COUNTDOWN DAY 2: Quality Measure Impact
Minimum data set (MDS) assessments provide the data foundation for many quality measures. The transition from MDS 3.0 version 1.17.2 to version 1.18.11 brings significant impacts to several quality measure specifications; one of the biggest changes being the shift from Section G: Functional Status to Section GG: Functional Abilities and Goals, as well as the inability to generate a RUG-IV grouper directly impacting staffing measures.
To account for these changes, CMS released Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual V16.0 and Nursing Home Five-Star Quality Rating System: Technical Users’ Guide last week.
Quality Measure Updates:
New Measures
- SNF Discharge Function Score measure (CMS ID: S042.01) will replace Percent of Residents Who Made Improvements in Function (Short Stay) (CMS ID: N037.03)
- Percent of Residents With Pressure Ulcers (Long Stay) (CMS ID: N045.01) will replace Percent of High-Risk Residents With Pressure Ulcers (LS) (CMS ID: N015.03)
- Percent of Residents With New or Worsened Bowel or Bladder Incontinence (LS) (CMS ID: N046.01) will replace Percent of Low-Risk Residents Who Lose Control of Their Bowel or Bladder (Long Stay) (CMS ID: N025.02)
Re-specified Measures to utilize Section GG items due to the removal of Section G
- Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased (Long Stay) (CMS ID: N028.03)
- Percent of Residents Whose Ability to Walk Independently Worsened (LS) (CMS ID: N035.04)
Starting in April 2024, CMS will freeze (hold constant) impacted quality measures on Nursing Home Care Compare.
Public reporting for these measures is scheduled to resume in January 2025 or as soon as technically feasible.
Nursing Home Five-Star Quality Rating Staffing Updates
- In July 2024, CMS will post nursing home staffing measures based on the new staffing case-mix adjustment methodology derived from PDPM as outlined in the appendix: “Updated Case-Mix Adjustment Methodology for Staffing Level Measures”
- CMS will revise the staffing rating thresholds to maintain the same overall distribution of points for affected staffing measures.
- Beginning in April 2024, CMS will freeze (i.e., hold constant) the staffing measures for three months while they transition to a SNF payment PDPM replacing the RUG-IV methodology.
Resources
- Quality Measures Website
- MDS 3.0 Quality Measures User’s Manual V16.0
- Nursing Home Five-Star Quality Rating System: Technical Users’ Guide
- QSO-23-21-NH
- Nursing Home Care Compare
Be on the lookout for tomorrow’s blog: Interdisciplinary Communication
IN CASE YOU MISSED IT
