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Nursing Home Compare expanded by six quality measures

Now has 24 measures for 15,655 nursing homes

People in hallway of nursing homeMay 2, 2016 - Six new quality measures have been added to the Nursing Home Compare website and three are the first to be based on Medicare-claims data from hospitals, rather than data self-reported by nursing homes.

With these updates, it now reports information on 24 quality measures for 15,655 nursing home providers on Nursing Home Compare.

These three measure the rate of re-hospitalization, emergency room use, and community discharge among nursing home residents, according to a news release from the Centers for Medicare & Medicaid Services (CMS).

They include:

1.   Percentage of short-stay residents who were successfully discharged to the community (claims-based)

2.   Percentage of short-stay residents who have had an outpatient emergency department visit (claims-based)

3.   Percentage of short-stay residents who were re-hospitalized after a nursing home admission (claims-based)

4.   Percentage of short-stay residents who made improvements in function (MDS-based)

5.   Percentage of long-stay residents whose ability to move independently worsened (MDS-based)

6.   Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based)

“These new quality measures broaden the set of quality measures already on the site so that patients, their family members, and caregivers have more meaningful information when they consider facilities,” said CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., MSc.

With today’s quality measure updates, CMS is nearly doubling the number of short-stay measures, which reflect care provided to residents who are in the nursing home for 100 days or less, on Nursing Home Compare. CMS is also 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.

Beginning in July 2016, CMS will incorporate all of these measures, except for the antianxiety/hypnotic medication measure, into the calculation of the Nursing Home Five-Star Quality Ratings. CMS is not incorporating the antianxiety/hypnotic medication measure because it has been difficult to determine appropriate nursing home benchmarks for the acceptable use of these medications.

(Read more in the CMS Fact Sheet below.)


 

Fact Sheet from CMS

New Quality Measures on Nursing Home Compare

Nursing Home Compare is a user-friendly federal web tool 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:

1.    Percentage of short-stay residents who were successfully discharged to the community (Medicare claims- and MDS-based)

2.    Percentage of short-stay residents who have had an outpatient emergency department visit (Medicare claims- and MDS-based)

3.    Percentage of short-stay residents who were rehospitalized after a nursing home admission (Medicare claims- and MDS-based)

4.    Percentage of short-stay residents who made improvements in function (Minimum Data Set (MDS)-based)

5.    Percentage of long-stay residents whose ability to move independently worsened (MDS-based)

6.    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.

Background

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.


 

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