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�� &#x/MCI; 0 ;&#x/MCI; 0 ; &#x/MCI; 1 ;&#x/MCI; 1 ; &#x/MCI; 2 ;&#x/MCI; 2 ; &#x/MCI; 3 ;&#x/MCI; 3 ; &#x/MCI; 4 ;&#x/MCI; 4 ;Nursing Home CompareivetarQuality Rating System:Technical Users’ GuideStateLevel Health Inspection Cut Point Tablectober�� &#x/Att;¬he; [/; ott;&#xom ];&#x/BBo;&#xx [2;—.8;( 2;.57; 32;.52;&#x 40.;Ѥ ;&#x]/Su; typ; /F;&#xoote;&#xr /T;&#xype ;&#x/Pag;&#xinat;&#xion ;&#x/Att;¬he; [/; ott;&#xom ];&#x/BBo;&#xx [2;—.8;( 2;.57; 32;.52;&#x 40.;Ѥ ;&#x]/Su; typ; /F;&#xoote;&#xr /T;&#xype ;&#x/Pag;&#xinat;&#xion ;1 &#x/MCI; 0 ;&#x/MCI; 0 ; &#x/MCI; 1 ;&#x/MCI; 1 ; &#x/MCI; 2 ;&#x/MCI; 2 ;IntroductionThe Centers for Medicare & Medicaid Services (CMS) has enhancedits Nursing Home Comparepublic reporting site to include a set of quality ratings for each nursing home that participates inMedicare or Medicaid. The ratings take the form of several “star” ratings for each nursing home. The primary goal in launching this rating system is to provide residents and their families with an easy way to understand assessment of nursing home quality, making meaningful distinctions between high andlow performing nursing homes.The rating system featuresan overall fivestarrating based on facility performance for three types of performance measures, each of which haits own associated fivestarating. These domains are: Health Inspections (measures based on outcomes from State health inspection surveys), Staffing (measures based on nursing home staffing levels reported at the time of State health inspection), and Quality Measures (measures basedon the CMS Minimum Data Set (MDS)). The Five Star Quality Rating System: Technical Users’ Guide provides detailed information about the content and scoring of each domain, as well as the overall star rating. This documentFive Star Quality Rating System Technical Users’ Guide: State Level Health Inpection Cut Point Table provides the data for the tatelevel cutpoints for the star ratingsincluded in the health inspection domain. Cut points for the staffing ratings and for the M ratings have been fixed and do not vary monthly. Data tables giving the cut points for those ratings are included in the Five Star Quality Rating System: Technical Users’ Guide. CMS’ FiveStar quality ratings forthe health inspection domain are based on the relative performance of facilities within a State. This approach helps to control for variation between StateFacility ratings are determined using these criteria:The top 10 percent (lowest 10 percent in terms of health inspectiondeficiency score) in each Statereceive a fivestarrating.The middle 70 percent of facilities receive a rating of two, three, or four stars, with an equal number (approximately 23.33 percent) in each rating category.The bottom 20 percent receive a onestar rating.This distribution is based on CMS experience and input from the Project’s TEP. The cut points arecalibratedeach month so that the distribution of star ratings within States remains relatively constantover timein an effort to reduce the likelihood that the rating process affectthe health inspection process. In the rare case that a Stateor territoryhas fewer than 5 facilities upon which to generate the cut points, the national distributi
on is used.Cut pointsfor the health insp
on is used.Cut pointsfor the health inspection ratings by state for the month of ctoberare shown in Cut Point Table 1 (CP Table 1). 2 Cut Point Table 1 Star Cut Points for Health Inspection Scores - by State - (10-01-2020) Health Inspection Score State Number of facilities 1 star 2 stars 3 stars 4 stars 5 stars Upper Lower Upper Lower Upper Lower Alabama227 �30.66730.667�21.33321.333�14.00014.000�6.0006.000Alaska18 �130.000130.000�102.667102.667�59.33359.333�43.33343.333Arizona144 �69.33369.333�30.66730.667�18.00018.000�8.6678.667Arkansas219 �122.167122.167�72.66772.667�46.00046.000�27.33327.333California1,178�113.833113.833�75.33375.333�50.66750.667�26.66726.667Colorado223 �94.00094.000�49.33349.333�33.33333.333�15.33315.333Connecticut211 �59.33359.333�41.33341.333�26.66726.667�16.00016.000D. C.18 �165.167165.167�107.333107.333�64.00064.000�28.00028.000Delaware45 �142.833142.833�81.33381.333�52.00052.000�15.33315.333Florida681 55.50055.500�34.00034.000�22.00022.000�12.00012.000Georgia356 �40.66740.667�23.33323.333�14.00014.000�4.6674.667Guam1* �90.00090.000�48.66748.667�26.66726.667�10.66710.667Hawaii42 �85.00085.000�49.33349.33338.00038.000�24.66724.667Idaho81 �124.833124.833�78.00078.000�48.00048.000�21.33321.333Illinois 714 �100.000100.000�62.00062.000�38.66738.667�18.66718.667Indiana532 �83.50083.500�49.33349.333�31.33331.333�14.66714.667Iowa430 �46.33346.333�26.00026.000�14.66714.667�4.6674.667Kansas324 �94.00094.000�59.33359.333�37.33337.333�12.00012.000Kentucky284 �82.33382.333�31.33331.333�17.33317.333�7.2007.200Louisiana275 �53.66753.667�30.00030.000�15.00015.000�4.0004.000Maine93 �40.00040.000�18.66718.667�10.66710.667�6.0006.000Maryland225 �116.917116.917�74.00074.000�47.33347.333�18.00018.000Massachusetts373 �82.00082.000�47.33347.333�28.00028.000�13.33313.333Michigan437 �162.500162.500�101.333101.333�67.33367.333�31.33331.333Minnesota366 �80.66780.667�45.33345.333�28.00028.000�14.00014.000Mississippi203 �47.33347.333�24.66724.667�14.66714.667�4.6674.667Missouri516 �89.33389.333�50.66750.667�31.33331.333�16.00016.000Montana70 �104.250104.250�59.33359.333�39.33339.333�18.66718.667Nebraska193 �80.00080.000�48.66748.667�32.00032.000�18.66718.667Nevada61 �86.00086.000�65.33365.333�50.00050.000�37.33337.333New Hampshire74
�19.33319.333�8.0008.
�19.33319.333�8.0008.000�4.0004.000�0.6670.667New Jersey362 �32.00032.000�19.33319.333�12.00012.000�5.3335.333 3 New Mexico69 �191.833191.833�138.000138.000�88.00088.000�36.00036.000New York615 �40.66740.667�24.00024.000�14.66714.667�5.3335.333North Carolina427 �65.50065.500�32.00032.000�16.00016.000�5.3335.333North Dakota80 �43.66743.667�28.00028.000�20.66720.667�10.00010.000Ohio943 �86.66786.667�46.66746.667�28.00028.000�12.00012.000Oklahoma295 �108.083108.083�62.33362.333�38.66738.667�18.66718.667Oregon129 �139.333139.333�80.66780.667�45.33345.333�25.33325.333Pennsylvania689 �88.00088.000�49.33349.333�27.33327.333�11.33311.333Puerto Rico6 �114.000114.000�80.00080.000�52.00052.000�32.66732.667Rhode Island79 �32.66732.667�16.00016.000�8.6678.667�2.0002.000South Carolina185 �87.66787.667�48.66748.667�29.33329.333�12.00012.000South Dakota104 �46.66746.667�28.80028.800�19.33319.333�10.00010.000Tennessee314 �38.00038.000�21.33321.333�11.33311.333�4.0004.000Texas1,187�107.333107.333�64.66764.667�38.66738.667�17.33317.333Utah97 �94.66794.667�62.66762.667�42.00042.000�14.00014.000Vermont35 �68.33368.333�28.66728.667�19.33319.333�8.0008.000Virginia284 �106.000106.000�65.33365.333�41.33341.333�22.66722.667Washington201 �216.000216.000�140.333140.333�83.33383.333�42.66742.667West Virginia122 �125.000125.000�70.66770.667�48.66748.667�24.00024.000Wisconsin351 �80.66780.667�40.00040.00020.66720.667�6.6676.667Wyoming36 �70.00070.000�56.00056.000�38.66738.667�22.66722.667Notes: A higher score indicates worse performance on health inspections. The cut points are based on facility health inspection scores and are set separately for each stateto achieve this distribution:5 stars: ≤percentile4 stars:� 10percentile and ≤ 33.33percentile3 stars:� 33.33percentile and ≤ 56.667percentile2 stars:� 56.667percentile and ≤ 80percentile1 star�: 80percentile Due to the small number of facilities, the cut points for Guam and the Virgin Islands are based on the national distribution of health inspection scores. �� &#x/Att;¬he; [/; ott;&#xom ];&#x/BBo;&#xx [2;—.8;( 2;.57; 32;.52;&#x 40.;Ѥ ;&#x]/Su; typ; /F;&#xoote;&#xr /T;&#xype ;&#x/Pag;&#xinat;&#xion ;&#x/Att;¬he; [/; ott;&#xom ];&#x/BBo;&#xx [2;—.8;( 2;.57; 32;.52;&#x 40.;Ѥ ;&#x]/Su; typ; /F;&#xoote;&#xr /T;&#xype ;&#x/Pag;&#xinat;&#xion ;2 Cut Point Table 1 Star Cut Points for H
ealth Inspection Scores - by State
ealth Inspection Scores - by State - (10-01-2020) Health Inspection Score State Number of facilities 1 star 2 stars 3 stars 4 stars 5 stars Upper Lower Upper Lower Upper Lower Alabama227 �30.66730.667�21.33321.333�14.00014.000�6.0006.000Alaska18 �130.000130.000�102.667102.667�59.33359.333�43.33343.333Arizona144 �69.33369.333�30.66730.667�18.00018.000�8.6678.667Arkansas219 �122.167122.167�72.66772.667�46.00046.000�27.33327.333California1,178�113.833113.833�75.33375.333�50.66750.667�26.66726.667Colorado223 �94.00094.000�49.33349.333�33.33333.333�15.33315.333Connecticut211 �59.33359.333�41.33341.333�26.66726.667�16.00016.000D. C.18 �165.167165.167�107.333107.333�64.00064.000�28.00028.000Delaware45 �142.833142.833�81.33381.333�52.00052.000�15.33315.333Florida681 55.50055.500�34.00034.000�22.00022.000�12.00012.000Georgia356 �40.66740.667�23.33323.333�14.00014.000�4.6674.667Guam1* �90.00090.000�48.66748.667�26.66726.667�10.66710.667Hawaii42 �85.00085.000�49.33349.33338.00038.000�24.66724.667Idaho81 �124.833124.833�78.00078.000�48.00048.000�21.33321.333Illinois 714 �100.000100.000�62.00062.000�38.66738.667�18.66718.667Indiana532 �83.50083.500�49.33349.333�31.33331.333�14.66714.667Iowa430 �46.33346.333�26.00026.000�14.66714.667�4.6674.667Kansas324 �94.00094.000�59.33359.333�37.33337.333�12.00012.000Kentucky284 �82.33382.333�31.33331.333�17.33317.333�7.2007.200Louisiana275 �53.66753.667�30.00030.000�15.00015.000�4.0004.000Maine93 �40.00040.000�18.66718.667�10.66710.667�6.0006.000Maryland225 �116.917116.917�74.00074.000�47.33347.333�18.00018.000Massachusetts373 �82.00082.000�47.33347.333�28.00028.000�13.33313.333Michigan437 �162.500162.500�101.333101.333�67.33367.333�31.33331.333Minnesota366 �80.66780.667�45.33345.333�28.00028.000�14.00014.000Mississippi203 �47.33347.333�24.66724.667�14.66714.667�4.6674.667Missouri516 �89.33389.333�50.66750.667�31.33331.333�16.00016.000Montana70 �104.250104.250�59.33359.333�39.33339.333�18.66718.667Nebraska193 �80.00080.000�48.66748.667�32.00032.000�18.66718.667Nevada61 �86.00086.000�65.33365.333�50.00050.000�37.33337.333New Hampshire74 �19.33319.333�8.0008.000�4.0004.000�0.6670.667New Jersey362 �32.00032.000�19.33319.333�12.00012.000�5.3335.