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A Postacute Care Function Process Quality Measure for the Collection of Standardized Self-Care and Mobility Data: Development, Implementation, and Quality Measure Scores

Published:February 11, 2022DOI:https://doi.org/10.1016/j.apmr.2022.01.148

      Abstract

      Objective

      To describe the development of and quality measure scores for the cross-setting postacute care function process quality measure that requires the collection of standardized self-care and mobility data at admission and discharge and at least 1 function goal.

      Design

      Description of the development and implementation of the quality measure and the associated standardized self-care and mobility data elements. Descriptive analyses of quality measure scores for the first calendar year using data from the Minimum Data Set, the Inpatient Rehabilitation Facility Patient Assessment Instrument, the Long-Term Care Hospitals (LTCH) Continuity Assessment Record and Evaluation Data Set, and Outcome and Assessment Information Set.

      Setting

      15,127 skilled nursing facilities (SNFs), 1129 inpatient rehabilitation facilities (IRFs), 414 LTCHs, and 10,352 home health agencies (HHAs) in the United States.

      Participants

      In total there were 9,216,943 stays/quality episodes (N = 9,216,943), including 2,084,774 SNF Medicare fee-for-service patient stays, 493,209 IRF Medicare patient stays, 161,714 patient stays, and 6,477,246 Medicare and Medicaid quality episodes.

      Interventions

      Not applicable.

      Main Outcome Measures

      Scores for the cross-setting postacute care function process quality measure.

      Results

      The mean process quality measure scores for SNFs, IRFs, LTCHs, and HHAs were 95.5%, 99.7%, 99.1%, and 95.8, respectively. The 10th percentile scores for SNFs, IRFs, LTCHs, and HHAs were 88.5%, 99.3%, 98.4%, and 89.4, respectively, indicating that at least 90% of postacute care providers submitted the standardized data for a large proportion of their patients. Mean quality measure scores did not vary by provider characteristics.

      Conclusions

      Most SNFs, IRFs, LTCHs, and HHAs submitted the self-care and mobility data, resulting in high quality measure scores during the first year of implementation. The availability of the standardized self-care and mobility data across postacute care settings offers the opportunity to compare the characteristics and functional outcomes of patients treated in postacute care.

      Keywords

      List of abbreviations:

      CARE (Continuity Assessment Record and Evaluation), CMS (Centers for Medicare & Medicaid Services), HHA (home health agency), IMPACT Act (Improving Medicare Post-Acute Care Transformation Act), IRF (inpatient rehabilitation facility), LTCH (long-term care hospital), NQF (National Quality Forum), PAC (post-acute care), QRP (Quality Reporting Program), SNF (skilled nursing facility)
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