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2006 National Healthcare Quality Report

Effectiveness of Care: Nursing Home, Home Health, and Hospice Care

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Nursing Facility Care
Nursing home residents whose need for help with daily activities has increased
Nursing home residents who have moderate to severe pain
Nursing home residents who were physically restrained
Nursing home residents who spent most of their time in bed or in a chair
Nursing home residents whose ability to move about in and around their room got worse
Nursing home residents with a urinary tract infection
Nursing home residents who have become more depressed or anxious
High-risk nursing home residents who have pressure sores
Low-risk nursing home residents who have pressure sores
Low-risk nursing home residents who lose control of their bowels or bladder
Nursing home residents who have/had a catheter inserted and left in their bladder
Nursing home short-stay residents who had moderate to severe pain
Nursing home short-stay residents with delirium
Nursing home short-stay residents with pressure sores
Nursing home residents who lose too much weight
Home Health Care
Improvement in management of oral medications
Improvement in bathing
Improvement in transferring
Improvement in ambulation/locomotion
Improvement in pain interfering with activity
Improvement in dyspnea
Improvement in urinary incontinence
Acute care hospitalization
Need for urgent, unplanned medical care
Home health care patients who stayed at home after an episode of home health care ends
Hospice Care
Hospice patients who received the right amount of medicine for pain
Hospice patients who received care consistent with their stated end of life wishes


Nursing Facility Care

Measure Title

Percent of nursing home residents whose need for help with daily activities has increased.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.110a. Long-stay nursing home residents whose need for help with daily activities has increased, United States, 2004.

1.110b. Chronic care: Percent of residents whose need for help with daily activities has increased, by State, 2002 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment and a valid prior assessment.

Numerator

Residents with worsening (increasing MDS item score) in at least 1 or 2 of the 4 Late-Loss activities of daily living (ADL) self-performance (bed mobility, transfers, toilet use, and eating) or at target relative to prior assessment.

Comments

Excludes residents who cannot show decline due to maximum values on target and prior assessments, residents with comatose status, residents with end-stage disease, residents receiving hospice care and residents with unknown status for these conditions. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents who have moderate to severe pain.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.111a. Long-stay nursing home residents who have moderate to severe pain, United States, 2004.

1.111b. Chronic care: Percent of residents who have moderate to severe pain, by State, 2002 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment.

Numerator

Residents with moderate pain at least daily, or horrible or excruciating pain at any frequency on the target assessment.

Comments

Rate is risk-adjusted using resident-level covariates.

Excludes admission assessments and assessments with inconsistent or missing responses regarding the measure. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents who were physically restrained.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.112a. Long-stay nursing home residents who were physically restrained, United States, 2004.

1.112b. Chronic care: Percent of residents who were physically restrained, by State, 2002 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment.

Numerator

Residents who were physically restrained daily on target assessment.

Comments

Excludes admission assessments or residents with missing values. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents who spent most of their time in bed or in a chair.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.113a. Long-stay nursing home residents who spent most of their time in bed or in a chair, United States, 2004.

1.113b. Chronic care: Percent of residents who spent most of their time in bed or in a chair, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment.

Numerator

Residents who were bedfast on target assessment.

Comments

Excludes admission assessments, residents with comatose status, or residents with missing values. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents whose ability to move about in and around their room got worse.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.114a. Long-stay nursing home residents whose ability to move about in and around their room got worse, United States, 2004.

1.114b. Chronic care: Percent of residents whose ability to move about in and around their room got worse, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment and a valid prior assessment.

Numerator

Residents whose value for locomotion self-performance is greater at target relative to prior assessment.

Comments

Percent is risk-adjusted using resident-level covariates.

Excludes admission assessments; residents with missing values on the target assessment or with "total dependence", "activity did not occur" or missing values on the prior assessment; residents with comatose status, residents with end-stage disease, residents receiving hospice care, and residents with unknown status for these conditions on the target assessment. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents with a urinary tract infection.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.115a. Long-stay nursing home residents with a urinary tract infection, United States, 2004.

1.115b. Chronic care: Percent of residents with a urinary tract infection, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment.

Numerator

Residents with a urinary tract infection on target assessment.

Comments

Excludes admission assessments and missing values on the target assessment. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents who have become more depressed or anxious.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.116a. Long-stay nursing home residents who have become more depressed or anxious, United States, 2004.

1.116b. Chronic care: Percent of residents who have become more depressed or anxious, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment and a valid prior assessment.

Numerator

Residents whose Mood Scale scores are greater on target assessment relative to prior assessment.

Comments

Excludes residents with missing Mood Scale scores on the target assessment or prior assessment, residents who had a maximum Mood Scale score on the prior assessment, or residents who were comatose or comatose status was unknown. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of high-risk nursing home residents who have pressure sores.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.117a. High-risk long-stay nursing home residents who have pressure sores, United States, 2004.

1.117b. Chronic care: Percent of high-risk residents who have pressure sores, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment and with any 1 of the following inclusion criteria: impaired in bed mobility or transfer, comatose, or suffering malnutrition on the target assessment.

Numerator

Subset of the denominator population with pressure sores (stage 1-4) on target assessment.

Comments

Patients with pressure sores at nursing home admission or with missing values are excluded, but their subsequent MDS reassessments are included in the numerator if the sore has not healed. Excludes facilities with fewer than 30 residents in the denominator. Excludes admission assessments and residents with certain disqualifying responses. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of low-risk nursing home residents who have pressure sores.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.118a. Low-risk long-stay nursing home residents who have pressure sores, United States, 2004.

1.118b. Chronic care: Percent of low-risk residents who have pressure sores, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment and not qualifying as high-risk.

Numerator

Subset of the denominator population with pressure sores (stage 1-4) on target assessment.

Comments

Patients with pressure sores at nursing home admission or with missing values are excluded, but their subsequent MDS reassessments are included in the numerator if the sore has not healed. The measure also excludes residents with missing values and residents with comatose status. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of low-risk nursing home residents who lose control of their bowels or bladder.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.119a. Low-risk long-stay nursing home residents who lose control of their bowels or bladder, United States, 2004.

1.119b. Chronic care: Percent of low-risk residents who lose control of their bowels or bladder, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment and not qualifying as high-risk.

Numerator

Subset of the denominator population who were frequently incontinent or fully incontinent on target assessment.

Comments

Excludes admission assessments, residents with missing values, residents with comatose status, residents had an indwelling catheter or ostomy, or residents with unknown status for these conditions. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents who have/had a catheter inserted and left in their bladder.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.120a. Low-risk long-stay nursing home residents have or had a catheter inserted and left in the bladder, United States, 2004.

1.120b. Chronic care: Percent of residents who have or had a catheter inserted and left in their bladder, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary chronic care residents with a valid target assessment.

Numerator

Subset of the denominator population with indwelling catheters on target assessment.

Comments

Rate is risk-adjusted using resident-level covariates.

Excludes admission assessments or residents with missing values. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home short-stay residents who had moderate to severe pain.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.121a. Short-stay nursing home residents who have moderate to severe pain, United States, 2004.

1.121b. Postacute care: Percent of short-stay residents who have moderate to severe pain, by State, 2002 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary post acute care patients with a valid SNF PPS 14-day assessment.

Numerator

Subset of the denominator population with moderate pain at least daily or horrible/excruciating pain at any frequency.

Comments

Excludes assessments with inconsistent responses regarding the measure.

PPS refers to Medicare Prospective Payment System for skilled nursing facilities (SNFs).

Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home short-stay residents with delirium.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.122a. Short-stay nursing home residents with delirium, United States, 2004.

1.122b. Postacute care: Percent of short-stay residents with delirium, by State, 2002 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary post acute care patients with a valid SNF PPS 14-day assessment.

Numerator

Subset of the denominator population with at least 1 symptom of delirium that represents a departure from usual functioning.

Comments

Percent is risk-adjusted using resident-level covariates.

Excludes residents with comatose status, residents with end-stage disease, residents receiving hospice care, and residents with unknown status for these conditions. Residents with neurodegenerative diseases are not automatically excluded.

PPS refers to Medicare Prospective Payment System for skilled nursing facilities (SNFs).

Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home short-stay residents with pressure sores.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.123a. Short-stay nursing home residents with pressure sores, United States, 2004.

1.123b. Postacute care: Percent of short-stay residents with pressure sores, by State, 2003 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

Medicare beneficiary post acute care patients with a valid SNF PPS 14-day assessment and a valid preceding SNF PPS 5-day assessment.

Numerator

Subset of the denominator population who satisfy either of the following conditions:

  1. Had no pressure sores on the SNF PPS 5-day assessment and has at least Stage 1 pressure sores on the SNF PPS 14-day assessment
  2. Had pressure sores on the SNF PPS 5-day assessment, and pressure sores worsened or failed to improve on the SNF PPS 14-day assessment

Comments

Percent is risk adjusted using resident-level covariates.

PPS refers to Medicare Prospective Payment System for skilled nursing facilities (SNFs).

Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Nursing Facility Care

Measure Title

Percent of nursing home residents who lose too much weight.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Nursing Home Quality Initiative.

Tables

1.124a. Long-stay nursing home residents who lose too much weight, United States, 2004.

1.124b. Chronic care: Percent of residents who lose too much weight, by State, 2004 and 2005.

Data Source

CMS, Minimum Data Set (MDS).

Denominator

All residents with a valid target assessment.

Numerator

Residents who have experienced weight loss of 5 percent of more in the last 30 days or 10 percent or more in the last 6 months.

Comments

Excludes admission assessments, residents with missing weight loss data and residents receiving hospice care. Excludes facilities with fewer than 30 residents in the denominator. For details about this and other measures of the Nursing Home Quality Initiative, please refer to the documentation available at http://www.cms.hhs.gov/NursingHomeQualityInits/.

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Home Health Care

Measure Title

Improvement in management of oral medications.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.125a. Home health care patients who get better at taking their medication correctly, United States, 2004.

1.125b. Percent of home health care patients who get better at taking their medication correctly, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes in which a person showed improvement in their ability to manage oral medications compared to a prior assessment.

Comments

The OASIS instrument measures management of oral medications on a 3-level scale from 0 (fully independent) to 2 (entirely dependent) and refers to ability, not medication compliance. Episodes are not included for persons who are at the highest level and cannot improve any more.

Excludes injectable and intravenous medications.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Improvement in bathing.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.126a. Home health care patients who get better at bathing, United States, 2004.

1.126b. Percent of home health care patients who get better at bathing, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes in which a person's ability to bathe improved compared to a prior assessment.

Comments

The OASIS instrument measures bathing ability on a 6-level scale from 0 (fully independent) to 5 (completely dependent). Episodes are not included for persons who are at the highest level and cannot improve any more.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Improvement in transferring.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.127a. Home health care patients who get better at getting in and out of bed, United States, 2004.

1.127b. Percent of home health care patients who get better at getting in and out of bed, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes in which a person who improved at getting in and out of bed compared to a prior assessment.

Comments

The OASIS instrument measures transferring on a 6-level scale from 0 (independent) to 5 (bedfast and unable to turn or position). Episodes are not included for persons who are at the highest level and cannot improve any more.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Improvement in ambulation/locomotion.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.128a. Home health care patients who get better at walking or moving around, United States, 2004.

1.128b. Percent of home health care patients who get better at walking or moving around, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes in which a person who improved at walking or moving around compared to a prior assessment.

Comments

The OASIS instrument measures ambulation or locomotion ability on a 6-level scale from 0 (full, independent ambulation) to 5 (bedfast). Episodes are not included for persons who are at the highest level and cannot improve any more.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Improvement in pain interfering with activity.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.129a. Home health care patients who have less pain when moving around, United States, 2004.

1.129b. Percent of home health care patients who have less pain when moving around, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes in which a person's frequency of pain interfering with activity or movement improved compared to a prior assessment.

Comments

The OASIS instrument measures frequency of pain on a 4-level scale from 0 (no pain or pain does not interfere with activity) to 3 (constant). Episodes are not included for persons who are at the highest level and cannot improve any more.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Improvement in dyspnea.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.130a. Home health care patients who have less shortness of breath, United States, 2004.

1.130b. Percent of home health care patients who have less shortness of breath, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in 2002 and 2003.

Numerator

Episodes in which a person's dyspneic status improved compared to a prior assessment.

Comments

The OASIS instrument measures dyspneic status on a 4-level scale from 0 (never short of breath) to 3 (dyspnea at rest). Episodes are not included for persons who are at the highest level and cannot improve any more.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Improvement in urinary incontinence.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.131a. Home health care patients who have less urinary incontinence, United States, 2004.

1.131b. Percent of home health care patients who have less urinary incontinence, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in 2002 and 2003.

Numerator

Episodes in which a person's urinary incontinence status improved compared to a prior assessment.

Comments

Episodes are not included for persons who are at the highest level and cannot improve any more.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Acute care hospitalization.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.132a. Home health care patients who had to be admitted to the hospital, United States, 2004.

1.132b. Percent of home health care patients who had to be admitted to the hospital, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes in which a person was hospitalized for an acute condition while receiving home health care services.

Comments

Reason for hospitalization may be for emergent, urgent, or elective conditions.

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Need for urgent, unplanned medical care.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.133a. Home health care patients who need urgent, unplanned medical care, United States, 2004.

1.133b. Percent of home health care patients who need urgent, unplanned medical care, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes with an assessment indicating that urgent or unplanned medical care was initiated.

Comments

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Home Health Care

Measure Title

Home health care patients who stayed at home after an episode of home health care ends.

Measure Source

Centers for Medicare and Medicaid Services (CMS), Home Health Quality Initiative.

Tables

1.134a. Home health care patients who stay at home after an episode of home health care ends, United States, 2004.

1.134b. Percent of home health care patients who stay at home after an episode of home health care ends, by State, 2005.

Data Source

Calculated by the Center for Health Services and Policy, Research, University of Colorado, from Outcome and Assessment Information Set (OASIS) data.

Denominator

All home health episodes that begin and end in the survey year.

Numerator

Episodes with final assessments indicating patients remained at home at the conclusion of services.

Comments

Risk-adjusted rates are available for State estimates only. Particulars about risk adjustment and further information about this and other measures of the Home Health Quality Initiative are available at http://www.cms.hhs.gov/HomeHealthQualityInits/.

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Hospice Care

Measure Title

Hospice patients who received the right amount of medicine for pain.

Measure Source

National Hospice and Palliative Care Organization (NHPCO).

Table

1.135. Percent of hospice patients who received the right amount of medicine for pain management, 2004.

Data Source

NHPCO, Family Evaluation of Hospice Care Survey data.

Denominator

Hospice patients age 18 and over.

Numerator

Subset of denominator who received the right amount of medicine for pain, according to the survey respondent.

Comments

The Family Evaluation of Hospice Care Survey is administered to family members of deceased recipients of hospice care. See the Data Sources section of this appendix for further information.

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Hospice Care

Measure Title

Hospice patients who received care consistent with their stated end of life wishes.

Measure Source

National Hospice and Palliative Care Organization (NHPCO).

Table

1.136. Percent of hospice patients who received care consistent with patient's wishes, 2004.

Data Source

NHPCO, Family Evaluation of Hospice Care Survey data.

Denominator

Hospice patients age 18 and over.

Numerator

Subset of denominator who received care consistent with their stated end of life wishes, according to the survey respondent.

Comments

The Family Evaluation of Hospice Care Survey is administered to family members of deceased recipients of hospice care. See the Data Sources section of this appendix for further information.

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