McKnight's October 11, 2024
In July, the Centers for Medicare & Medicaid Services introduced significant changes to the Staffing Five-Star domain, impacting how staffing adjustments are made in relation to resident acuity.
Previously, these adjustments relied on the STRIVE study, which primarily used historical data to estimate the acuity of residents. However, CMS now uses the Patient-Driven Payment Model nursing case-mix index (CMI) to perform these adjustments.
This transition has caused confusion among providers and external stakeholders alike. Many are uncertain about how CMS calculates these adjustments, what role Minimum Data Set coding accuracy plays, and how payer mix influences the adjustments. Moreover, questions are being raised about whether external factors beyond resident acuity affect the new staffing adjustment formula.
Background on staffing...
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