Trends in Publicly Reported Nursing Facility Quality Measures

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1 Trends in Publicly Reported Nursing Facility Quality Measures American Health Care Association Reimbursement and Research Department January 2011

2 Trends in Publicly Reported Nursing Facility Quality Measures TABLE OF CONTENTS Table of Contents...2 Chronic Care: Physical Condition and Depression...3 Chronic Care: Physical Functioning and Weight Loss...4 Chronic Care: Urinary System...5 Post Acute Care...6 Overview of CMS Nursing Facility Quality Measures...7 Contact Information...8 American Health Care Association Reimbursement and Research Department 2

..3 Chronic Care: Physical Functioning and Weight Loss...4 Chronic Care: Urinary System.

3 2002Q2 2002Q3 2002Q4 2003Q1 2003Q2 2003Q3 2003Q4 2004Q1 2004Q2 2004Q3 2004Q4 2005Q1 2005Q2 2005Q3 2005Q4 2006Q1 2006Q2 2006Q3 2006Q4 2007Q1 2007Q2 2007Q3 2007Q4 2008Q1 2008Q2 2008Q3 2008Q4 2009Q1 2009Q2 2009Q3 2009Q4 2010Q1 2010Q2 2010Q3 Trends in Nursing Facility Chronic Care Quality Measures: Physical Condition and Depression Related 18.0% 16.0% 14.0% 14.6% 13.8% 14.1% 12.0% 10.0% 8.0% 10.7% 9.7% 10.3% 6.0% 4.0% 3.2% 2.0% 0.0% 2.8% 1.8% 2.6% Depression High Risk Pressure Ulcer Physical Restraints Pain Low Risk Pressure Ulcer Source: Computed by AHCA R&R Department using CMS Nursing Home Compare. Various years and quarters. American Health Care Association - Reimbursement and Research Department 6

0% 14.0% 14.6% 13.8% 14.1% 12.0% 10.0% 8.0% 10.7% 9.7% 10.3% 6.0% 4.0% 3.2% 2.0% 0.0% 2.8% 1.8% 2.

4 Trends in Nursing Facility Chronic Care Quality Measures: Physical Functioning and Weight Loss Related 18.0% 16.0% 15.4% 14.0% 12.0% 12.0% 13.9% 10.7% 10.0% 8.0% 8.9% 7.4% 6.0% 4.0% 4.4% 3.9% 2.0% 0.0% ADL Locomotion Weight Loss Bedfast Source: Computed by AHCA R&R Department using CMS Nursing Home Compare. Various years and quarters. American Health Care Association - Reimbursement and Research Department 6

0% ADL Locomotion Weight Loss Bedfast Source: Computed by AHCA R&R Department using CMS Nursing Home

5 Trends in Nursing Facility Chronic Care Quality Measures: Urinary System Related 60.0% 51.6% 50.0% 46.3% 40.0% 30.0% 20.0% 10.0% 8.4% 9.0% 0.0% 5.7% 4.8% Incontinence UTIs Catheter Source: Computed by AHCA R&R Department using CMS Nursing Home Compare. Various years and quarters. American Health Care Association - Reimbursement and Research Department 6

8% Incontinence UTIs Catheter Source: Computed by AHCA R&R Department using CMS Nursing

6 2002Q2 2002Q3 2002Q4 2003Q1 2003Q2 2003Q3 2003Q4 2004Q1 2004Q2 2004Q3 2004Q4 2005Q1 2005Q2 2005Q3 2005Q4 2006Q1 2006Q2 2006Q3 2006Q4 2007Q1 2007Q2 2007Q3 2007Q4 2008Q1 2008Q2 2008Q3 2008Q4 2009Q1 2009Q2 2009Q3 2009Q4 2010Q1 2010Q2 2010Q3 Trends in Nursing Facility Post-Acute Care Quality Measures 30.0% 25.4% 25.0% 20.0% 20.4% 19.1% 15.0% 11.8% 10.0% 5.0% 3.7% 1.2% 0.0% Pain Pressure Ulcer Delirum Source: Computed by AHCA R&R Department using CMS Nursing Home Compare. Various years and quarters. American Health Care Association - Reimbursement and Research Department 6

Quality Measures 30.0% 25.4% 25.0% 20.0% 20.4% 19.1% 15.0% 11.8% 10.0% 5.0% 3.7% 1.2% 0.

7 Overview of CMS Nursing Facility Quality Measures Nursing Facility (NF) Quality Measures (QM) data are computed and updated quarterly by the Centers for Medicare & Medicaid Services (CMS), and are publicly reported on the Nursing Home Compare website ( There is generally a three to four month lag between the end date of the target quarter over which the QMs are calculated, and when the QMs are reported on Nursing Home Compare. The nursing facility QMs are derived from the Minimum Data Set (MDS) and area reported at the facility level. Subject to a number of exclusions, the score for each facility-level QM is computed as the ratio of the sum of eligible residents in the facility with a particular condition to the sum of eligible residents in the facility. The state-level QMs reported below are computed as the unweighted average of available facility-level QMs. A brief description of each QM is found below. A more detailed snap shot of how the QMs are calculated can be found at: CMS Nursing Facility Quality Measures Measure Description Look Back Period Chronic Care Pain Percent of Residents who have Moderate to Severe Pain 7 days High Risk Pressure Ulcer Percent of High-Risk Residents Who Have Pressure Sores 7 days Low Risk Pressure Ulcer Percent of Low-Risk Residents Who Have Pressure Sores 7 days Physical Restraint Percent of Residents Who Were Physically Restrained 7 days Depression Percent of Residents Who are More Depressed or Anxious 30 Days Weight Loss Percent of Residents Who Lose Too Much Weight 30 days ADL Percentage of Residents Whose Need for Help With Daily Activities has Increased 7 Days Bedfast Locomotion Indwelling Catheter Incontinence 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 Who Have/Had a Catheter Inserted and Left in Their Bladder Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder 7 days 7 days 7 days 14 days UTI Percent of Residents with Urinary Tract Infection 30 days Influenza Vaccination Pneumococcal Vaccination Percent of Residents Given Influenza Vaccination During the Flu Season Percent of Residents Who Were Assessed and Given Pneumococcal Vaccination October 1 thru March 31 5 years Post Acute Care Delirium Percent of Short-Stay Residents With Delirium 7 days Pain Percent of Residents Who Had Moderate to Severe Pain 7 days Pressure Ulcer Percent of Short-Stay Residents With Pressure Sores 7 Days Influenza Vaccination Pneumococcal Vaccination Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination October 1 March 31 5 Years 7

There is generally a three to four month lag between the end date of the target quarter over which the QMs are calculated, and when the QMs are reported on Nursing Home Compare.

8 American Health Care Association 1201 L Street, NW Washington, DC, T: (202) research@ahca.org 8

UNDERSTANDING THE REPORTS

3 UNDERSTANDING THE REPORTS KEY CONCEPTS AND TERMS...2 A QUICK GUIDE TO THE QIS/QMS...3 CHRONIC CARE MEASURES...4 POST-ACUTE CARE (PAC) MEASURES...9 COMPARISON OF OLD AND NEW RECORD SELECTION METHODS FOR