Centers for Medicare & Medicaid Services Ratings

What is CMS? Why is it relevant?

The Centers for Medicare & Medicaid Services (CMS) is a federal agency – an agency is a part of the federal government that oversees specific sections. CMS is part of the Department of Health and Human Services, which oversees federal health care programs.

Some specific roles of CMS are to:

  • to oversee and put in place the Medicare program.
  • work with state governments to put in place Medicaid and other programs.
  • create and put in place some health insurance standards.

CMS also monitors hospitals that work with Medicaid and Medicare insurance. These include hospital inpatient psychiatric units, and other psychiatric facilities. CMS monitors them via surveys and guidelines, and core quality indicators. The methods for enforcement are here.

What are the core quality indicators? How can I see ratings of facilities based on them?

CMS uses the indicators in an Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program. The program is designed to give the public information on their options. Facilities in this program must submit all quality measures to CMS. There are 16 total quality indicators. The core quality indicators include but aren’t limited to:

  • amount of restraint and seclusion
  • post-discharge continuing care plan
  • continuing care plan sent to patients’ outside care providers
  • assessment of patient experience of care
  • percentage of patients receiving follow-up care within 30 and 7 days

You can see more information on core quality indicators at CMS’s Medicare website. 

You can view CMS evaluations and sets of data on hospitals here on the same website.