Percent of short-stay residents who entered or re-entered the nursing home from a hospital and were re-admitted to a hospital for an unplanned inpatient stay or observation stay within 30 days of the start of the nursing home stay.

Nursing home stays for beneficiaries in the denominator; AND b) Were admitted to a hospital for or an inpatient stay or outpatient observation stay within 30 days of entry/re-entry to the nursing home, regardless of whether they were discharged from the nursing home prior to the hospital readmission.

Stays for residents who: a) Entered or re-entered the nursing home within 1 day of discharge from an inpatient hospitalisation (inpatient rehabilitation facility and long-term care hospitalisations are not included). These hospitalisations are identified using Medicare Part A claims; AND b) Entered or re-entered the nursing home within the target 12-month period.

Residents that did not have Fee-for-Service Parts A and B Medicare enrolment for the entire risk period; residents ever enrolled in hospice care during their stay; residents who were comatose or missing data on comatose on the first MDS assessment after the start of the stay; Data missing for any of the claims or Minimum Data Set items used to construct the numerator or denominator; resident did not have an initial Minimum Data Set assessment to use in constructing covariates for risk-adjustment.

Risk adjustment to account for differences across nursing homes in patient demographic and clinical characteristics. Covariates Constructed from Claims: age, sex, length of stay during the hospitalisation preceding the nursing home stay, any time spent in the intensive care unit during the hospitalisation preceding the nursing stay, Ever enrolled in Medicare under disability coverage, End-Stage Renal Disease (ESRD), Number of acute care hospitalisations in the 365 days before the beginning of the nursing stay, Principal diagnosis as categorized using AHRQ's single-level Clinical Classification System, Outcome-Specific Comorbidity Index(based on the clinical conditions included in the Charlson Comorbidity Index and captures the complexity beyond the linear additivity of the individual comorbidities). Covariates Constructed from MDS Items: functional status, clinical conditions, clinical treatments, clinical diagnoses and other.

Administrative Data.

Nursing Home Quality Reporting Program (CMS and Providers). CMS Care Compare - Nursing Homes including rehab services and CMS Provider Compare (CMS, providers and publicly reported).

cmit.cms.gov/cmit/#/MeasureView?variantId=3054&sectionNumber=1 www.cms.gov/medicare/quality/nursing-home-improvement/quality-measures - Nursing Home Compare Claims-Based Quality Measure Technical Specifications