January 26, 2023 | Net Health

3 min read

Asking the Right Questions for Your SNF: The “What If” 5-Star Solution

For skilled nursing facilities (SNFs), the Five-Star Quality Rating System, created by the Centers for Medicare and Medicaid Services (CMS), represents an opportunity and a challenge. 

The opportunity? If SNFs can increase their star rating they can raise their brand profile and attract more patients. The challenge? With these providers still reeling from post-COVID staffing and resource issues, it’s difficult to pinpoint where process improvements will yield rating results.

However, the innovative “What If” tool, offered by Net Health® PointRight, can help your SNF ask the right questions and get you on the road to better ratings. Let’s take a closer look at what this tool entails and how it can help improve your SNF quality rating. 

The Five-Star Quality Rating System

The Centers for Medicare and Medicaid Services introduced its Five-Star Quality Rating System in 2008 to let patients and their families more easily compare and contrast healthcare skilled nursing facilities.

The Five-Star Quality Rating System consists of separate ratings for the following:

  • Overall score
  • Health inspections 
  • Staffing
  • Quality measures

Facilities with five-star ratings are considered to be much above average, while those with one star are considered significantly below.2 Once data is collected and compiled by the CMS, the top 10% of SNFs are assigned a 5-star rating, the bottom 20% get a 1-star rating and the remaining 70% are divided across 2, 3, and 4-star ratings, with 23.33% of SNFs in each category.3 The thresholds for star distribution are fixed, which means that staying in the 4- and 5-star range isn’t just about scoring well, it’s about scoring well compared to the competition. 

As a result, it’s worth putting in the work for higher ratings. SNFs with higher than average overall ratings along with strong subcategory scores are more likely to bring in new patients and keep the ones they have.  

What If? How the Right Questions can Boost Quality

Of course, it’s one thing to understand the value of better ratings, and another to understand the relationships between the three domains and their influence on the overall rating.

The Net Health® PointRight “What If” 5-Star Solution uses healthcare analytics to help SNFs ask the right questions and understand how specific actions will impact overall ratings, in turn helping administrators pinpoint where they should focus their efforts.

Consider a SNF with a 3-star rating looking to make the move to four stars. Using the “What If” tool, staff can leverage predictive analytics to see the impact of specific changes on their rating. Teams input theoretical values to see what would happen to both their current domain scores and overall rating if they got a perfect score on their next survey, improved their short- or long-stay quality measures, added more weekend staff, or increased the total number of registered nurses (RNs) available. 

By comparing the results, SNFs can then determine their best course of action. For example, if increasing the number of RNs on staff boosts the overall star rating by 50 points it may be worth looking for new ways to find and recruit staff. If improving specific quality measures  — such as the use of short-stay antipsychotic medications to improve the patient experience —  provides a similar increase, SNFs can focus on putting the right resources in the right place for staff. 

From Answers to Action

Asking the right questions can help SNFs focus their resources, improve their clinical decision-making, and take targeted action to improve their 5-star ratings. Ready to see where “What If” can take your skilled nursing facility? Schedule a demo with us today. 

References:

1 Healthcare Exec Intelligence, “Skilled Nursing Facilities Are Facing a Staffing Crisis,” January 26, 2022.
2 Centers for Medicare & Medicaid Services, “Five-Star Quality Rating System,” December 6, 2022.
3 Centers for Medicare & Medicaid Services ,“Brief Explanation of the Five-Star Rating Methodology,” 2022.

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