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Quality Measures

What's New

March 5, 2019

See below the list of nursing home quality measures that has been updated.

February 21, 2019

MDS 3.0 QM User’s Manual Version 12.0 Now Available

The MDS 3.0 QM User’s Manual Version 12.0 has been posted. The MDS 3.0 QM User’s Manual V12.0 contains detailed specifications for the MDS 3.0 quality measures. The MDS 3.0 QM User’s Manual V12.0 can be found in the Downloads section of this page and the MDS 3.0 QM User’s Manual V11.0 has been moved to the Quality Measures Archive page.

Two files related to the MDS 3.0 QM User’s Manual have been posted:

  1. MDS 3.0 QM User’s Manual V12.0 contains detailed specification for the MDS 3.0 quality measures. MDS 3.0 QM User’s Manual V12.0 is available under the Downloads section of this page.
  2. Quality Measure Identification Number by CMS Reporting Module Table V1.7 documents CMS quality measures calculated using MDS 3.0 data and reported in a CMS reporting module.  A unique CMS identification number is specified for each QM. The table is available under the Downloads section of this page. 

November 29, 2017

CMS held a webinar on the Meaningful Measures Initiative on November 28. To review the presentation, go here

May 25, 2017

An errata for the MDS 3.0 QM User's Manual Version 11.0 has been added to the downloads section. This errata addresses an error pertaining to N015.01 Percent of High-Risk Residents with Pressure Ulcers (long stay).

April 19, 2017

The MDS 3.0 QM User’s Manual Version 11.0 has been posted. The MDS 3.0 QM User’s Manual V11.0 contains detailed specifications for the MDS 3.0 quality measures. The MDS 3.0 QM User’s Manual Version 11.0 can be found in the Downloads section of this page. The MDS 3.0 QM User’s Manual Version 10.0 and the updated MDS 3.0 QM User’s Manual Version 10.1 have been moved to the Quality Measures Archive

Nursing home quality measures have four intended purposes:

  • To give you information about the quality of care at nursing homes in order 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 give you information to facilitate your discussions with the nursing home staff regarding the quality of care; and
  • To give data to the nursing home to help them in their quality improvement efforts.

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.

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. The quality measures 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 quality measure percentages. The quality measures have been validated and are based on the best research currently available. As this research continues, scientists will keep improving the quality measures on this website.

The quality measure short stay and long stay definitions are:

  • The short stay resident quality measures show the average quality of resident care in a nursing home for those who stayed in a nursing home for 100 days or less or are covered under the Medicare Part A Skilled Nursing Facility (SNF) benefit. Short-stay residents often are those recovering from surgery or being discharged from a hospital stay. Many short-stay residents get care in a nursing home until they’re able to go back home or to the community.
  • The long stay resident quality measures show the average quality of care for certain care areas in a nursing home for those who stayed in a nursing home for 101 days or more. Residents in a nursing home for a long-stay are usually not healthy enough to leave a nursing home and can’t live at home or in a community setting. These residents may be older and have more serious health issues.

The current nursing home quality measures are:

Short Stay Quality Measures

  • Percentage of short-stay residents who were re-hospitalized after a nursing home admission.
  • Percentage of short-stay residents who have had an outpatient emergency department visit.
  • Percentage of short-stay residents who got antipsychotic medication for the first time.
  • Percentage of SNF residents with pressure ulcers that are new or worsened (SNF QRP).
  • Percentage of short-stay residents who report moderate to severe pain.
  • Rate of successful return to home and community from a SNF (SNF QRP).
  • Percentage of short-stay residents who improved in their ability to move around on their own.
  • Percentage of short-stay residents who needed and got a flu shot for the current flu season.
  • Percentage of short-stay residents who needed and got a vaccine to prevent pneumonia.
  • Percentage of SNF residents who experience one or more falls with major injury during their SNF stay (SNF QRP).
  • Percentage of SNF residents whose functional abilities were assessed and functional goals were included in their treatment plan (SNF QRP).
  • Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (SNF QRP).
  • Medicare Spending Per Beneficiary (MSPB) for residents in SNFs (SNF QRP).

Long Stay Quality Measures

  • Number of hospitalizations per 1,000 long-stay resident days.
  • Outpatient emergency department visits per 1,000 long-stay resident days.
  • Percentage of long-stay residents who got an antipsychotic medication.
  • Percentage of long-stay residents experiencing one or more falls with major injury.
  • Percentage of long-stay high-risk residents with pressure ulcers.
  • Percentage of long-stay residents with a urinary tract infection.
  • Percentage of long-stay residents who have or had a catheter inserted and left in their bladder.
  • Percentage of long-stay residents whose ability to move independently worsened.
  • Percentage of long-stay residents whose need for help with daily activities has increased.
  • Percentage of long-stay residents who report moderate to severe pain.
  • Percentage of long-stay residents who needed and got a flu shot for the current flu season.
  • Percentage of long-stay residents who needed and got a vaccine to prevent pneumonia.
  • Percentage of long-stay residents who were physically restrained.
  • Percentage of long-stay low-risk residents who lose control of their bowels or bladder.
  • Percentage of long-stay residents who lose too much weight.
  • Percentage of long-stay residents who have symptoms of depression.
  • Percentage of long-stay residents who got an antianxiety or hypnotic medication.

Quality measure specifications are available in the QM Users’ Manual download file, which can be found under the download section below. A sub-group of quality measures are incorporated into the Five-Star Quality Rating System and used to determine scoring for the quality measures domain on Nursing Home Compare.