CMS Quality Safety & Oversight Memorandum
MEMO NUMBER: 23-21-NH
PUBLISHED: September 20, 2023
CMS LISTING: Quality, Safety and Oversight Letter 23-21-NH
QSO memorandum 23-21-NH – issued September 20, 2023 – updated the Staffing Five Star ratings with a new Case Mix (or expected hours) calculation to take effect in July 2024. During the transition, staffing measures will be frozen for 3 months beginning in April 2024.
The end of RUGS-IV (MDS’ Section G) on October 1 necessitates a change to how CMS calculates “Expected Nursing Hours” – now called Case-Mix Hours – for the Staffing Five Star rating. The early 2000’s STRIVE study for each of the 66 RUGS-IV categories are being replaced by 25 PDPM categories.
Also, when these new measures take effect, the exception on Turnover points goes away for facilities that failed to submit or submitted invalid PBJ data for one or more of the quarters used to calculate the turnover measures. Currently the sum of the 6 staffing measure points are recalculated excluding the Turnover points. Instead, these facilities will be scored with the lowest possible points on the three turnover measures.
CMS plans also to revise the staffing rating thresholds to maintain the same overall distribution of points for affected staffing measures.
Finally, by late October 2023 the 672 form will be eliminated and a streamlined 671 form will be released.