The Centers for Medicare & Medicaid Services (CMS) on Tuesday announced stricter standards for its consumer-facing nursing home ratings, including a lower threshold for staffing penalties and new separate ratings for short-term and long-term stays.

Starting April 24, CMS will automatically hand out one-star staffing ratings to buildings that have four or more days in a quarter with no registered nurse on site, down from the current seven-day standard.

“Nurse staffing has the greatest impact on the quality of care nursing homes deliver, which is why CMS analyzed the relationship between staffing levels and outcomes,” the agency said in a Tuesday statement announcing the new rules for the Five-Star Quality Rating System. “CMS found that as staffing levels increase, quality increases.”

CMS will also lift a temporary freeze on health inspection ratings initially implemented in February 2018 amid a shift in survey requirements; due to differences in timing, federal officials had stopped updating the category until all of the facilities could be assessed under the new rules.

“Ending the freeze is critical for consumers,” CMS noted. “In April, they will be able to see the most up-to-date status of a facility’s compliance, which is a very strong reflection of a facility’s ability to improve and protect each resident’s health and safety.”

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