Percent of Residents Whose Need for Help With Activities of Daily Living Has Increased

Identifying Attributes

Care Settings
Residential Aged Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Minimum Data Set (MDS) 3.0 Resident Assessment Instrument Quality Measures
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Function / Activities of Daily Living

Defining Attributes

Definition

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 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. Residents meet the definition of increased need of help with late-loss ADLs if either of the following are true 1. At least two of the following are true: 1.1 Bed mobility, or 1.2 Transfer, or 1.3 Eating, or 1.4 Toileting. 2. At least one of the following is true: 2.1 Bed mobility, or 2.2 Transfer, or 2.3 Eating, or 2.4 Toileting.

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, as indicated by: Sit to Lying, Sit to Stans, Eating, Toilet Transfer. Resident is comatose, prognosis of life expectancy is less than 6 months, hospice care.

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

None

Data Attributes

Type of Data Collection
Standardised clinical data
Data Collection Methods

Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI).

Frequency of Data Collection
90 days
Frequency of Data Collection in Days
90
Reporting Methods

Nursing Home Care Comparison publicly reported on CMS website of all Medicare and Medicaid US nursing homes. Reports the average adjusted QM values for most recent three quarters. Quality measure reports available at national, state, facility and resident level (providers only). Five-star quality rating system (n=9 QIs) available publicly online.

Reporting Frequency
Quarterly
Reporting Frequency in Days
91
Indicator Has Recommended Targets
No

Source and Reference Attributes

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025