Authored by Kristine A. Schaan, M.A., CPG, NHA, Consultant

The addition of six new Nursing Home Compare quality measures has just been confirmed by the Centers for Medicare & Medicaid Services (CMS). Three of the new quality measures are based on Medicare-claims data submitted by hospitals, in contrast to data that has historically all been self-reported. The same claims-based measures also provide insight into short-stay resident outcomes. Specifically, these new claims and outcome-based measures include:

• Percent of short-stay residents successful discharged to community
• Percent of short-stay residents with outpatient emergency department visits
• Percent of short-stay residents re-hospitalized after a nursing home admission

In addition, the other three measures added are MDS-based and include:

• Percent of short-stay residents who experience improvements in function
• Percent of long-stay residents whose independent mobility worsened
• Percent of long-stay residents who received an anti-anxiety or hypnotic medication

Come July 2016, all measures with exception of the anti-anxiety or hypnotic medication measure will be incorporated into the Nursing Home Five-Star Quality Rating System. The anti-anxiety or hypnotic medication measure is being precluded by CMS as an appropriate benchmark has not yet been determined.

The addition of these measures provides consumers as well as health care providers with a more robust data set when making decisions on selecting a facility, whether that be for a loved one (consumer perspective) or as a hospital searching for preferred partners (health care provider perspective). Moreover, the move to incorporate outcome-based measures supports CMS in its pursuit of value-based payment.