Proven strategies to improve star ratings for skilled nursing facilities
Skilled nursing facilities (SNFs) cannot afford to overlook the considerable (and growing) impact that the Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Ratings System has on their operations and resident care. This system serves as a guide for families looking for a nursing home and for acute care hospitals when referring a patient. Insurers use star ratings to determine which organizations to include in their service networks, and Medicare uses them as a basis for reimbursements. Most importantly, star ratings for skilled nursing facilities help administrators and staff identify ways to improve the quality of care they provide to their residents.
While Medicare’s quality rating can make or break a post-acute care organization’s reputation and bottom line, many struggle to meet the requirements to earn five stars. That’s why analysts from Inovalon teamed up with the American Association of Post-Acute Care Nursing (AAPACN) to find out if a correlation exists between AAPACN certification and quality performance. The findings revealed two effective strategies that SNFs can use to drive better CMS quality ratings.1
1. Provide nursing staff with access to AAPACN certification programs
AAPACN certification prepares nurses for leadership roles by equipping them with crucial knowledge to lead in today’s ever-changing healthcare environment. The study looked at the quantity and severity of survey deficiencies, CMS star rating, and quality measures of SNFs without AAPACN certifications compared to facilities employing at least one staff member holding the certification of Resident Assessment Coordinator-Certified (RAC-CT™), Director of Nurse Services-Certified (DNS-CT), or QAPI Certified Professional (QCP).
The findings showed that 48% of AAPACN-certified facilities have a 4+ overall star rating vs. only 35% of uncertified facilities. Furthermore, those SNFs that employed at least one certified staff member had:
- 15% higher overall star rating
- 8% higher health inspection rating
- 6% higher quality measure rating
- 23% higher staffing rating
From managing the resident assessment process and tackling quality improvement in care delivery to keeping up with regulatory changes and managing a nursing department, certified nurses are valuable assets to nursing home operators. Enabling nurse leaders to earn AAPACN certification is an effective strategy for boosting quality performance and star ratings.
2. Pair Inovalon clinical quality solutions with AAPACN certification
Having AAPACN certifications while using Inovalon’s clinical quality applications to their fullest potential is an effective approach to further improving overall star ratings. The study revealed a synergistic effect for SNFs that had certified staff and used Inovalon solutions.
According to the results, these facilities demonstrated:
- Substantially increased star rating across each of the key performance indicators
- An overall rating that was 15% higher than with certification alone
- An overall rating that was 31% higher than uncertified sites
When AAPACN-certified staff can effectively put their knowledge to work with cloud-based software that supports proper coding and care planning, facilitates quality of care initiatives, and drives expected staffing, the SNF can ultimately reduce federal tags on surveys and improve star ratings.
Improve star ratings with Inovalon and AAPACN
From 2021 to 2022, star ratings decreased by 8% across the SNF market; however, AAPACN-certified facilities continued to show higher star ratings across all categories than the uncertified cohort. How do you want your facility’s stars to trend in 2023 and beyond?
Equipping your nursing staff and leadership with the knowledge, confidence, and tools to manage the delivery of quality care and ensure accurate assessments and reimbursement is a sure-fire way to reach your organization’s star-rating goals. Take a deeper dive into the results of this study in our on-demand webinar, “Skilled Nursing Facilities with AAPACN Certification.”
1 “Skilled Nursing Facilities with AAPACN Certification,” Laurie Laxton, Maureen McCarthy, and Harry Vanderburg, Inovalon Webinar, July 2022 https://www.aapacn.org/wp-content/uploads/2022/12/Inovalon_How-AAPACN-Certification-Impacts-SNF-Outcomes.pdf.
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