Number of Hospitalisations per 1,000 Long-Stay Resident Days

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
Safety
Domain
Hospitalisation

Defining Attributes

Definition

Number of unplanned inpatient admissions or all-cause outpatient observation stays.

Numerator

All unplanned inpatient hospital admissions or outpatient observation stays while residing in the nursing home and not enrolled in hospice.

Denominator

The sum of all long-stay days in the target period, divided by 1,000.

Exclusions

Not a Medicare beneficiary or enrolled in Medicare, enrolled in hospice care, resident not in the nursing home for any reason during the episode.

Use of Risk Adjustment
Yes
Risk Adjustments

Claims covariates: age, sex, race / ethnicity, LoS during hospitalisation, number of acute care hospitalisations in 365 days prior to nursing home admission, comorbidity index MDS covariates: functional status, clinical conditions (daily pain, SoB exertion, SoB lying, end-stage prognosis, internal bleeding), clinical treatments (anticoagulant, antibiotic, diuretic, chemotherapy for cancer, radiation for cancer, oxygen therapy, IV medications, transfusion, hospice care after nursing home admission, isolation or quarantine for infectious disease, speech therapy, respiratory therapy), clinical diagnoses (GERD or ulcer, ulcerative colitis/Crohn's disease/IBD, neurogenic bladder, multiresistant organism, septicaemia, CVA/TIA/stroke, quadriplegia, MS, Parkinson's disease, anxiety, respiratory failure), other (entered nursing home from psychiatric facility).

Stratifications

None

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Medicare claims data. All days after the resident's one-hundredth cumulative day in the nursing home or the beginning of the 12-month target period (whichever is later) and until the day of discharge, the day of death, or end of the 12-month target period (whichever is earlier).

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
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)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025