How to Land a Perfect Five-Star Rating

August 10, 2017 Tom Jegou

Consumers rely on the Medicare.gov Nursing Home Compare database to review and select facilities using the Five-Star Quality Rating System. With metrics on health inspections, staffing and quality, as well as an overall rating, the site provides consumers with information that can influence whether they ultimately choose your facility, which makes keeping your facility in top shape more important than ever.

Potential residents aren’t the only ones looking at your Five-Star Rating. As the long-term care industry faces a nursing shortage, potential applicants are now turning to the Nursing Home Compare database to get a better look at prospective employers. A poor staffing rating may indicate a lack of employee engagement, while a high health inspection rating will let applicants know that your facility is both safe and sanitary.

Depending on your rating, the Nursing Home Compare database can either act as a strong tool to appeal to prospective residents and applicants — or as a red flag. Of course, while it is in everyone’s best interest to aim for the former, achieving and subsequently maintaining a perfect Five-Star Rating can be difficult for any skilled nursing facility.

5 Star Rating

If your facility is struggling with its Five-Star Rating, here are a few tips on how to give it a much-needed boost to attract new residents and applicants, and earn that perfect five out of five:

Maintain a clean, safe, and healthy environment.

This first aspect of the Five-Star Rating system may seem obvious, but it is important to keep in mind that Health and Safety Inspections are the most important aspect of your rating, having the largest impact on your overall score. This category is broad, with measures ranging from preventing mistreatment, the number of resident falls, keeping the facility sanitary, and deficiencies in fire safety. This rating is influenced by inspections conducted over the last three years, so scoring poorly now will harm your facility for years to come. Finally, it is important to remember that this score is based on standard surveys and complaint surveys, so your facility must be constantly maintained to keep your score high.

Schedule up-front for compliant staffing.

Staffing is the second highest influencer in your Five-Star Rating. Being understaffed or overstaffed can create a myriad of issues for your facility. Understaffing can lead to a lower, possibly noncompliant, PPD, and overstaffing can cause loss of revenue due to overtime. Nevertheless, when it comes to this star rating, the most important factor is achieving a perfectly balanced staff-to-patient ratio. When you fall into the sweet spot of staffing, you give your residents the best care possible and earn a great star rating — with the bonus of lowering your overtime costs.

Report accurately to prevent score inflation.

Inaccuracies in Payroll-Based Journal reporting are sometimes overlooked, which at first glance may seem to be a boon to some facilities; however, there is an unforeseen, damaging aspect to this oversight. Inaccurate reporting can lead to the artificial inflation of your Five-Star Rating. Your facility may appear to be in perfect condition, until your mistakes are revealed in an audit, causing your Five-Star Rating to plummet. If you put processes in place to keep your reporting methods in good shape now, you’ll always have an accurate measure of your facility’s performance.

Set up practices to support auditable and verifiable information.

While you may view switching to a new system for your PBJ reporting as cumbersome, filling out reports manually or using other, similarly inefficient and inaccurate reporting can increase the likelihood of error. Not only can this make audits a nightmare, but such errors can lead to a black mark next to your facility’s name on the Medicare.gov Nursing Home Compare tool, right by your Five-Star Rating. While such audits may seem to be far off, CMS is already beginning its pilot auditing program with select facilities, and more official, widespread audits are soon to follow.

Maintain quality through optimized scheduling.

The third metric in your facility’s Five-Star Rating is quality measures. Including categories such as the amount of successful discharges, self-reported pain, and the mental health of residents, this measure has the least impact on your overall Five-Star Rating, but is still crucial to the decision-making process of consumers and investors alike. By optimizing your staffing levels, you will be able to provide the best possible care to your residents by maintaining a balanced staff-to-patient ratio. This can in turn raise the morale of your staff through fair scheduling, boosting your staffing rating in the process. After all, happy staff means happy residents! To take things up another step, by using the right applicant hiring systems to acquire top-notch employees, you can provide the greatest quality care to your patients and easily improve your overall rating.

Now that you know exactly what goes into your Five-Star Rating, it’s time to act. By putting in place the right policies and tools to help, your facility will be on the road to a perfect Five-Star Rating.

Looking for the best methods to improve your Five-Star Rating? SmartLinx Solutions’ schedule optimization and reporting tools can put you on the right track.

 

About the Author

Tom Jegou

As Compliance Expert at SmartLinx, Tom Jegou oversees SmartLinx innovations in our payroll and compliance systems. Tom is focused on transforming client needs into leading-edge products. Tom leads cross-functional teams from a product's conception through to its launch. Tom led the design of the 1095-C and Payroll-Based Journal reporting features in the WorkLinxTM suite. Since 1996, Tom has worked with every aspect of Human Capital Management Systems. He has defined, supported, implemented and managed Payroll, Time and Labor and HR systems. Tom is a Certified Payroll Professional through American Payroll Association.

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