The federal government is further tightening the screws on regulation of nursing home staffing and quality via a big shakeup this month.

The Centers for Medicare & Medicaid Services first announced the slew of modifications to both Nursing Home Compare and the field’s Five-Star Quality Rating System on March 5. 

Regulators, for example, have dropped from seven to four the number of days a skilled nursing facility may go without an RN on duty before it is lowered to a one-star rating.

The revisions include unfreezing health inspection ratings, which were set February 2018, in order to enable more “apples-to-apples” comparisons after implementing a new survey process. 

Officials said they also are changing the quality component of Nursing Home Compare to better identify differences in care among various nursing homes, and incentivize providers to up their game.

Finally, the barrage of changes also will mean the addition of new measures tied to long-stay hospitalizations and emergency room transfers, along with removing some “duplicative and less meaningful” metrics. The agency said it desires separate quality ratings for short-stay and long-stay residents, and revised rating thresholds to better pinpoint quality variations among SNFs.