Scoring Methodology - How to Calculate the Score


The Maximum Possible Score that a facility can achieve is 132 points. The tool includes information from the 3 most recent standard surveys and information from all complaint surveys performed after or within one year of the most recent standard survey. Five categories (Administration, Nursing, Resident Rights, Kitchen/Food Services, and Environment) are reported and there are 132 items (3 surveys x 44 requirements). As part of the survey process, each deficiency (requirement not met) is assigned an alphabetic scope and severity rating (A through L). A numeric value has been assigned to each alphabetic scope and severity rating given. Each category is scored and these results are then summed to compute a total score for the nursing home.

In order to enhance the scoring methodology, a new approach will be applied to surveys which are completed after January 1, 2007.  Scores will be computed using a blend of the new and old method until the time when a facility has had 3 certification surveys after January 1, 2007.  (The year 2009 for most facilities.)  At that point, only the new method will be applied.

The scoring begins with the Maximum Possible Score (132) from which points are deducted based on the scope and severity of deficiencies that were cited.  The numeric value assigned to each deficiency will depend on whether the survey was completed before or after January 1, 2007.  For deficiencies cited from surveys completed after January 1, 2007, the numeric value also depends on whether the deficient item is one of the requirements used to determine Substandard Quality of Care in a facility.  See Numeric Values for Scope and Severity Ratings to familiarize yourself with the scope and severity (S/S) tables and their corresponding numeric values as they are referenced several times in the example below.


  • Using Steps One through Nine, which are described in the example below, calculate a score for each category (Administration, Nursing, Resident Rights, Food Services, and Environment) reviewed.
  • Sum the scores for each category to get the nursing home's Total score.

The following is an example of how to calculate a score for each category. The category is Administration which has a maximum possible score of 39 points.

Administration

 

RESULTS:     Standard Survey: 34 of 39 Met      Complaint Deficiencies: 0
      Score after Adjustment for Scope and Severity 29



The home met 34 of 39 requirements and there were 0 complaint deficiencies in the key requirements evaluated in the tool. The home's Score after Adjustment for Scope and Severity is 29.


Step One: Determine if the deficiencies were cited from surveys completed before or after January 1, 2007.  For deficiencies cited after January 1, 2007, determine if they are included in the Substandard Quality of Care regulations.


Step Two: Locate the alphabetic S/S rating for the deficiencies listed under the Administration category. Then, using the appropriate table, find its corresponding numeric value. (When a nursing home has met all of the key requirements in a category, no deficiencies are listed and there is no further adjustment to the score. The home's score in that category is equal to the Maximum Possible Score for the category.)

In this example there are 5 deficiencies cited under Administration:

Deficiency #1: The facility must make the results of the most recent survey available for examination in a place readily accessible to residents and must post a notice of their availability. (F 167)  6/23/2007(D)The deficiency was cited on the 6/23/2007 survey.   F 167 is not a Substandard Quality of Care item.  Thus, use S/S Table 2.  S/S rating is "D" =  numeric value of "1"

Deficiency #2: Each resident receives adequate supervision and assistance devices to prevent accidents. (F 250)     7/4/2006(G)The deficiency was cited on the 7/4/2006 survey.  Thus, use S/S Table 3.  S/S rating is "G" = numeric value of "7"

Deficiency #3: Each resident receives adequate supervision and assistance devices to prevent accidents. (F 250)     6/23/2007(G)The deficiency was cited on the 6/23/2007 survey.  F 250 is a Substandard Quality of Care item.  Thus, use S/S Table 1.  S/S rating is "G" =  numeric value of "3"

Deficiency #4: Each resident receives adequate supervision and assistance devices to prevent accidents. (F 324) 8/5/2005(D)The deficiency was cited on the 8/5/2005 survey.  Thus, use S/S Table 3.  S/S rating is "D" = numeric value of "4"

Deficiency #5: The facility ensures that residents and facility records are well maintained, complete, and accessible for review by regulatory agencies. (F 514) 6/23/2007(G)The deficiency was cited on the 6/23/2007 survey.  F 514 is not a Substandard Quality of Care item.  Thus, use S/S Table 2.  S/S rating is "G" =  numeric value of "2"


Step Three:  Add the numeric S/S values for the deficiencies from surveys completed after January 1, 2007.

Deficiency #1 + Deficiency #3 + Deficency #5 = 1 + 3 +2 = 6 points


Step Four:  Compute an average S/S score for the deficiencies from surveys completed before January 1, 2007 by summing the numeric S/S values and dividing the result by the total number of deficiencies from surveys completed before January 1, 2007:

Deficiency #2 + Deficiency #4 = 4 + 7 = 11 divided by 2 deficiencies = 5.5 round up to 6


Round the result up or down to the nearest whole number. In this case, the result is rounded up and the average S/S score is 6. This value is now used to determine the weighting factor that will be used to calculate the number of points to be deducted for each deficiency cited in surveys completed before January 1, 2007.


Step Five: Determine which weighting factor should be used and the number of points to be deducted.                                                                                                                                         
                                                                                                                                                      Once again, using the Scope and Severity Table 3 , locate the box that contains a numeric value matching the Average S/S score calculated in Step Four, in this case 6. That match is found in Box "F = 6" so the weighting factor to be used in calculating the number of points to be deducted is 2. Now, multiply the weighting factor times the number of deficiencies cited from surveys completed before January 1,2007. 

Weighting factor of 2 x 2 deficiencies = 4 points


Step Six: Add the points calculated from Step Three and Step 5.

6 points + 4 points = 10 points


Step Seven: : Subtract the points calculated in Step Six from the maximum possible score in the category; Recall that it was 39 for the Administration category. The result is the Administration Score after Adjustment for Scope and Severity.

39 maximum points - 10 point deduction = 29 Score after Adjustment for S/S

 


Step Eight: Repeat Steps One through Seven for the remaining 4 categories reviewed.


Step Nine: Sum the scores for all 5 categories to get the home's Total score.

Category

Score after Adjustment for S/S

Administration

29

Nursing

31

Resident Rights

24

Food Services

12

Environment

20

        Nursing Home's Total Score  

116

 

 

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