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.

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.

All long-stay residents with a selected target and prior assessment, except those with 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.

None

None

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

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.

www.cms.gov/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual

www.cms.gov/files/document/mds-30-qm-users-manual-v160pdf.pdf