The Five-Star Quality Rating System Technical User’s Guide

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The Five-Star Quality Rating System Technical User’s Guide

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The Five-Star Quality Rating System Technical User’s Guide

Maureen McCarthy, BS, RN, RAC-MT, QCP-MT
Reginald M. Hislop III, PhD

Stay compliant with the most up-to-date Five-Star Quality Rating System. The Five-Star Quality Rating SystemTechnical User’s Guide includes CMS’ technical guide to the Five-Star Rating System, as well as expert analysis and insight into how providers can use the guide, how ratings are affected, and what providers can do to improve their rating. Industry experts Reginald M. Hislop III, PhD, and Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, provide analysis and insight to assist facilities in determining their overall facility five-star rating, employing strategic opportunities for marketplace differentiation, and driving performance with quality care that can translate to maximum star ratings.

This valuable resource provides word-for-word CMS regulatory guidance covering virtually every aspect of a nursing home’s quality rating system, including:

  • Health inspections
  • Staffing
  • Quality Measures (QM)


Table of Contents

  • Chapter 1: Using the Technical User’s Guide for Five-Star Reporting
  • Chapter 2: How to Employ Strategic Opportunities for Marketplace Differentiation
  • Chapter 3: Five-Star Technical User’s Guide and Cutpoints Table
  • Chapter 4: How to Improve Quality


About the Authors

Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, is president of Celtic Consulting, LLC, and CEO and founder of Care Transitions, LLP, a care coordination service provider. She is also the creator of the McCarthy Method, a documentation improvement system for ADL coding. She and her associates at Celtic Consulting educate and train on ICD-10 transitioning and coding for skilled nursing facilities (SNF), state affiliates, and provider organizations.

McCarthy has been a registered nurse for 30 years with experience as an MDS coordinator, director of nursing, rehab director, and Medicare specialist. She is a recognized leader and expert in clinical reimbursement in the SNF environment. Currently, she is the president for the Association of Long Term Care Financial Managers; the Medicare and MDS 3.0 advisor for the Connecticut Association of Health Care Facilities; and an advisor to the J13 Medicare contractor National Government Services Provider Advisory Group. McCarthy is an advisor to the New York State Health Facilities Association on the Nursing Leadership Committee, as well as the Payment for Services Group. She is also an editorial advisor for HCPro.

McCarthy is certified in the resident assessment process and Quality Assurance and Performance Improvement by nationally recognized organizations and holds Master Teacher status with AANAC. She holds a degree in business management as well as a nursing degree. She released her first co-authored publication, The Long-Term Care Compliance Toolkit, in September 2011; in June 2015, she followed it with ICD-10 Compliance: Process Improvement and Maintenance for LTC. In October 2016, she released Medicare Audits: A Survival Guide for Skilled Nursing Facilities.

Reginald M. Hislop III, PhD, co-founded H2 Healthcare in June of 2011. Before forming H2, he served for 24 years as the CEO of Wisconsin’s largest specialized health system (top 50 largest nationally), then as the managing partner of a national healthcare advisory group in partnership with Grubb & Ellis, specializing in mergers/acquisitions, capital development, and financial/corporate development.

Hislop’s practice focus is strategy, health and economic policy, and business and corporate development. He has over 30 years of experience as an executive and consultant in the development, operations, and financing of all aspects of healthcare, with particular experience in postacute care. He is the author of over 250 published articles and research reports, a frequent national speaker, and a consultant and advisor to numerous trade, investment, and professional organizations. His internationally read website on health policy is www.rhislop3.com.


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Published: February 2017

Page count: 78
Dimensions: 7x9
ISBN: 978-1-68308-182-1