New Quality Measures on Nursing Home Compare
Nursing Home Compare is a user-friendly federal web tool found at https://www.medicare.gov/nursinghomecompare/search.html that provides information on how well Medicare- and Medicaid-certified nursing homes provide care to their residents. Nursing Home Compare allows consumers to select multiple nursing homes at a time to compare the health inspection history, staffing levels, and self-reported quality of care outcomes.
On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) added six new quality measures to the Nursing Home Compare website as part of an initiative to broaden the quality information available on that site. For the first time, CMS is including quality measures that are not based solely on data that are self-reported by nursing homes. These new measures, which are based primarily on Medicare claims data submitted by hospitals, measure the rate of rehospitalization, emergency room use, and community discharge among nursing home residents. The six new measures include:
- Percentage of short-stay residents who were successfully discharged to the community (Medicare claims- and MDS-based)
- Percentage of short-stay residents who have had an outpatient emergency department visit (Medicare claims- and MDS-based)
- Percentage of short-stay residents who were rehospitalized after a nursing home admission (Medicare claims- and MDS-based)
- Percentage of short-stay residents who made improvements in function (Minimum Data Set (MDS)-based)
- Percentage of long-stay residents whose ability to move independently worsened (MDS-based)
- Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based)
These newly added measures will be reported on Nursing Home Compare, but will not be incorporated into the methodology to compute nursing home star ratings until July 2016.
CMS launched Nursing Home Compare in 1998. In 2003, CMS added quality measures to the health inspection and staffing information already on the site. In 2008, CMS implemented a Five Star Nursing Home Quality Rating System to summarize much of the detailed information on Nursing Home Compare so that consumers could more easily distinguish among nursing homes. Since 2008, CMS has been continually adding information to Nursing Home Compare, including facility ownership information, sanctions against nursing homes, and the full text of nursing home inspection reports.
The New Quality Measures
The six newly added quality measures represent the largest addition of quality measures to Nursing Home Compare since CMS introduced quality measures information to Compare in 2003. More importantly, with this change, CMS is nearly doubling the number of short-stay measures on Nursing Home Compare and is providing information about key short-stay outcomes, including the percentage of residents who are successfully discharged and the rate of activities of daily life (ADL) improvement among short-stay residents. Short-stay measures reflect care provided to residents who are in the nursing home for 100 days or less, while long-stay measures reflect care for residents who are in the nursing home for more than 100 days.
For more information about these measures, please visit:
Payroll-Based Staffing Reporting
With critical funding provided in the bipartisan Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, CMS will implement an auditable, payroll-based quarterly electronic staffing reporting system for nursing homes in an effort to verify facility-reported staffing information. This new system will increase the accuracy and timeliness of data and allow for the calculation of quality measures for staff turnover, retention, types of staffing, staffing levels per type. CMS will begin collecting information under this new system for all Medicare and Medicaid-participating nursing homes in July 2016.
Quality Improvement (QI) Tools
In order to help nursing homes incorporate these new quality measures into their Quality Assurance and Process Improvement (QAPI) processes, CMS is also providing a list of publicly available QI resources: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/QAPI/qapiresources.html.