Since 2017, Wesbury’s Grace Rehabilitation and Health Center has held a 5-star rating in Quality Measures from the Centers for Medicare and Medicaid Services (CMS), and in March 2019, Grace achieved an overall 5-star rating! This is no small accomplishment! It requires consistent top quality care and service on Wesbury’s part with much federal oversite and review.
CMS is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children’s Health Insurance Program (CHIP), and health insurance portability standards.
The “Long Term Care Stay” and “Short Rehabilitation Stay” quality measures, are calculated separately and then a total score is given. There are seven short stay quality items and nine long stay quality items measured. These areas include controlling pain, pressure ulcer development rates, medication management and infection prevention, as well as if the resident’s physical functions improve or decline. The data that is collected from CMS to determine these measures has changed and evolved over the years to include Minimum Data Set data (MDS). The MDS was originally developed to provide consistent quality of care assessments to all nursing home residents and became a reimbursement tool that now serves dual purposes.
The acuity of the residents we serve is also compared to Grace’s staffing levels to ensure we have enough staff to care for those we serve. CMS looks at claims based measures as well, for example, how many times we send Grace residents to the Emergency Room for treatment. Lastly, they look at our annual state survey results and assign a rating according to how well we did. CMS has worked over the last several years to standardize the survey tools to ensure consistent surveys from all sites visited. A positive review of all of these areas combined has given Wesbury’s Grace Rehabilitation and Health Center its 5-star overall rating.
What does this mean for our consumers?
“Thankfully, Wesbury keeps quality of care at the heart of what we do every day,” says Grace Administrator, Sheila Bundy. “There are variables to this star rating, sometimes outside of our control, and we work hard as an organization to achieve this rating. While our goal is to sustain this, there are frequent changes made to this system. For example, they may add a new measure, and rate us on data collection from a year ago. While we may have corrected the issue, we will still be rated on that old data. So ask questions, be a wise consumer, and know that Wesbury will continue to strive to be the best that we can be to meet the needs of those we serve.”