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A Guide to Improving DPH (Department of Public Health) Facility Ratings

We’ve put together this strategic guide to help you to further understand what DPH facility ratings are, how to improve census growth, and ultimately, some easy steps you can take today to significantly improve the overall facility ratings of your nursing home or long-term care facility.

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Improving Department of Public Health (DPH) Facility Ratings

Improving Department of Public Health (DPH) facility ratings in nursing homes can be challenging. However, we’ve pulled together a quick guide to help your facility get there quicker!

36% of US nursing homes have a 1- or 2-star rating. These ratings are accessible to the public, meaning nearly a third of nursing homes could get passed up because of poor scores. Are you among them?

If so, you may be wondering about tips for improving Department of Public Health (DPH) facility ratings for your nursing home. 

We’ve put together this strategic guide to help you to further understand what DPH facility ratings are, how to improve census growth, and ultimately, some easy steps you can take today to significantly improve the overall facility ratings of your nursing home or long-term care facility.

What Goes Into Nursing Home Ratings?

To learn how to improve your nursing home’s DPH rating, you first need to understand which factors you’re graded on.  While you likely are already aware of these, it’s always good to take a moment for a quick refresher. If you already feel well informed on this, you can skip down to “Strategies for Improving Department of Public Health (DPH) Facility Ratings” below.

DPH ratings are based on the Centers for Medicare and Medicaid Services (CMS) Five-Star Quality Rating System. You can score between 1 and 5 stars overall — 1 being the lowest and 5 being the highest.

This is the score prospective residents see when they look up your facility. CMS calculates your overall rating by averaging together your scores in three categories:

  1. Annual health inspections
  2. Staffing
  3. Quality measures

If you receive a 1-star rating in any of these categories, the highest overall rating you can get is 2 stars. And if you get a 1 star for quality measures, the highest overall rating you can get is 1 star. 

We’ll talk more about how each of these individual categories gets scored below.

Health Inspection Score

CMS bases health inspection star ratings on a facility’s state health inspection report. Interestingly, health inspection scores get curved before applying the star rating.

That means scoring within the top 10% of homes will earn you 5 stars. It won’t matter if you didn’t receive a perfect health inspection score. Conversely, you get 1 star if you fall within the bottom 20% of nursing home scores. 

What determines where you fall within these percentages? The CMS will mark you down for any deficiencies. And a deficiency is defined as an instance of immediate risk to one or more residents’ health or safety. 

The health inspection score makes up the core of your overall star rating. 

Staff Rating

CMS determines a facility’s staffing score using the staff to resident ratio. This ratio equals the total nurse hours worked per resident day. There should be separate ratios for each type of nurse your facility employs. 

Any facility with a ratio of 3 staff hours or fewer per resident day qualifies for a 1-star rating. You must also have more than 16 minutes of registered nursing (RN) hours per day to achieve over a 1-star staff rating.

To get 5 stars in this category, both nursing and RN hours must qualify. In other words, RN and nurse ratios have to qualify for 5 stars to get a 5-star rating overall. 

Quality Measures Score

Quality measures are extremely important. Getting a 1-star rating for quality measures means the highest your facility can score overall is 1 star. 

CMS uses the Minimum Data Set to calculate your facility’s quality measures rating.

Strategies for Improving Department of Public Health (DPH) Facility Ratings

The secret to improving your overall nursing home rating is simple. All you have to do is get high scores in health inspections, staff ratios, and quality measures

It sounds fairly obvious, but if it was easy, everyone would be doing it.  Here’s how to do just that. 

How to Improve Your Health Inspection Score

If you get marked down on health inspections for threats to residents’ health and safety, you need to remove those threats. But completely eliminating all health and safety risks at your facility is much easier said than done.

Another strategy is to reduce the impact of these threats. For example, CMS won’t penalize you for a potential safety issue that never actually caused harm. Also, the fewer patients harmed by an adverse event, the fewer points it’ll cost you.

To reduce health inspection penalties, you also should ensure you’re familiar with all state and local nursing home regulations. Enforce these rules with your staff and implement training programs if your employees fail to comply. 

Finally, when you get marked down for something during an inspection, fix it before the inspector’s next visit. CMS will go harder on you and your score the longer it takes you to correct any health or safety threats. 

How to Improve Your Staff Rating

Scored low on your staffing measures? This is the easiest thing to fix to improve your star rating. All you need to do is hire more staff or increase the number of hours your current nurses work. This is easier said than done and is not cheap, but far less expensive than the impact a low facility rating can have on your bottom line.

Keep in mind that the more specialized nursing staff you have, the more likely you are to score higher. As an example, hiring more RNs could help you improve your staff star rating.  

Retaining employees is also key to upping staff ratings. After all, the lower your staff turnover, the more employees you’ll have to contribute to hours per resident day. 

How to Improve Your Quality Measure Score

The quality measure rating is tricky because it relies on so many components. CMS originally evaluated nursing home quality based on 11 measures. They’ve since upped that to 16 measures, including:

  • Percent of residents with new or re-emerging pressure sores
  • Percent of residents who experience moderate to severe pain
  • Percent of residents majorly injured after a fall 

The best strategy for improving your quality measures score is to know Minimum Data Set requirements in and out. Collect all data points needed to calculate your score. Challenge your staff to review gaps and identify areas of improvement to improve your data.  You cannot manage what you do not measure!

Software systems can help you analyze your quality measure data. That way, you can create actionable insights for your administrative and care staff to follow. Ultimately, this can result in better scores. 

How the Engage with™ Older Adults Skills Training Program Can Help Increase Your Facility Rating

Improving Department of Public Health (DPH) facility ratings is no small or easy task. Focusing on upping your quality measures and health inspection scores can certainly help. 

But one area that we see have a significant impact on boosting facility ratings is ensuring that your staff receives the necessary skills needed to interact with and care for older adults. Not only does skills training reduce staff turnover because they are better equipped and prepared to care for your residents, it significantly reduces the exuberant cost associated with recruiting new nurses for your facility.  In fact, in a recent study, the Engage with™ Older Adults Skills Training Program reduced staff turnover by as much as 40% for long-term care facilities!

Are you searching for a solution to up your Five-Star Quality Rating? Get in touch with us to find out how our virtual skills training program can improve your staff rating and your overall facility rating!

 

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