Percent of Residents Whose Need for Help With Activities of Daily Living Has Increased
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
This measure reports the percent of long-stay residents whose need for help with late-loss Activities of Daily Living (ADLs) has increased when compared to the prior assessment.
Numerator
Long-stay residents with selected target and prior assessments that indicate the need for help with late-loss Activities of Daily Living (ADLs) has increased when the selected assessments are compared. The four late-loss ADL items are self-performance bed mobility, self-performance transfer, self-performance eating, and self-performance toileting. An increase is defined as an increase in two or more coding points in one late-loss ADL item or one point increase in coding points in two or more late-loss ADL items. Note that for each of these four ADL items, if the value is equal to on either the target or prior assessment, then recode the item to equal to allow appropriate comparison
Denominator
All long-stay residents with a selected target and prior assessment, except those with exclusions.
Exclusions
- All four of the late-loss ADL items indicate total dependence on the prior assessment, 2. Three of the late-loss ADLs indicate total dependence on the prior assessment, 3. If resident is comatose on the target assessment. 4. Prognosis of life expectancy is less than 6 months on the target assessment. 5.Hospice care on the target assessment. 6. The resident is not in the numerator on the prior or target assessment: Bed Mobility, Transferring, Eating, OR Toileting
Use of Risk Adjustment
Risk Adjustments
None
Stratifications
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Nursing Home Minimum Data Set (MDS) Resident Assessment Instrument
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Public report, available from www.medicare.gov/care-compare/
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/nursinghomequalityinits/nhqiqualitymeasures Fitzler, S., Raia, P., Buckley, F. O., & Wang, M. (2016). Does Nursing Facility Use of Habilitation Therapy Improve Performance on Quality Measures? American Journal of Alzheimer's Disease and other Dementias, 31(8), 687-692. Konetzka, R. T., Brauner, D. J., Coca Perraillon, M., & Werner, R. M. (2015). The Role of Severe Dementia in Nursing Home Report Cards. Medical care research and review : MCRR, 72(5), 562-579.