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How the CMS Five-Star Rating System is Failing to Measure the Quality of Resident Care

March 25, 2019

WRIGHTSVILLE, PA–A recent announcement from the Centers for Medicare and Medicaid Services (CMS) shared changes to their Five-Star Quality Rating System, starting in April 2019. The system’s domains will not change, but the thresholds within each domain of Health Inspections, Staffing and Quality Measures will be impacted.

Yet, there is one aspect that CMS is failing to consider in their Rating System—Resident Engagement. How successfully is a campus supporting its residents in their journey of aging well? A campus could be providing above-average levels of care according to the CMS standards, but not considering the quality of the resident’s life on campus and their connection with other residents and employees.

“Organizations are legally bound to the CMS guidelines,” notes Nikki Rineer, President of Holleran, the leading firm for engagement and satisfaction research for residents and other stakeholders of senior living and retirement communities. She continues “… but, CMS does not require providers to take stock of their levels of engagement and satisfaction, at least in ways defined by theory grounded research firms like Holleran. Without measuring these important factors, communities could be missing an opportunity to market themselves better and even offset a less-than-favorable CMS score.”

Holleran’s research shows that where resident engagement scores are higher, residents are also more likely to recommend their campus to friends or relatives; specifically, 7.9% are more likely to recommend the campus over those whose engagement level is average or lower. Instinctively, every senior living leader knows that a community could meet and exceed the CMS’s criteria, yet still not be providing the kind of environment that encourages positive aging

CMS itself notes that their system should not be the only measurement an individual or family uses to choose a senior living community. As quoted on their website, “No rating system can address all of the important considerations that go into a decision about which nursing home may be best for a particular person.”

Still, their failure to include a component that addresses resident engagement and satisfaction seems like a glaring exception.

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