CMS 5 Star Rating; Quality Measures

CMS 5 Star Quality Rating
Quality Measures / Quality Indicators
 
The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which you may want to ask questions.  This rating system is based on continued efforts as a result of the Omnibus Reconciliation Act of 1987 (OBRA '87), a nursing home reform law, and more recent quality improvement campaigns such as the Advancing Excellence in America's Nursing Homes, a coalition of consumers, health care providers, and nursing home professionals.
 
Nursing home ratings are taken from the following three sources of data:

Health Inspections
Staffing
Quality Measures
It is critical for facilities to be well versed on the quality measures used in the process of calculating the 5 Star Rating. 
 
CMS describes several limitations with the use Quality Measures:
Self-Reported Data:  The quality measures are self-reported by the nursing home, rather than collected and reported by an independent agency.
Just a Few Aspects of Care:  The quality measures represent only a few of the many aspects of care that may be important to you.
Not Adjusted for the Population:  The quality measures are not adjusted for any special characteristics that residents of a particular nursing home may have, compared to most other nursing homes.  More specialized nursing homes may look better or worse with respect to any particular quality measure, depending on how different the population is compared to the residents in most other nursing homes.
The Quality Measures are as follows:
 

Long-stay Prevalence measures:
ADL change
Mobility change
High-risk pressure ulcers
Long-term catheters
Physical restraints
Urinary Tract Infection (UTIs)
Pain
 Short-Stay Prevalence Measures:
Delirium
Pain
Pressure Ulcers
Kris B Harmony will continue to discuss Quality Measures in subsequent newsletters with MDS coding and training tips to ensure accurate coding and measures which represent the facility and improve the 5 Star Qualtiy Rating.