Worsened Cognitive Ability
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Percentage of residents whose cognitive ability worsened (assessed by Cognitive Performance Scale).
Numerator
Residents with a lower Cognitive Performance Scale (CPS) score on their target assessment compared with their prior assessment.
Denominator
All residents (must have assessment in previous quarter).
Exclusions
Residents who are comatose, end-stage (6 months or less to live) or receiving hospice/palliative care. Residents whose cognitive performance could not worsen (had maximum CPS score of 6 on prior assessment).
Use of Risk Adjustment
Risk Adjustments
Direct standardisation, indirect standardisation Standard Population: 3,000 facilities in 6 U.S. states and 92 residential care facilities and continuing care hospitals in Ontario and Nova Scotia Individual covariates: Full Personal Severity Index (PSI), PSI Subset 1 Diagnoses, Age younger than 65.
Stratifications
Facility-level stratification: Cognitive Performance Scale.
Data Attributes
Type of Data Collection
Data Collection Methods
Data availability 2017-21. 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.