Measures and Benchmarks
As required by House Bill (HB) 2658, 87th Legislature, Regular Session, 2021, HHSC has adopted rules and established the Minimum Performance Standards (MPS) for NFs that participate in STAR+PLUS. Information on the Minimum Performance Standards, and benchmarks, is provided below.
The Centers for Medicare & Medicaid Services (CMS) collect multiple long-stay measures. Five of those measures comprise the STAR+PLUS nursing facility (NF) minimum performance standards (MPS) and are listed in Table 1: Benchmarks for CY 2022 and 2023. HHSC will evaluate each NF’s four-quarter average on each measure to determine if they did not meet, met, or exceeded the benchmark.
The data for evaluating MPS will be available each spring. HHSC will pull the previous calendar year’s data, analyze, and assess performance. The results for STAR+PLUS NF MPS will be available annually in July.
Table 1: Benchmarks for CY 2022 and 2023
|CMS Long-Stay Measures||2022-2023 Benchmarks||Performance Requirement to Meet the MPS|
|N028.02 Percent of long-stay residents whose need for help with activities of daily living has increased||30%||At or Below 30%|
|N015.03 Percent of high-risk residents with pressure ulcers||17%||At or Below 17%|
|N016.03 Percent of residents assessed and appropriately given the seasonal influenza vaccine||77%||At or Above 77%|
|N020.02 Percent of residents assessed and appropriately given the pneumococcal vaccine||80%||At or Above 80%|
|N035.03 Percent of residents whose ability to move independently worsened||31%||At or Below 31%|
The MCO will be required to adhere to STAR+PLUS Uniform Managed Care Manual requirements in chapters 8.6 – State Mandated Requirements for STAR+PLUS Nursing Facility Providers and 8.11 – STAR + PLUS Nursing Facility Minimum Performance Standards, and may refuse to contract with a NF seeking to participate in or renew a contract for STAR+PLUS, if the NF does not meet the minimum performance standards (under certain conditions).
Minimum Performance Standards - Calendar Year 2022 Results
HHSC Minimum Performance Standards – Facility Specific Performance 2022 (PDF). The final data reflects nursing facility-specific performance on HHSC-established benchmarks (met/failed) for the five MPS long-stay quality measures in calendar year 2022. Quality measure performance was derived from the minimum data set (MDS) four-quarter average made available on April 27, 2023, by the Centers for Medicare & Medicaid Services (CMS) on Nursing Home Compare (NHC).
HHSC Minimum Performance Standards – Aggregate Number of Providers Failing 1 to 5 Benchmarks 2022 (PDF). The final data reflects the aggregate number of providers that failed one, two, three, four, and five benchmarks.
HHSC Minimum Performance Standards – Performance All Providers: Aggregate Number and Percentage of Providers that Met/Failed Benchmarks 2022 (PDF). The final data reflects the aggregate number and percentage of providers that met/failed HHSC-established performance benchmarks, as identified in the HHSC Minimum Performance Standard Results.
HHS has developed the following toolkits as resources for NFs. The information contained in each toolkit is evidence-based and can be used by facilities to improve their systems in these areas: