National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013
Measures
Adult home health care patients whose ability to walk or move around improved
Long-stay nursing home residents whose ability to move about in and around their room decreased
Adult home health care patients whose ability to get in and out of bed improved
Long-stay nursing home residents whose need for help with daily activities increased
Long-stay nursing home residents with most of their time spent in bed or in a chair
Adult home health care patients whose bathing improved
Adult home health care patients whose management of oral medications improved
Measure Title
Adult home health care patients whose ability to walk or move around improved
Measure Source
Centers for Medicare & Medicaid Services (CMS), Home Health Quality Initiative (HHQI)
Table Description
Geographic Representation
National, States
Years Available
States: 2006-2011
National: 2002-2011
Population Subgroups
Age, gender, race/ethnicity
Data Source
National & State
CMS, Home Health Outcome and Assessment Information Set (OASIS)
Denominator
All valid home health care episodes that began in the survey year, excluding episodes with nonresponsive patients
Numerator
Subset of the denominator in which a person improved at walking or moving around compared with a prior assessment
Comments
The OASIS instrument measures ambulation or locomotion ability on a 7-level scale from 0 (full, independent ambulation) to 6 (bedfast).
Further information about HHQI measures is available at http://www.cms.hhs.gov/HomeHealthQualityInits/.
Measure Title
Long-stay nursing home residents whose ability to move about in and around their room decreased
Measure Source
Centers for Medicare & Medicaid Services (CMS), Nursing Home Quality Initiative (NHQI)
Table Description
Geographic Representation
National, State
Years Available
State: 2006-2010
National: 2000-2010
Population Subgroups
Age, gender, race/ethnicity
Data Sources
National & State
CMS, Nursing Home Minimum Data Set (MDS)
Denominator
Medicare chronic care nursing home residents with a valid target assessment and a valid prior assessment. Excludes: residents with missing values on the target assessment; residents for which assessment performance indicated "total dependence" or "activity did not occur"; residents with missing values on the prior assessment; residents with comatose status or end-stage disease; residents receiving hospice care; and residents with unknown status for these conditions on the target assessment.
Numerator
Subset of the denominator for which locomotion self-performance scores got worse compared with a prior assessment
Comments
Estimates are risk adjusted using resident-level covariates.
This measure excludes admission assessments; and residents with missing values on the target assessment or with "total dependence," "activity did not occur," or missing values on the prior assessment; residents with comatose status, residents with end-stage disease; residents receiving hospice care; and residents with unknown status for these conditions on the target assessment. Facilities with fewer than 30 residents in the denominator are excluded. Long-stay residents enter a nursing facility typically because they can no longer care for themselves at home; they tend to remain in the facility for several months or years. For details about this and other NHQI measures, refer to the documentation available at: http://www.cms.hhs.gov/NursingHomeQualityInits/.
Measure Title
Adult home health care patients whose ability to get in and out of bed improved
Measure Source
Centers for Medicare & Medicaid Services (CMS), Health Quality Initiative (HHQI)
Table Description
Geographic Representation
National, State
Years Available
State: 2006-2011
National: 2002-2011
Population Subgroups
Age, gender, race/ethnicity
Data Source
National and State
CMS, Home Health Outcome and Assessment Information Set (OASIS)
Denominator
All valid home health care episodes that begin in the survey year, excluding episodes with nonresponsive patients
Numerator
Subset of the denominator in which a person improved at getting in and out of bed compared with a prior assessment in the episode
Comments
The OASIS instrument measures transfers on a 6-level scale from 0 (independent) to 5 (bedfast and unable to turn or position) Further information about HHQI measures is available at http://www.cms.hhs.gov/HomeHealthQualityInits/.
Measure Title
Long-stay nursing home residents whose need for help with daily activities increased
Measure Source
Centers for Medicare & Medicaid Services (CMS), Nursing Home Quality Initiative (NHQI)
Table Description
Geographic Representation
National, State
Years Available
State: 2006-2011
National: 2000-2011
Population Subgroups
Age, gender, race/ethnicity
Data Source
National & State
CMS, Nursing Home Minimum Data Set (MDS)
Denominator
Medicare chronic care nursing home residents with a valid target assessment and a valid prior assessment, excluding residents who cannot show decline due to maximum values on prior assessments; residents with comatose status, residents with a less than 6-month prognosis; residents receiving hospice care; and residents with unknown status for these conditions.
Numerator
Subset of the denominator with worsening performance scores in at least two or more of the four late-loss activities of daily living (bed mobility, transfers, toilet use, and eating) or who are at have a worsening of at least 2 on one of the four activities
Comments
Long-stay quality measures include all residents in an episode whose cumulative days in the facility is greater than or equal to 101 days at the end of the target period. An episode is a period of time spanning one or more stays, beginning with an admission and ending with either a discharge or the end of the target period (whichever comes first). The target period used for these measures ended on December 31, 2011.
For details about this and other NHQI measures, refer to the documentation available at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html.
Measure Title
Long-stay nursing home residents who spent most of their time in bed or in a chair
Measure Source
Centers for Medicare & Medicaid Services (CMS), Nursing Home Quality Initiative (NHQI)
Table Description
Geographic Representation
National, State
Years Available
State: 2006-2010
National: 2000-2010
Population Subgroups
Age, gender, race/ethnicity
Data Sources
National & State
CMS, Nursing Home Minimum Data Set (MDS)
Denominator
Medicare chronic care nursing home residents with a valid target assessment, excluding admission assessments and residents who are comatose
Numerator
Subset of the denominator who were bedfast on target assessment
Comments
Facilities with fewer than 30 residents in the denominator and those with incomplete or missing MDS data are excluded.
Long-stay residents enter a nursing facility typically because they can no longer care for themselves at home; they tend to remain in the facility for several months or years.
For details about this and other NHQI measures, refer to the documentation available at: http://www.cms.hhs.gov/NursingHomeQualityInits/.
Measure Title
Adult home health care patients whose bathing improved
Measure Source
Centers for Medicare & Medicaid Services (CMS), Home Health Quality Initiative (HHQI)
Table Description
Geographic Representation
National, State
Years Available
State: 2006-2011
National: 2002-2011
Population Subgroups
Age, gender, race/ethnicity
Data Sources
National & State
CMS, Home Health Outcome and Assessment Information Set (OASIS)
Denominator
All valid home health care episodes that begin in the survey year, excluding episodes with nonresponsive patients
Numerator
Subset of the denominator in which a person’s ability to bathe improved compared with a prior assessment in the episode
Comments
The OASIS instrument measures bathing ability on a 7-level scale from 0 (fully independent) to 6 (completely dependent). Further information about HHQI measures is available at http://www.cms.hhs.gov/HomeHealthQualityInits/.
Measure Title
Adult home health care patients whose management of oral medications improved
Measure Source
Centers for Medicare & Medicaid Services (CMS), Home Health Quality Initiative (HHQI)
Table Description
Geographic Representation
National, State
Years Available
State: 2006-2011
National: 2002-2011
Population Subgroups
Age, gender, race/ethnicity
Data Sources
National and State
CMS, Home Health Outcome and Assessment Information Set (OASIS)
Denominator
All valid home health care episodes that begin in the survey year, excluding people who are episodes with nonresponsive or have missing oral medication management data
Numerator
Subset of the denominator in which a person showed improvement in ability to manage oral medications compared with a prior assessment in the episode
Comments
The OASIS instrument measures management of oral medications on a 4-level scale from 0 (fully independent) to 3 (entirely dependent) and refers to ability, not medication compliance.
Further information about HHQI measures is available at http://www.cms.hhs.gov/HomeHealthQualityInits/.
Page originally created July 2014
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