The Special Focus Facility (SFF) program is designed to implement increased oversight on poorly performing homes and has dire consequences like decertification for those that fail to improve. It’s based on a home’s performance in their recent Health Inspections (Surveys) and has wide-ranging impacts from referrals to lending. The full version of StarPRO also includes an SFF Watchlist to keep an eye on the state of SFFs within a state. Click below to schedule a demo and see your yourself.

Starting in 2019, CMS has added a "red hand" designation on their Care Compare tool to any home with recent citations for abuse. Click here for details and history on this designation. Aside from the negative association to anyone looking at the home on CMS’s site, the flag also limits the Star Ratings and may take 1-2 years to fall off. Get in touch with us to learn more.

The Overall Star Rating represents a nursing home’s high-level performance, combining its scores in Survey, Staffing and Quality using the logic shown here.

The significance of the Overall Star Rating has grown rapidly since its introduction, and it’s now used by:

• Residents and their families, when trying to make informed decisions about a home
• Hospitals, when deciding which homes to include in a preferred referral network
• HUD, when approving section 232 loans, plus banks and lenders, who may have covenants certain star rating levels
• Commercial insurance providers, when analyzing the risk of insuring a home during underwriting
• REITs, when assessing acquisition deals and in analyzing their portfolio
• Health insurance providers, when contracting for services

It’s important that investors, lenders and other key stakeholders understand that each Skilled Nursing Facility (SNF) has more control over their ratings than they might think. We can show you how. Our SNF Search brings you to a facility view that tracks and trends all four Star Rating domains so you can understand the full story of the home. It also crunches the numbers to identify where a home risks losing a star, and where it has an opportunity to gain one. Schedule a demo today to learn more.

Also called Civil Monetary Penalties (CMPs), fines are issued to nursing homes for issues found during Survey. Fines can be an indication of a simple mistake, or of gross mismanagement. Either way, it’s smart to follow up with the home if they’ve had one.

As an alternative penalty, CMS may issue a Denial of Payment for New Admissions (DPNA or Admission Ban), which effectively suspends any Medicare reimbursement for newly admitted patients until the home comes into compliance. Like fines, the details of any DPNA should be discussed with management. has had payment denial(s) over the past three years.

Click here to read more about both Fines and Payment denials directly from CMS.

When assessing a nursing home, it’s essential to compare it to its neighbors for context. State and National averages are often available, but nursing homes don’t compete for referrals at the state level. Additionally, state surveyors are assigned to regions or counties and frequently differ in how they interpret and apply the regulations. So our Market Compare tool lets you compare a number of metrics in several ways. Let us show you the full-screen version in a short demo today.

When it comes to a facility’s Health Inspection (or Survey), the stakes are high. Negative findings can result in fines, payment denials, or the abuse designation. It’s the most heavily weighted aspect of the Overall Star Rating and poor performance can land a home in SFF status.

So understanding how the numbers work is complicated and represents a constantly moving target. The Survey rating is based on points earned from deficiencies on the last 3 Survey cycles, and with new Infection Control Surveys playing an outsized role, it’s more important than ever to understand how things come together. Most people believe that Survey only updates annually with the Standard Survey, but that's not the case. In a short demo, we can show you the full detail of each cycle and deficiency, plus tools to understand how frequent certain tags are and even a potential prediction for each home’s future rating.

Occupancy, also called Census, is a measure of how often a facility is able to fill its available beds. Occupancy is influenced by a number of factors, including hospital referrals, participation in ACO or MCO networks, market saturation, and Star Ratings. This is a key metric because low occupancy means lost revenue, and in an industry with very high fixed costs, an inability to fill beds will always result in poor financial performance.

The full version of StarPRO presents trended occupancy data in two ways – quarterly data, calculated based on MDS assessments submitted by the facility, are more official but are delayed by 3-6 months. Weekly data, submitted as part of COVID reporting requirements, is much more current but self-reported figures are often less reliable. Schedule a demo today to learn more about how our platform can help you make sense of census.

Healthcare Providers, including SNFs, have revenue and expenses just like any other business. Understanding how much it costs to deliver care compared with how much a facility is paid to deliver that care is critical to assessing the long-term financial viability of the home.

All Medicare-certified Nursing Homes are required to file annual Cost Reports outlining their finances. This provides a critical look at how their revenues and expenses have been trending. By digesting and decoding 5 years’ worth of Medicare Cost Reports, the full version of StarPRO can help you understand the impact of the other key measures on a home’s financial performance and where they may be headed next.

Care delivered within nursing homes varies in complexity and therefore payment mix is an indicator of patient acuity level and reimbursement patterns. Medicare A pays more for care than Medicaid and Managed Care Plans (Other) typically pays somewhere in between. Medicare A and Medicare Managed Care plans are the primary reimbursors for short stay sub-acute rehab care and Medicaid is the primary reimbursor for long-term care residents.

Average length of stay (ALOS) varies depending payer source. This metric is particularly important within the short-term rehab population because it is an indication of how many days' worth of subacute staff and resources are required before patients can be safely discharged back home.

Scrolled to the bottom, but not seeing what you were looking for? The the full version of StarPRO offers more. Let us show you how we track and trend data in other key areas like:

• Payroll-Based Journal (PBJ)/Staffing
• Quality Measures (QMs)
• Quality Reporting Program (QRP)
• Value-Based Purchasing (VBP)
• Ownership Analysis

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