NQF Nursing Home Steering Committee Considers MDS 3.0 Quality Measures

VHCA (5/7/2010)

The National Quality Forum (NQF), National Voluntary Consensus Standards for Nursing Homes has started selection of a core set of chronic and post acute care measures for public reporting.  The steering committee considered 25 candidate measures and approved or provisionally approved 18 measures.   Provisional approval may include the need for slight modification to denominator definition, request for more data to justify measure intent, or more measure testing recommended before public release.  The following candidate measures were approved or provisionally approved:

• Percent of residents whose need for help with daily activities has increased (long stay)
• Percent of residents who lose too much weight (long stay)
• Percent of residents who have symptoms of major depression (long stay)
• Falls: Percent of residents who receive physical therapy/assistive device for new balance problem 
• Percent of residents experiencing one or more falls with major injury (long stay)
• Percent of residents with effective pain management (short stay)
• Percent of residents who have moderate to severe pain (short stay)
• Percent of residents who have moderate to severe pain (long stay)
• Percent of residents with pressure ulcers (Stage 2-4) that are new or have not improved (short stay)
• Percent of high risk residents with pressure ulcers (long stay)
• Percent of residents who were assessed and given the seasonal influenza vaccine during the flu season (short stay)
• Percent of residents who were assessed and given the seasonal influenza vaccine (long stay)
• Percent of residents who were assessed and given the pneumococcal vaccine (short stay)
• Percent of residents who were assessed and given the pneumococcal vaccine (long stay)
• Percent of residents with a urinary tract infection (long stay)
• Percent of resident who lose control of their bowels or bladder (long stay)
• Percent of residents who have/had a catheter inserted and left in their bladder (long stay)
• Percent of residents who were physically restrained (long stay)

Measures rejected by the nursing home steering committee included two measures on staffing mix and care hours per patient day, assessment of dementia, behavioral interventions for worsening urinary incontinence, and two additional measures on patient falls. Until a better measure is produced, the committee deferred a long stay measure related to the percent of residents whose ability to move in and around their room and adjacent corridors worsened.  NQF plans to post the nursing home measures for member and public comment on August 25, 2010 – September 24, 2010.  The final NQF nursing home measure report is due to the Centers for Medicare & Medicaid Services (CMS) by December 31, 2010.  CMS holds the right to consider the NQF measure recommendations and to decide whether to accept the measures.  CMS may decide to add new measures, including those rejected by the NQF nursing home steering committee.