CMS Adds Six Quality Measures to Nursing Home Compare

April 29, 2016
Policy Snapshot
Skilled Nursing Care, Centers for Medicare and Medicaid (CMS), Federal Regulations, Quality, Measures

This week the Centers for Medicare & Medicaid Services (CMS) added six new quality measures to the Nursing Home Compare website. Three of these six new quality measures are based on Medicare-claims data submitted by hospitals, which is significant because this is the first time CMS is including quality measures that are not based solely on data that are self-reported by nursing homes. These three quality measures measure the rate of rehospitalization, emergency room use, and community discharge among nursing home residents. They 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 re-hospitalized after a nursing home admission (Medicare claims- and MDS-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)

With these additional measures, 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.