How does the Nursing Home Compare, Five Star Quality Rating impact my facility's ability to ensure a direct admission stream from my local hospitals/physician practices?

A: Your facility's Five Star Rating can affect your daily census in two glaring ways. First, there are many ACO's that are routinely breaking admission contracts with facilities that demonstrate a Five Star Rating less than 3 decimating the facility's ability to keep their beds filled in many cases.

And second, CMS requires that the "Awardee's" - hospitals and/or physician practices that have applied for, and been awarded, participation in Model 2 of the BCPI program for diagnoses/procedures of their choice - can only admit their patients to SNF settings that have in effect a quality rating of 3 or more stars for at least 7 out of the preceding 12 months. (See MLN Matters Number MM8792 and Change Request (CR) #: CR 8792).

SNF's, who have not been approached by local hospitals and physician practices whose client base has historically been a dependable admission stream, could be swimming upstream at this point. Proactive management of your facility's admission relationships and proactive daily management of the internal quality markers that drive your facility's Five Star Quality Measure score should be your first weapons of choice in the defense of your facilities patient census and bottom line.

(See MLN Matters Number MM8792 and Change Request (CR) #: CR 8792 for more details)