Five new skilled nursing quality measures were officially added to the Five-Star Quality Ratings system on Wednesday, the Centers for Medicare & Medicaid Services announced.

The ratings update comes two weeks later than the estimated July 27 phase-in date, mentioned by CMS officials during a recent Open Door Forum call. The measures will be fully phased into the Five-Star system by January 2017.

The addition of the new measures will “likely change” nursing homes’ quality measure star ratings, as well as their overall rating, CMS said. The five new measures, first unveiled in March, include:

  • Percentage of short-stay residents who have had an outpatient emergency room visit (Medicare claims- and MDS-based)

  • Percentage of short-stay residents who were successfully discharged to the community, and did not die or were readmitted to a hospital or skilled nursing facility within 30 days of discharge (Medicare claims- and MDS-based)

  • Percentage of short-stay residents who were re-hospitalized after SNF admission, including observation stays (Medicare claims- and MDS- based)

  • Percentage of short-stay residents who made made improvement in physical function and locomotion (MDS-based)

  • Percentage of long-stay residents whose ability to move independently worsened (MDS-based)

A sixth measure, percentage of long-stay residents who received an anti-anxiety or hypnotic medication, was not included in Wednesday’s Five-Star update because it is difficult to set benchmarks for acceptable use of those medications, CMS said in a fact sheet.

“When residents and their families are faced with important decisions about care, they need an easy, transparent way to figure out which facility is the best fit for them or their loved ones,” said Patrick Conway, M.D., MSc., CMS acting principal deputy administrator and chief medical officer. “With this update, star ratings will provide an even more accurate reflection of the services that nursing homes provide.”