CMS’ rollout decisions don’t always make sense

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You have to wonder who is making some of the calls at the Centers for Medicare & Medicaid Services—because they don’t seem altogether consistent.

While some decisions are spot on, others leave you shaking your head. Take the latest decision (a wise one) by CMS to delay the rollout of MDS 3.0 for one year until Oct. 1, 2010. CMS said that it is postponing the start based on concerns of state and partner groups that there is not enough time to update all the systems that interact with MDS 3.0.

“(We're) making sure all of the needs of our stakeholders and programs and systems that rely on the MDS can be updated to work efficiently with the MDS 3.0,” according to Sheila Lambowitz, division director of the Chronic Care policy group at CMS, at an Open Door Forum Thursday. “Rather than rush into it, we are stepping back and taking a little more time to work on it."

Sensible, right? So that makes me wonder what the folks at CMS were thinking back in December. That is when they decided to unfurl the controversial Five-Star Quality Rating System. The system, which ranks nursing homes based on state inspections, staffing levels and quality measures, has few fans in the nursing home world. Many criticize it because they believe it is based on a flawed certification system and outdated data.

Even those who think it has merit tend to say it was unveiled too quickly and does not take into account other information, such as consumer surveys.

The Five-Star system could have been delayed just as easily as MDS 3.0—and established more credibility. So why the drastic difference in judgment? Some think it has something to do with rushing a program into place before a new administration takes control. Perhaps.

But that’s still no excuse for poor decision-making.
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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.

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