Effectiveness: Functional Status Preservation and Rehabilitation

2010 National Healthcare Quality and Disparities Reports

Effectiveness of Care: Functional Status Preservation and Rehabilitation

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).

National 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, 2000, 2002, 2006, 2008

10_1_1.2a-c Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement, United States, 2008, by:

• Race.
• Ethnicity.
• Family Income.

National 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 (HHQI).

National Tables

10_1_2.1 Home health care patients who get better at walking or moving around, United States, 2002 -2008

10_1_2.2a-b Home health care patients who get better at walking or moving around, United States, 2008, by:

• Race.
• Ethnicity.

National Data Source

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

National Denominator

All home health care episodes that began and ended in the survey year.

National Numerator

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

State Tables

10_1_2.3a-b Home health care patients who get better at walking or moving around, State, 2008 by:

• Race.
• Ethnicity.

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

Risk-adjusted rates are available for State estimates only. Further information about risk adjustment and Home Health Quality Initiative measures 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, 1999-2008

10_1_3.2 Long-stay nursing home residents whose ability to move about in and around their room got worse, United States, 2008, by:

• Race/ethnicity.

National Data Source

CMS, Nursing Home Minimum Data Set (MDS 2.0).

National Denominator

Medicare beneficiary chronic care nursing home residents with a valid target assessment and a valid prior assessment, excluding: residents with missing values on the target assessment; residents for which assessment performance indicated "total dependence" or "activity did not occur"; missing values on the prior assessment; residents with comatose status or end-stage disease; residents receiving hospice care; and residents with unknown status for these conditions on the target assessment.

National Numerator

Subset of the denominator for which locomotion self-performance scores got worse compared with a prior assessment.

State Table

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

• Race/ethnicity.

State Data Source

CMS, MDS 2.0.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Estimates are risk adjusted using resident-level covariates.

Facilities with fewer than 30 residents in the denominator are excluded.

Long-stay residents enter a nursing facility typically because they can no longer care for themselves at home; they tend to remain in the facility for several months or years.

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, 2002-2008

10_1_4.2a-b Home health care patients who get better at getting in and out of bed, United States, 2008, 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, excluding episodes for which the patient is at the highest level of performance and cannot improve further.

National Numerator

Subset of the denominator in which a person improved at getting in and out of bed compared with 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, by:

• Race.
• Ethnicity.

State Data Source

CMS, OASIS.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

The OASIS instrument measures transfers on a 6-level scale from 0 (independent) to 5 (bedfast and unable to turn or position).

Risk-adjusted rates are available for State estimates only. Further information about risk adjustment and the Home Health Quality Initiative measures 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, 1999-2008

10_1_5.2 Long-stay nursing home residents whose need for help with daily activities has increased, United States, 2008, by:

• Race/ethnicity.

National Data Source

CMS, Nursing Home Minimum Data Set (MDS 2.0).

National Denominator

Medicare chronic care nursing home residents with a valid target assessment and a valid prior assessment, excluding residents who cannot show decline due to maximum values on target and prior assessments; residents with comatose status or end-stage disease; residents receiving hospice care; and residents with unknown status for these conditions.

National Numerator

Subset of the denominator with worsening performance scores in at least two of the four late-loss activities of daily living (bed mobility, transfers, toilet use, and eating) or who are at target relative to prior assessment.

State Table

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

• Race/ethnicity.

State Data Source

CMS, MDS 2.0.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Facilities with fewer than 30 residents in the denominator are excluded.

Long-stay residents enter a nursing facility typically because they can no longer care for themselves at home; they tend to remain in the facility for several months or years.

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, 1999-2008

10_1_6.2 Long-stay nursing home residents who spend most of their time in bed or in a chair, United States, 2008, by:

• Race/ethnicity.

National Data Source

CMS, Nursing Home Minimum Data Set (MDS 2.0).

National Denominator

Medicare chronic care nursing home residents with a valid target assessment, excluding admission assessments and residents who are comatose or have missing values.

National Numerator

Subset of the denominator who were bedfast on target assessment.

State Table

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

• Race/ethnicity.

State Data Source

CMS, MDS 2.0.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Facilities with fewer than 30 residents in the denominator are excluded.

Long-stay residents enter a nursing facility typically because they can no longer care for themselves at home; they tend to remain in the facility for several months or years.

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, 2002-2008

10_1_7.2a-b Home health care patients who get better at bathing, United States, 2008, 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, excluding those for persons who are at the highest performance level and cannot improve any more.

National Numerator

Subset of the denominator in which a person's ability to bathe improved compared with a prior assessment.

State Tables

10_1_7.3a-b Home health care patients who get better at bathing, State, 2008, by:

• Race.
• Ethnicity.

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).

Risk-adjusted rates are available for State estimates only. Further information about risk adjustment and the Home Health Quality Initiative measures 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, 2002-2008

10_1_8.2a-b Home health care patients who get better at taking their medication correctly, United States, 2008, 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, excluding persons who are at the highest performance level and cannot improve any more, and persons taking injectable or IV medications.

National Numerator

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

State Tables

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

• Race.
• Ethnicity.

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.

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

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