CMS adds hospital Medicare claims data to quality measures for nursing homes

For the first time, the Centers for Medicare and Medicaid Services is adding Medicare claims data submitted by hospitals to quality measures posted on its consumer-based website, Nursing Home Compare.

Six new quality measures are being added, CMS announced Wednesday, the largest addition since 2003.

This is significant, CMS said, because it's the first time the agency is including quality measures not based solely on self-reported data from nursing homes.

Beginning in July, CMS will incorporate five of the six measures into its calculation of nursing home five-star quality ratings, it said.

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The three new hospitals measures assess the rate of re-hospitalization, emergency room use, and community discharge among nursing home residents, CMS said.

The six measures include information on: the percentage of short-stay residents who were successfully discharged to the community; the percentage of short-stay residents who had an outpatient emergency department visit; the percentage of short-stay residents who were re-hospitalized after a nursing home admission; the percentage of short-stay residents who made improvements in function; the percentage of long-stay residents whose ability to move independently worsened; and the percentage of long-stay residents who received an antianxiety or hypnotic medication.

All but the medication measure will be incorporated into nursing home five star quality ratings. CMS is not including the medication assessment because it has been difficult to determine appropriate nursing home benchmarks for acceptable use, it said.

In releasing the new updates, CMS is nearly doubling the number of short-stay measures on care provided to residents who are in the nursing home for 100 days or less.

[Also: CMS tests payment model for skilled nursing, ups reimbursement for on-site assessments]

CMS is also providing information about key short-stay outcomes, including the percentage of residents who are successfully discharged and the rate of activities of daily life improvement among short-stay residents.

Consumers may view the quality measures for over 15,000 nursing homes on the Nursing Home Compare website, www.medicare.gov/nursinghomecompare/search.html.

"These new quality measures broaden the set of quality measures already on the site so that patients, their family members, and caregivers have more meaningful information when they consider facilities," said Patrick Conway, CMS Deputy Administrator and Chief Medical Officer.

Twitter: @SusanJMorse