Percentage of residents whose cognitive ability worsened (assessed by Cognitive Performance Scale).

Residents with a lower Cognitive Performance Scale (CPS) score on their target assessment compared with their prior assessment.

All residents (must have assessment in previous quarter).

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).

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.

Facility-level stratification: Cognitive Performance Scale.

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).

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.

www.cihi.ca/en/topics/long-term-care/indicators

www.cihi.ca/en/indicators/residents-worsened-in-cognitive-ability