AGING AND DISABILITY SERVICES ADMINISTRATION

Enhanced Quality Measures to be Reported

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). From the beginning of this Initiative, CMS has said that quality measures are dynamic and will continue to be refined as part as part of their ongoing commitment to quality. Later this month, CMS will begin reporting an enhanced set of quality measures that have been endorsed by the National Quality Forum.

The enhanced chronic care measures that will be posted on Nursing Home Compare are:

• Percent of residents whose need for help with daily activities has increased
• Percent of residents who have moderate to severe pain
• Percent of residents who were physically restrained
• Percent of residents who spent most of their time in bed or in a chair
• Percent of residents whose ability to move about in and around their room got worse
• Percent of residents with a urinary tract infection
• Percent of residents who have become more depressed or anxious
• Percent of high risk residents who have pressure sores
• Percent of low risk residents who have pressure sores
• Percent of low risk residents who lose control of their bowels or bladder
• Percent of residents who have/had a catheter inserted and left in their bladder

The enhanced post-acute care measures that will be posted are:

• Percent of short stay residents who had moderate to severe pain
• Percent of short stay residents with delirium
• Percent of short stay residents with pressure sores

Of the eleven chronic care measures listed above, four of the measures are clinically related to each other. These four measures have been grouped into two pairs. If one of the measures in a pair is selected on the Nursing Home Compare website, the other measure will also be displayed. The Nursing Home Compare website is at www.Medicare.gov/nhcompare/home.asp. The first set of paired measures is percent of low risk residents who have pressure sores and percent of high-risk residents who have pressure sores. The second set of paired measures is percent of low risk residents who lose control of their bowels or bladder and percent of residents who have/had a catheter inserted and left in their bladder.

Preview of Scores

CMS will provide facilities with a preview of their scores on the new measures through the QIES (Quality Improvement and Evaluation System) MDS system. QIES is the same system that the MDS Coordinator uses to transmit MDS data. The scores will be available for preview from January 12 through January 21, 2004. The enhanced measures will be posted to Nursing Home Compare by the end of the month, replacing the measures that appear presently. Resident level data will be provided to facilities on February 6 through the QIES system.

Qualis Health will distribute updated information concerning the enhanced set of quality measures as it becomes available later this month. For questions regarding the measures or the preview period, contact Anna Baron, project coordinator, at annab@qualishealth.org or 800-949-7536, ext 2272.