Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
Effective with the January 2023 refresh, CMS will be conducting audits of schizophrenia coding in the Minimum Data Set (MDS) data. Facilities that have coding inaccuracies identified through the schizophrenia MDS audit will have their Quality Measure (QM) ratings adjusted as follows:
• The overall QM and long-stay QM ratings will be downgraded to one star for six months (this drops the facility’s overall star rating by one star).
• The short-stay QM rating will be suppressed for six months.
• The long-stay antipsychotic QM will be suppressed for 12 months.
To be more transparent, CMS will now display citations under informal dispute on the Nursing Home Care Compare website. While the citations will be publicly displayed, they will not be included in the calculation of a facility’s star rating until the dispute is complete (and the survey is considered final).
Changes are identified in red, italicized text.
For more information on these updates see: QSO-23-05-NH.
The updated Five-Star Technical User’s Guide – January 2023 is found here.
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