Translating Scores into Pass/Not Pass Determinations

To translate findings into Pass/Not Pass determinations, CMS performs the following steps for each contract:

1. CMS sums the standard/sub-standard scores for each reporting section; these scores are derived from the Yes/No findings or the Likert scale for each applicable standard/sub-standard.
2. CMS calculates the average Part C (if applicable) score by summing the scores for all Part C reporting sections and dividing by the number of reporting sections.
3. CMS calculates the average Part D (if applicable) score by summing the scores for all Part D reporting sections and dividing by the number of reporting sections.
4. CMS calculates the overall (average) Part C and Part D score (if applicable) by summing the result of steps 2 and 3 and dividing by 2.

Refer to Section 1 of Appendix J for more information on Pass/Not Pass Determinations and DV standards.