New Quality Measures on Nursing Home Compare

On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) added six new quality measures to the Nursing Home Compare website. This was done as part of an initiative to broaden the quality of information available on the site. For the first time, CMS is including quality measures that are not based solely on data that are self-reported by nursing homes. These new measures are based primarily on Medicare claims data submitted by hospitals. They measure the rate of rehospitalization, emergency room use, and community discharge among nursing home residents. The six new measures 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 rehospitalized after a nursing home admission (Medicare claims- and MDS-based)
4. Percentage of short-stay residents who made improvements in function (Minimum Data Set (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)

These newly added measures will be reported on Nursing Home Compare. However, they will not be incorporated into the methodology to compute nursing home star ratings until July 2016.

These new quality measures represent the largest addition of quality measures to Nursing Home Compare since CMS introduced quality measures information in 2003. More importantly, with this change, CMS is nearly doubling the number of short-stay measures on Nursing Home Compare. This  change also provides 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. Short-stay measures reflect care provided to residents who are in the nursing home for 100 days or less. Long-stay measures reflect care for residents who are in the nursing home for more than 100 days.

Your AlixaRx Clinical Pharmacists (ACPs) can be a valuable asset to improve compliance with existing and new quality measures.  ACPs provide prospective and retrospective medication reviews and change of condition medication reviews. These reviews help to improve the care of your residents and avoid medication-related events that may lead to rehospitalizations.  Your clinical pharmacists assess medication therapy in at least three settings:

1. In the AlixaRx pharmacy hubs, pharmacists review all new admission and new medication orders prior to dispensing;
2. In your facility, ACPs conduct monthly comprehensive Medication Regimen Reviews, change of condition medication reviews, and participate in various patient care and quality improvement meetings; and
3. In the AlixaRx Medication Review and Optimization Center (MROC), all orders for new admissions and new orders for high risk medications are reviewed within 24-72 hours.  Please contact your AlixaRx Clinical Pharmacist if you are interested in this service.

AlixaRx Clinical Pharmacists work collaboratively with each other and your facility staff to improve patient care and regulatory compliance.

References: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-04-27.html

This article was originally published in our monthly issue of From the Front Lines – a monthly publication that shares best practices and medication-related challenges faced by “front line” staff in long-term care and post-acute (LTCPAC) facilities.

>>> From the Front Lines – July 2016 <<<