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Nursing home quality measures have four intended purposes: - To give information about the quality of care at nursing homes to help you choose a nursing home for yourself or others;
- To give you information about the care at nursing homes where you or family members already live;
- To get you to talk to nursing home staff about the quality of care; and
- To give data to the nursing home to help them with their quality improvement efforts.
The current quality measures have been chosen because they can be measured and don't require nursing homes to prepare additional reports. They are valid and reliable. However, they are not benchmarks, thresholds, guidelines, or standards of care. They are based on care provided to the population of residents in a facility, not to any individual resident, and are not appropriate for use in a litigation action. These quality measures were selected because they are important. They show ways in which nursing homes are different from one another. There are things that nursing homes can do to improve their percentages. The quality measures have been checked and are based on the best research currently available. As this research continues, scientists will keep improving the quality measures on this website. The nursing home quality measures come from resident assessment data that nursing homes routinely collect on the residents at specified intervals during their stay. 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 resident's physical and clinical needs. From the beginning of this Initiative, CMS has said that the quality measures are dynamic and will continue to be refined as part of CMS's ongoing commitment to quality. In June 2011, the National Quality Forum (NQF) endorsed our 17 Nursing Home Quality Measures. The National Quality Forum is a voluntary standard setting, consensus-building organization representing providers, consumers, purchasers and researchers. These measures will become the enhanced set of publicly reported quality measures available on Nursing Home Compare in the spring of 2012. The periods of time for the quality measures follow: - For the chronic care measures, calculations are based on any resident with a full or quarterly MDS in the target quarter.
- For post-acute care measures, calculations are based on any resident with a 14-day PPS MDS in the 2 consecutive target quarters.
The current nursing home quality measures are as follows: Short Stay Quality Measures - The Percentage of Residents on a Scheduled Pain Medication Regimen on Admission Who Report a Decrease in Pain Intensity or Frequency
- Percent of Residents who Self-Report Moderate to Severe Pain
- Percent of Residents with Pressure Ulcers that are New or Worsened
- Percent of Residents Assessed and Given, Appropriately, the Seasonal Influenza Vaccine
- Percent of Residents Assessed and Given, Appropriately, the Pneumococcal Vaccine
Long Stay Quality Measures - Percent of Residents Experiencing One or More Falls with Major Injury
- Percent of Residents who Self-Report Moderate to Severe Pain
- Percent of High-Risk Residents with Pressure Ulcers
- Percent of Long Stay Residents Assessed and Given, Appropriately, the Seasonal Influenza Vaccine
- Percent of Long Stay Residents Assessed and Given, Appropriately, the Pneumococcal Vaccine
- Percent of Long-stay Residents with a Urinary Tract Infection
- Percent of Low-Risk Residents Who Lose Control of their Bowels or Bladder
- Residents Who Have/Had a Catheter Inserted and Left in Their Bladder
- Percent of Residents Who Were Physically Restrained
- Percent of Residents Whose Need for Help with Daily Activities Has Increased
- Percent of Long-stay Residents Who Lose Too Much Weight
- Percent of Residents Who have Depressive Symptoms
Specifications for the short stay measure titled "Percent of Residents with Pressure Ulcers that are New or Worsened" are available below under the download section. Specifications for the other measures listed above can be viewed on the MDS 3.0 Technical Information Page (www.cms.gov/NursingHomeQualityInits/30_NHQIMDS30TechnicalInformation.asp) Development of Staffing Quality Measures Phase I The Final Report from the Development of Staffing Quality Measures Phase I is available below in the download section. This report includes an Overview of the files, an Executive Summary, the Final Report and Appendices, the Nursing Home Staffing Database and Data Dictionary, the Literature Review, and the Stakeholder Meeting Summary. This phase of the project was completed July 2005. Development of Staffing Quality Measures Phase I Continuation currently underway is expected to conduct a feasibility study and test specified payroll data reporting. Updates on the current phase will be published on this page once available. Pay for Performance CMS has implemented a value-based purchasing demonstration for nursing homes in New York, Wisconsin and Arizona. The Nursing Home Value Based Purchasing (NHVBP) demonstration is part of a CMS initiative to improve the quality of care furnished to Medicare beneficiaries in nursing homes. This demonstration tests the "pay for performance" concept applied to the nursing home setting. CMS is assessing the performance of participating nursing homes based on selected measures of quality of care, and then make payment awards to those nursing homes that achieve a high level of performance or exceptional improvement based on those measures. Domains represented in the quality measures including staffing, appropriate hospitalizations, outcome measures from the minimum data set (MDS), and inspection survey deficiencies. CMS awards points to each nursing home based on how they perform on the measures within each of the domains. These points will be summed to produce an overall quality score. This three year demonstration began July 1, 2009. The following numbers of nursing homes were selected to participate at the beginning of the demonstration: Arizona - 41, New York - 79, Wisconsin - 62. CMS has not completed the evaluation of participants' performance during the first year of the demonstration.
Page Last Modified: 11/10/2011 12:06:55 PM
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