Quality Measures are related to specific areas of care. The measures are derived from assessment data completed by the nursing homes. The quality measures are intended to provide objective means by which an individual can determine how well a nursing home's staff is able to manage various aspects of care being provided to their residents.

There are 8 quality measures, which are divided into 2 different groups: chronic and post-acute. The chronic group looks at residents who have been in the facility for longer than 3 months. The acute group looks at data from residents during their first two weeks in the facility. In all but one of the quality measures (improvement in a resident's ability to walk), a lower number is a better score than a higher number. The following is a list of the quality measures with a brief description of what they are measuring:

Chronic

Percent of Residents with Pain - This area measures the percentage of chronic residents who have either moderate daily pain or excruciating pain at least once during the assessment period.

Percent of Residents with Infections - This area measures the percentage of chronic residents with infections or symptoms of infections. A few examples of infections are pneumonia, fever, or urinary tract infection.

Percent of Residents with Pressure Sores - This area measures the percentage of chronic residents with one or more pressure ulcers at any stage.

Percent of Residents with Pressure Sores with an Additional Level of Risk Adjustment - Adjusts the percentage of chronic residents with one or more pressure ulcers using facility specific information. For example, there are nursing homes that are specialized in healing pressure ulcers. If a resident develops a pressure ulcer at home or in the hospital, for example, they may come to a nursing home to have the pressure ulcer healed. This facility specific information will adjust the pressure ulcer rate so that the nursing home is not penalized for admitting this type of resident.

Percent of Residents in Physical Restraints - This area measures the percentage of chronic residents who are physically restrained (upper body, limbs, or lower body). A few examples of devices that are considered a physical restraint are seatbelts, side rails or gerichairs.

Percentage of Residents who had an unexplained loss of function in some basic Daily Activity - This area measures the percentage of chronic residents who lost their ability or declined in their ability to feed themselves, move around in bed, transfer themselves from a bed to a chair, or use the toilet.

Acute

Percentage of Short-Stay Residents with Pain - This area measures the percentage of short-stay residents who have either moderate daily pain or excruciating pain at least once during the assessment period.

Percentage of Short-Stay Residents with Delirium - This area measures the percentage of short-stay residents who develop a quick change in condition that affects awareness, attention, perception, and understanding of what is going on around them.

Percentage of Short-Stay Residents with Delirium with an Additional Level of Risk Adjustment - This area measures the percent of short-stay residents with delirium, but adjusts it for facility specific information. For example, if a facility admits frail or very sick residents, their residents may have delirium upon admission due to confusion of surroundings, etc. This facility specific information will adjust the short-stay delirium rate so that the nursing home is not penalized for admitting this type of resident.

Percent of Short-Stay Residents Who Walk as Well or Better on Day 14 as on Day 5 of their Stay - This area measures the percentage of short-stay residents whose level of independence in walking has been maintained or improved between 5-day and 14-day assessment periods. Higher values on this measure indicate better quality in this indicator.

For more information, see:
http://www.aahsa.org/member/healthlinks/QIdefinitions.pdf

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