The National Nursing Home Quality Initiative was launched on November 12, 2002. In January 2004, the Centers for Medicare & Medicaid Services (CMS) updated the quality measures to include 19 enhanced measures.
Quality Strategy
The quality initiative, an important component of CMS’s comprehensive strategy to improve the quality of care provided by America’s nursing homes is a four-prong effort that consists of:
- Improved consumer information of quality of care
- Continual community-based quality improvement programs designed for nursing homes to improve the quality of care
- Collaboration and partnership to leverage knowledge and resources
- Regulation and enforcement efforts conducted by state survey agencies and CMS
Healthcare Quality Strategies (HQSI’s) work with an intensive group of volunteer nursing facilities began in November 2002. Quality improvement strategies, data abstraction education and, personal site visits by a staff of professional nurses resulted in improvement with the quality measures pain, infections, and pressure ulcers. HQSI will continue to assist New Jersey nursing homes in their effort to continue to provide quality care for the residents they serve.
CMS established the Nursing Home quality measures by using patient and administrative data reported by all Medicare and Medicaid certified nursing homes. The quality measures come from the assessment data (Minimum Data Set or MDS) that nursing homes routinely collect on residents at specified intervals during their stays. The information collected pertains to the resident’s physical and clinical conditions and abilities, as well as family preferences and life care wishes.
Nineteen quality measures (QM’s) were selected by CMS in targeting both the chronic and post-acute care populations.
“Chronic” care (CC) refers to those types of patients who enter a nursing facility typically because they are no longer able to care for themselves at home. These residents tend to remain in the nursing facility from months to several years.
“Post Acute” care (PAC) refers to those types of patients who are admitted to a facility and typically stay fewer than 30 days. These admissions typically follow an acute care hospitalization and involve high-intensity rehabilitation or clinically complex care.
Enhanced Quality Measures:
There are fourteen “chronic” care quality measures to be used for used for national reporting on www.medicare.gov
- Percent of long-stay residents given infuenza vaccination during the flu season NEW!
- Percent of long-stay residents who were assessed and given pneumococcal vaccination NEW!
- Percent of long-stay residents whose need for help with daily activities has increased
- Percent of long-stay residents who have moderate to severe pain
- Percent of high-risk long-stay residents who have pressure sores
- Percent of low-risk long-stay residents who have pressure sores
- Percent of long-stay residents who were physically restrained
- Percent of long-stay residents who are more depressed or anxious
- Percent of low-risk long-stay residents who lose control of their bowels or bladder
- Percent of long-stay residents who have/had a catheter inserted and left in their bladder
- Percent of long-stay residents who spend most of their time in bed or in a chair
- Percent of long-stay residents whose ability to move about in and around their room got worse
- Percent of long-stay residents with a urinary tract infection
- Percent of long-stay residents who lose too much weight
There are five "post acute" care quality measures. They include the following: short-stay
- Percent of short-stay residents given the influenza vaccination during the flu season NEW!
- Percent of short-stay residents who were assessed and given pneumococcal vaccination NEW!
- Percent of short-stay residents with delirium
- Percent of short-stay residents who had moderate to severe pain
- Percent of short-stay residents with pressure sores