April 28, 2020

On April 24, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released a Quality, Safety & Oversight Memorandum (the “Memorandum”) titled “Nursing Home Five Star Quality Rating System updates, Nursing Home Staff Counts, and Frequently Asked Questions.” In the Memorandum, CMS announced it would temporarily freeze the health inspection domain of the Five-Star Quality Rating for nursing homes. Specifically, the results of health inspections conducted on or after March 4, 2020, will be posted publicly on Medicare’s Nursing Home Compare website, but will not be used to calculate a nursing home’s health inspection star rating. This decision follows CMS’s recent release of its updated survey plan in March 2020 in response to COVID-19 (See QSO Memorandum 20-20-All). Under this plan, state agencies are directed to limit survey activity generally to addressing circumstances of immediate jeopardy and matters related to infection control, among other urgent matters. According to CMS, these limits on survey activity have significantly impacted the number and nature of nursing home inspections. As CMS clarified, “nursing homes that would normally be inspected, will not, thereby over-weighting and impacting the ratings of those facilities that are inspected.’’ CMS’s freeze of the Five Star health inspection domain is intended to address this change in circumstances and avoid misleading consumers.


Importantly, while survey results will not impact nursing homes’ Five-Star ratings until further notice, CMS will post results for surveys conducted on or after March 4, 2020, on the Nursing Home Compare website starting April 29, 2020. Given CMS’s emphasis on infection prevention and control with respect to ongoing survey activity, providers are encouraged to continue reviewing COVID-19 guidance and updates from CMS, the Centers for Disease Control and Prevention, and state and local governmental agencies. To read the full version of the Memorandum, please click here.

If you have any questions or need further guidance regarding the updates to the Five-Star Quality rating domain please contact a member of Hancock Daniel’s Long-Term Care & Post-Acute Care team. 

Click here for a full PDF of this advisory.

The information contained in this advisory is for general educational purposes only. It is presented with the understanding that neither the author nor Hancock, Daniel & Johnson PC, is offering any legal or other professional services. Since the law in many areas is complex and can change rapidly, this information may not apply to a given factual situation and can become outdated. Individuals desiring legal advice should consult legal counsel for up-to-date and fact-specific advice. Under no circumstances will the author or Hancock, Daniel  & Johnson PC be liable for any direct, indirect, or consequential damages resulting from the use of this material.

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