CMS: No changes imminent to staffing formula for Five-Star rating

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Federal health officials with the Centers for Medicare & Medicaid Services say they are considering tweaking their new Five-Star nursing home ranking system, but altering the way staffing is graded will not happen in the near future.

Logistical reasons preclude regulators from making changes at this point, said Sheila Lambowitz, division director of the Chronic Care policy group at CMS, during a SNF Open Door Forum on Thursday.

"If it's something (an error) you actually submitted, we would have to wait until we're onsite to address it," Lambowitz told a forum caller who called the current system "unfair" because of its relatively infrequent updates. "We can't have 15,000 nursing homes deciding to change their forms. That would be very labor intensive."

The caller, however, was not persuaded: "If a facility makes changes in staffing, it will be 12 to 15 months before an update," the caller said. "It doesn't make sense to have three of the four indicators dynamic and the other static. As a provider, it's not fair." The caller also criticized wording that said "all staffing" is included in the calculations because it isn't.

Before cutting off the line of inquiry, Lambowitz said the situation was under review and that there might be quarterly updates in the future, but nothing would change in the short term. CMS activated the nation's first-ever star-ranking system in December.