.

To access your facility report, access this Medicare website …

The report has three components which make up the facility Five Star status:

1. Health Inspection – this data is pulled from on-site inspections by government agencies. The Functional Pathways Survey Readiness form can be used to prepare the therapy department for this process.
2. Staffing – this data is pulled from the Payroll Based Journal (PBJ) which is provided to each of our clients to report to the federal government.
3. Quality Measures – this is based on the clinical presentation of both short and long stay residents.

Quality Measures are based on the prevalence of identified patient characteristics within the facility population. Short stay residents are individuals who are in the facility for 100 days or less. Long stay residents are those who are in the facility more than 101 days or more.

Both short stay and long stay measures can be analyzed by using the CASPER report which is pulled by the facility’s MDS coordinator. This will identify at risk residents in need for focused nursing and therapy collaboration.

The use of Functional Pathway’s innovative products RightTrack™ and ScreenRight™ provide an excellent resource to identify and track the needs of all residents within the facility. Collaboration with facility leadership and therapy is essential to developing key action activities to promote the Five Star Ranking.