CMS Releases Overall Hospital Quality Star Ratings for Hospitals
Question: How are the Overall Hospital Quality Star Ratings calculated? What will their impact be on hospitals and physicians?
Answer: The CMS published the much-anticipated Overall Hospital Quality Star Ratings last week in the face of calls by industry groups and Congress to delay their release. The ratings, which range from 1 to 5 stars, are intended to convey the “overall quality” of nearly 4,000 hospitals in the U.S. In grading hospitals on their overall quality, the CMS used 64 measures, such as hospital-acquired infection rates and emergency room wait times. It then grouped the 64 measures into broader categories and weighted them. Hospitals had to meet minimum reporting requirements in order to be eligible to receive a star rating. Dr. Kate Goodrich, director of the Center for Clinical Standards and Quality at CMS, stated that these “easy-to-understand star ratings are available online and empower people to compare and choose across various types of facilities from nursing homes to home health agencies.” Hospitals and other industry groups are highly critical of the CMS’ star ratings, claiming that the system oversimplifies the quality of a multi-faceted institution. Critics also question the underlying methodology the CMS used to calculate the star ratings, calling it “flawed.” They warn the star ratings will provide inaccurate information to consumers and damage hospitals’ reputations.

The CMS currently uses star rating systems as quality indicators for nursing homes, Medicare plans and dialysis facilities. As with the recent publication of hospital star ratings, when the CMS published the metric for nursing homes in 2009, industry groups pushed back calling the ratings system flawed. A subsequent investigation of the system by the New York Times found that many of the metrics that went into nursing home ratings were incomplete and sometimes misleading.

The first set of star ratings revealed that only 102 institutions out of 4,599 hospitals, or 2.2%, earned 5 stars. Of the rest of the hospitals, 20.3% garnered 4 stars, 38.5% received 3, 15.7% earned 2 stars and 2.9% received a single star. A considerable number of hospitals, 20.4%, were deemed ineligible to be rated as the CMS lacked data to report measure results. The ratings are posted to the CMS’ site at

Weekly Charting Tip:

Make sure that when you record a prescription given for a patient, it not only has the name of the medication, but the dosage, how many to take, and how and when as well as the number being dispensed! Also note why any changes have been made to the prescription, such as dosage or frequency and note that it is a change from the prior prescription.  - Larry Kobak, Esq.

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