Wednesday, April 27, 2016

New Measures are Live on Nursing Home Compare!



Holly Harmon, RN, MBA, LNHA
AHCA Senior Director of Clinical Services



The CMS Nursing Home Compare website now includes six new quality measures, four short-stay and two long-stay measures. The measures are:

Short-Stay

  • Percentage of short-stay residents who made improvement in function (MDS-based)
  • Percentage of short-stay residents who were successfully discharged to the community (Claims-based)
  • Percentage of short-stay residents who were rehospitalized after a nursing home admission (Claims-based)
  • Percentage of short-stay residents who had an outpatient emergency department visit (Claims-based)
Long-Stay
  • 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)
Five of the six new measures (not including antianxiety/hypnotic use) will be added to the Five-Star quality measure component starting in July. Although CMS has not yet announced the specific schedule for when these new measures will affect the Five-Star rating, a phase-in of the measures is expected.

Four key points to consider and explore regarding these changes:


1) Accountability after Discharge - Recognize that three of the new short-stay measures include outcomes after discharge from the center. The three measures are discharge to community, rehospitalization and emergency department use. Traditional discharge planning and assumed release of responsibility after the day of discharge will not position a center for success in this changing healthcare environment. 

What can you do? Evaluate your systems and processes around care transitions and pursue performance improvement opportunities to achieve improved outcomes. 

2) Influence of Short-Stay Outcomes - As the new measures are added to Five-Star starting in July, the quality measure component will be more influenced by quality measure performance for the short-stay population than it has in the history of the Five-Star rating system for nursing centers. Eventually, there will be seven short-stay measures versus three short-stay measures contributing to the Five-Star quality measure component.

What can you do?
Know the person, each individual served in your center from day one. Understand the needs of your short-stay population. Use root cause analysis often to support continuous improvement.

3) Claims Based - This is the first time claims based measures will be used on Nursing Home Compare and eventually the Five-Star Quality Rating System. Hospital claims for Medicare Part A and Medicare Part B are a source of information for the new short-stay claims based measures.

What can you do? Verify that the right systems and processes are in place in your center for timely submission of MDS and claims. Develop channels with local hospitals to foster timely communication and coordination as individual patients and residents move to and from hospitals and nursing centers.

4) Quality Strategy - Pursuing the AHCA Quality Initiative goals position members for success in this changing world where quality and payment are becoming one and successful patient and resident outcomes determine business success.

What can you do?
Embark on the AHCA Quality Initiative today! Explore the Getting Started Guide.

AHCA offers several resources to help members along the journey of quality improvement. Visit LTC Trend Tracker to dig into your data, ahcancalED for online education specifically tailored to post-acute and long term care and AHCA Quality Initiative goals for many resources available to apply into every day practice.

To learn more about what you can do to prepare for upcoming Five-Star changes, click here.


Read more about the CMS additions here and here.

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