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Weekend Staffing and Staff Turnover Data Added to Five-Star Quality Ratings

The July 2022 Care Compare refresh includes the addition of nursing home staff turnover rates and weekend nurse staffing levels to the Five-Star Quality Ratings. The refresh also consists of a change to how staffing scores can impact a nursing home's Overall Five-Star Quality Rating.

The revised staffing star rating is based on six separate staffing measures, including the four new measures that were added to Care Compare earlier this year. Points are assigned based on a nursing home's performance on each measure. The total points are compared to the staffing rating point thresholds, which determine assigning a one-to-five-star rating. The six staffing measures include:

  • Total nurse (RN, LPN/LVN, aide) staffing levels (hours per resident per day) averaged across all days (weekdays and weekends); case-mix adjusted
  • RN staffing levels (hours per resident per day) averaged across all days (weekdays and weekends); case-mix adjusted
  • Total nurse staffing levels (RN, LPN/LVN, aide) averaged across all weekend days; case-mix adjusted
  • Total nurse turnover (percentage of nursing staff that left the nursing home over a 12-month period)
  • RN turnover (percentage of RN staff that left the nursing home over a 12-month period)
  • Administrator turnover (number of administrators who left the nursing home over a 12-month period)

In addition to the change in the calculation of the staffing star rating, the July 2022 refresh also includes a shift in the overall quality star rating calculation. Only nursing homes with a five-star staffing rating will get an increase in their overall quality star rating due to their performance on the staffing measures. Previously, nursing homes obtaining a four- or five-star staffing rating received an additional star in their overall quality star rating.

The detailed technical specifications for these changes can be found in a July 2022 revision to the Nursing Home Five Star Rating System Technical Users’ Guide. The details of the Five-Star Staffing Domain changes begin on page six, new scoring rules for the staffing measures start on page 14, and changes to the calculation of the overall nursing home star rating are included on page 22.

Because Minnesota care centers have historically had very high staffing ratings, we anticipate that the changes will reduce the average staffing and overall scores. In the April 2022 data, 84% of Minnesota care centers had four or five stars for staffing. If those numbers drop, it will add to the number of care centers losing a star overall on top of eliminating the star that will no longer be available to four-star staffing care centers.

As members were notified by email about a month ago, we have now moved the links to the Five Star Analysis reports to the data portal, where members can access them anytime. The links currently on the portal are to the reports from April that do not reflect the changes in the staffing and overall measures, but we will inform members as soon as new reports are posted.

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