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Nursing Home Quality Initiative

This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses quality measures that are shown at the Nursing Home Compare website (medicare.gov), which allows consumers, providers, States and researchers to compare information on nursing homes. Many nursing homes have already made significant improvements in the care being provided to residents by taking advantage of these materials and the support of Quality Improvement Organization staff. The NHQI website comprises important web subdirectory pages shown on the left hand side of the page:

  1. Highlights: hot topics, current issues and immediate plans.
  2. Quality measures: quality measures development, current quality measures, quality measures under development research summaries and user manuals.
  3. Minimum Data Set, Version 2.0 (MDS 2.0): manuals, forms, RAVEN software links, historical files and swing bed information.
  4. Minimum Data Set, Version 3.0 (MDS 3.0): national validation study information and implementation timelines.
  5. NHQI Archives: contains historical downloadable 2002-2006 zip files from Nursing Home Quality Initiative (NHQI).

In November 2002, the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, began a national Nursing Home Quality Initiative (NHQI). Historical information, the NHQI Pilot Evaluation Report and the NHQI Overview is available on the Archives page accessed on the left hand side of this page.

The nursing home quality measures come from resident assessment data that nursing homes routinely collect on the residents at specified intervals during their stay, are posted on nursing home compare in the Downloads section of this page and current quality measures can be viewed at Quality Measures on the left hand side of this page. These measures assess the resident's physical and clinical conditions and abilities, as well as preferences and life care wishes. These assessment data have been converted to develop quality measures that give consumers another source of information that shows how well nursing homes are caring for their residents' physical and clinical needs.

Related Links provide a broad range of information regarding MDS, nursing home compare, payment, quality improvement organizations, survey and certification information, and frequently asked questions (FAQs). The following list describes the purpose for each link:

  • Nursing Home Compare: Past performance of every Medicare and Medicaid certified nursing home in the country
  • MDS 3.0: MDS 3.0 updates, forms, study findings & timeline
  • SNF PPS Payment: SNF PPS information, updates & schedules
  • Nursing Home Survey: NH Survey & certification information including to applicable laws, regulations, and compliance information
  • SNF Open Door Forum (ODF): SNF ODF information and schedules
  • SNF Value-Based Purchasing Report to Congress
  • Medicare Learning Network: Easy-to-understand educational materials to accompany the release of new or revised Medicare Program policies including SNF Policies
  • Post Acute Care Payment Reform Demonstration (PAC-PRD): Design of the PAC-PRD which uses a continuity assessment record evaluation (CARE) uniform assessment instrument for acute hospitals and four PAC settings considering payment recommendations, discharge patterns, and patient outcomes
  • AHRQ Nursing Home Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surveys: Three separate instrument that ask current residents, former residents, and families of residents about their experiences with the nursing home

Additionally, Related Links provide links to the Medicare Quality Improvement Community, which provides easy access to quality improvement resources and a community of professionals sharing knowledge and experiences to accelerate healthcare quality improvement across the nation. A second link is to the Health Care Quality Improvement & Evaluation System (QIES), which is the clinical umbrella that supports MDS as well as Online Survey and Certification and Reporting System (OSCAR), Outcome and Assessment Information Set (OASIS), Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) and many other functional systems.. A third link is provided to the national staff time measurement study, which is conducting a national nursing home time study to re-calibrate the case mix structure used in the Resource Utilization Group System (RUG-III) that will provide data and analysis to update the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS).