Effectiveness of Care: Functional Status Preservation and Rehabilitati

2009 National Healthcare Quality and Disparities Reports

The National Healthcare Quality Report (NHQR) is a comprehensive national overview of quality of health care in the United States. It is organized around four dimensions of quality of care: effectiveness, patient safety, timeliness, and patient centeredness.

 

Functional Status Preservation and Rehabilitation
Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement.
Adult home health care patients whose ability to walk or move around improved.
Long-stay nursing home residents whose ability to move about in and around their room decreased.
Adult home health care patients whose ability to get in and out of bed improved.
Long-stay nursing home residents whose need for help with daily activities increased.
Long-stay nursing home residents with most of their time spent in bed or in a chair.
Adult home health care patients whose bathing improved.
Adult home health care patients whose management of oral medications improved.


Functional Status Preservation and Rehabilitation

Measure Title

Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Medicare Current Beneficiary Survey (MCBS).

Tables

10_1_1.1 Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement, United States, 2001 and 2006.

10_1_1.2 Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density, United States, 2006, by:

  • Race
  • Ethnicity
  • Family income

Data Source

CMS, MCBS.

Denominator

Number of female Medicare beneficiaries age 65 and over residing in the community for the full year.

Numerator

Subset of the denominator who reported ever being screened for osteoporosis with a bone mass or bone density measurement.

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Functional Status Preservation and Rehabilitation

Measure Title

Adult home health care patients whose ability to walk or move around improved.

Measure Source

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

National Tables

10_1_2.1 Home health care patients who get better at walking or moving around, United States, 2002 and 2007.

10_1_2.2 Home health care patients who get better at walking or moving around, United States, 2007, by:

  • Race
  • Ethnicity

National Data Source

CMS, Home Health Outcome and Assessment Information Set (OASIS).

National Denominator

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

National Numerator

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

State Tables

10_1_2.3 Home health care patients who get better at walking or moving around, by State, 2005 and 2008.

State Data Source

CMS, OASIS.

State Denominator

Same as National.

State Numerator

Same as National.

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 people 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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Functional Status Preservation and Rehabilitation

Measure Title

Long-stay nursing home residents whose ability to move about in and around their room decreased.

Measure Source

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

National Tables

10_1_3.1 Long-stay nursing home residents whose ability to move about in and around their room got worse, United States, 1999 and 2007.

10_1_3.2 Long-stay nursing home residents whose ability to move about in and around their room got worse, United States, 2007, by:

  • Race/ethnicity

National Data Source

CMS, Nursing Home Minimum Data Set (MDS).

National Denominator

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

National Numerator

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

State Tables

10_1_3.3 Long-stay nursing home residents whose ability to move about in and around their room got worse, by State, 2002 and 2008.

State Data Source

CMS, MDS.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Percentage 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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Functional Status Preservation and Rehabilitation

Measure Title

Adult home health care patients whose ability to get in and out of bed improved.

Measure Source

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

National Tables

10_1_4.1 Home health care patients who get better at getting in and out of bed, United States, 2002 and 2007.

10_1_4.2 Home health care patients who get better at getting in and out of bed, United States, 2007, by:

  • Race
  • Ethnicity

National Data Source

CMS, Home Health Outcome and Assessment Information Set (OASIS).

National Denominator

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

National Numerator

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

State Tables

10_1_4.3 Home health care patients who get better at getting in and out of bed, by State, 2005 and 2008.

State Data Source

CMS, OASIS.

State Denominator

Same as National.

State Numerator

Same as National.

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 people 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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Functional Status Preservation and Rehabilitation

Measure Title

Long-stay nursing home residents whose need for help with daily activities increased.

Measure Source

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

National Tables

10_1_5.1 Long-stay nursing home residents whose need for help with daily activities has increased, United States, 1999 and 2007.

10_1_5.2 Long-stay nursing home residents whose need for help with daily activities has increased, United States, 2007, by:

  • Race/ethnicity

National Data Source

CMS, Nursing Home Minimum Data Set (MDS).

National Denominator

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

National 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.

State Tables

10_1_5.3 Long-stay nursing home residents whose need for help with daily activities has increased, by State, 2002 and 2008.

State Data Source

CMS, MDS.

State Denominator

Same as National.

State Numerator

Same as National.

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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Functional Status Preservation and Rehabilitation

Measure Title

Long-stay nursing home residents with most of their time spent in bed or in a chair.

Measure Source

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

National Tables

10_1_6.1 Long-stay nursing home residents who spend most of their time in bed or in a chair, United States, 1999 and 2007.

10_1_6.2 Long-stay nursing home residents who spend most of their time in bed or in a chair, United States, 2007, by:

  • Race/ethnicity

National Data Source

CMS, Nursing Home Minimum Data Set (MDS).

National Denominator

Medicare beneficiary chronic care residents with a valid target assessment.

National Numerator

Residents who were bedfast on target assessment.

State Tables

10_1_6.3 Long-stay nursing home residents who spend most of their time in bed or in a chair, by State, 2002 and 2008.

State Data Source

CMS, MDS.

State Denominator

Same as National

State Numerator

Same as National.

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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Functional Status Preservation and Rehabilitation

Measure Title

Adult home health care patients whose bathing improved.

Measure Source

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

National Tables

10_1_7.1 Home health care patients who get better at bathing, United States, 2002 and 2007.

10_1_7.2 Home health care patients who get better at bathing, United States, 2007, by:

  • Race
  • Ethnicity

National Data Source

CMS, Home Health Outcome and Assessment Information Set (OASIS).

National Denominator

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

National Numerator

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

State Tables

10_1_7.3 Home health care patients who get better at bathing, by State, 2005 and 2008.

State Data Source

CMS, OASIS.

State Denominator

Same as National.

State Numerator

Same as National.

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 people 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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Functional Status Preservation and Rehabilitation

Measure Title

Adult home health care patients whose management of oral medications improved.

Measure Source

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

National Tables

10_1_8.1 Home health care patients who get better at taking their medication correctly, United States, 2002 and 2007.

10_1_8.2 Home health care patients who get better at taking their medication correctly, United States, 2007, by:

  • Race
  • Ethnicity

National Data Source

CMS, Home Health Outcome and Assessment Information Set (OASIS).

National Denominator

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

National Numerator

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

State Tables

10_1_8.3 Home health care patients who get better at taking their medicines correctly (by mouth), by State, 2005 and 2008.

State Data Source

CMS, OASIS.

State Denominator

Same as National.

State Numerator

Same as National.

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 people who are at the highest level and cannot improve any more.

Excludes injectable and IV 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/

Current as of March 2010
Internet Citation: Effectiveness of Care: Functional Status Preservation and Rehabilitati: 2009 National Healthcare Quality and Disparities Reports. March 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr09/measurespec/functional_status_preservation_and_rehabilitation.html