Centers for Medicare & Medicaid Services officials are reminding providers about changes dropping this week that could have a big impact on nursing homes’ star ratings.

The agency particularly placed an emphasis on the importance of staffing during an Open Door Forum call with providers Tuesday. Effective with the update to Nursing Home Compare at the end of this month, CMS is dropping the threshold that SNFs can go without a registered nurse onsite from seven days to just four.

Those not in compliance will be automatically downgraded from five stars to one, said CMS’s Lorelei Kahn.

“Nurse staffing has the greatest impact on the quality of care nursing homes deliver. CMS has found that as staffing levels increase, quality increases and is, therefore, assigning an automatic one-star rating when a nursing facility reports no registered nurse is onsite,” she said.

Kahn reminded providers that staffing data from the quarter ending March 31 must be submitted no later than May 15. Only data submitted by that date is considered timely, and used on the NHC website and in Five-Star rating calculations. CMS also “strongly recommends” that providers review the following in CASPER to ensure accuracy and completeness: 1700D (employee report), 1702D (individual daily staffing report) and 1702F (staffing summary report).

An industry analysis by the American Health Care Association found that about half of the nation’s 15,000 nursing homes will not see their star ratings change come Wednesday, while about one-sixth can expect an increase. An estimated one-third, however — roughly 5,000 facilities — will suffer a ratings drop overnight.

CMS officials also highlighted two new measures that are hitting Nursing Home Compare this week. Those will be tied to long-stay hospitalizations and emergency room transfers and are expected to go live by the end of the day today or first thing Thursday, said Evan Schulman, deputy director for the Division of Nursing Homes.