On Febr. 20, 2015, the Centers for Medicare & Medicaid Services (CMS) revised quality standards for nursing homes, causing ratings to change on the Five Star Nursing Home Quality Rating System, a part of the CMS Nursing Home Compare website.

The Nursing Home Compare website features a rating system that gives nursing homes an overall composite rating of one to five stars based on several facility performance measures. Each performance measure is also given a rating of one to five stars. The performance measures include:

• Health inspections rating—This rating is based on on-site surveys conducted in the past three years, both standard surveys and any complaint surveys;

• Staffing rating—The staffing rating is based upon the number of hours of care provided on average to each resident each day by nursing staff; and

• Quality measures rating—This rating is calculated from information about 11 different physical and clinical measures for nursing home residents and is collected by the nursing home.

The revised quality rating will include:

• The use of antipsychotic medications for long-stay and short-stay residents;

• Enhanced calculations for staffing levels; and

• Higher quality standards.

As a result of the changes, CMS stated that there will be a decline in quality measure star ratings for many nursing homes. CMS estimated that about 80 percent of nursing homes had a 4 or 5 star quality measures rating before the recalculation, and with the changes, CMS expected about 49 percent of nursing homes to receive a 4 or 5 star quality rating.