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First Release of Quality Reporting Data (QRP) About Skilled Nursing Facilities on Nursing Home Compare

on Monday, 5 November 2018 in Health Law Advisory: Zachary J. Buxton, Editor

On October 24, 2018, CMS released “inaugural” QRP data on Nursing Home Compare regarding skilled nursing facilities (SNFs). This release is in accordance with Section 1899B(g)(1) of the Social Security Act requiring CMS to publicly report SNF provider performance on selected quality measures. Reporting of certain quality measures is also required by the Improving Medicare Post-Acute Care Transformation Act.

On October 26, 2018, CMS posted a Fact Sheet about this addition to Nursing Home Compare which included the following information:

  • Data is for Medicare and Medicaid certified nursing facilities
  • Quality and staffing information is available for 15,000 plus nursing facilities in the United States
  • Quality data is compared to other nursing facilities and to the national average

CMS explained that the data is collected both from claims data and data submitted to CMS by nursing facilities via the Minimum Data Set. The quality measures are calculated on the admission and discharge data submitted by nursing facilities for each resident.

The specific quality measures that have been added to Nursing Home Compare are both assessment based and claims based as follows:

Assessment-based measures:

  1. Percent of residents or patients in a SNF that develop new or worsened pressure ulcers (National Quality Forum #0678)
  2. Percentage of residents or patients whose activities of daily living and thinking skills were assessed and related goals were included in their treatment plan (NQF #2631)
  3. Percentage of SNF patients who experience one or more falls with major injury during their SNF stay (NQF #0674)

Claims-based measures:

  1. Medicare Spending Per Beneficiary (MSPB) for patients in SNFs
  2. Rate of successful return to home or community from an SNF

CMS has also collected data about a 6th quality measure, Potentially Preventable 30-Day Post-Discharge Readmissions, but has decided not to add this data to Nursing Home Compare at this time. CMS wants to conduct more testing on this measure before making it public.

Resources Available to Skilled Nursing Facilities

  • The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) webpage.
  • The SNF QRP Measures and Technical Information webpage.

Nursing Home Compare is one example of CMS’s response to statutory requirements designed to enhance quality of care through data transparency. Several other “compare” websites are also maintained by CMS:

  • Dialysis Compare
  • Home Health Compare
  • Hospital Compare
  • Inpatient Rehabilitation Facility (IRF) Compare
  • Long-Term Care Hospital (LTCH) Compare
  • Medicare Plan Finder
  • Hospice Compare
  • Physician Compare

Julie A. Knutson

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