New Long-Term Care Residents Who Potentially Could Have Been Cared for at Home
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Percentage of newly admitted long-term care residents who have a clinical profile similar to the profile of clients cared for at home with formal supports in place.
Numerator
Total number of newly admitted long-term care residents (incident cases) with a completed RAI-MDS 2.0 or interRAI LTCF assessment that details clinical characteristics similar to those of home care clients who are living well in the community with formal supports, defined by the following inclusions. Inclusions: -Long-term care residents with a completed assessment that details the following combination of characteristics: Cognitive Performance Scale = 0, 1 or 2 ADL Hierarchy Scale = 0, 1 or 2 No falls in the past 30 days -Not physically abusive in the past 7 days (RAI-MDS 2.0) or 3 days (interRAI LTCF)* -Not verbally abusive in the past 7 days (RAI-MDS 2.0) or 3 days (interRAI LTCF)* -Did not wander in the past 7 days (RAI-MDS 2.0) or 3 days (interRAI LTCF)* * The Assessment Reference Date is the end of the observation period for items on the RAI-MDS 2.0 or interRAI LTCF assessment. The look-back period for most RAI-MDS 2.0 items is 7 days. The look-back period for most interRAI LTCF items is 3 days.
Denominator
Total number of newly admitted long-term care residents (with completed assessments in a given fiscal year).
Exclusions
Assessments done in the hospital-based continuing care sector (for provinces / territories submitting to CCRS) Residents missing any assessments for numerator definition (i.e., Cognitive Performance Scale, ADL (Activities of Daily Living) Self-Performance Hierarchy Scale, falls, verbal or physical abuse, wandering) Residents without valid age recorded, schizophrenia diagnosis, bipolar disorder diagnosis, and living situation prior to admission (these covariates are used in risk adjustment) -Residents admitted for a short length of stay (discharge projected within 90 days, length of stay at discharge for the resident ≤120 days).
Use of Risk Adjustment
Risk Adjustments
Logistic regression, adjusted rate. Individual covariates: age group, sex, schizophrenia diagnosis, bipolar disorder diagnosis, and whether a resident lived alone prior to admission to a long-term care facility.
Stratifications
None
Data Attributes
Type of Data Collection
Data Collection Methods
Data availability 2018-21. Resident Assessment Instrument–Minimum Data Set 2.0 (RAI-MDS 2.0) and submitted to the Continuing Care Reporting System (CCRS), or using the interRAI Long-Term Care Facilities (interRAI LTCF) assessment and submitted to the Integrated interRAI Reporting System (IRRS).
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Publicly reported at national and provincial/territory level as part of national Continuing Care Reporting System (CCRS), quarterly. Also includes reporting at region, LTCF, corporation, and sector level (not public). The CCRS quality indicators use 4 rolling quarters of data for calculations in order to have a sufficient number of assessments for risk adjustment. Since residents are assessed on a quarterly basis, each resident can contribute to the indicator up to 4 times.