2012 National Healthcare Quality and Disparities Reports

Effectiveness of Care: Functional Status Preservation and Rehabilitati

Functional Status Preservation and Rehabilitation
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

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

2_11_1_1.1 Adult home health care patients who get better at walking or moving around, United States, 2010

2_11_1_1.2 Adult home health care patients who get better at walking or moving around, United States, 2002-2009

2_11_1_1.3a-b Adult home health care patients who get better at walking or moving around, United States, 2010, by:

  1. Race.
  2. 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

Subset of the denominator in which a person improved at walking or moving around compared with a prior assessment.

State Tables

2_11_1_1.4a-b Home health care patients who get better at walking or moving around, by State, United States, 2010 by:

  1. Race.
  2. 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 people 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 HHQI measures is available at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/index.html

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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 (NHQI).

National Tables

2_11_1_2.1 Long-stay nursing home residents whose ability to move about in and around their room got worse, United States, 2007-2010

2_11_1_2.2 Long-stay nursing home residents whose ability to move about in and around their room got worse, United States, 2000-2006

2_11_1_2.3 Long-stay nursing home residents whose ability to move about in and around their room got worse, by race/ethnicity, United States, 2010

National Data Source

CMS, Nursing Home Minimum Data Set (MDS).

National Denominator

Medicare 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 whom assessment performance indicated "total dependence" or "activity did not occur"; residents with 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 whom locomotion self-performance scores got worse compared with a prior assessment.

State Table

2_11_1_2.4 Long-stay nursing home residents whose ability to move about in and around their room got worse, by race/ethnicity and State, United States, 2010

State Data Source

CMS, MDS.

State Denominator

Same as national.

State Numerator

Same as national.

Comments

This measure excludes admission assessments; and 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. 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 NHQI measures, refer to the documentation available at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/index.html

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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 (HHQI).

National Tables

2_11_1_3.1 Home health care patients who get better at getting in and out of bed, United States, 2010

2_11_1_3.2 Home health care patients who get better at getting in and out of bed, United States, 2002-2009

2_11_1_3.3a-b Home health care patients who get better at getting in and out of bed, United States, 2010, by:

  1. Race.
  2. 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 further improve.

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

2_11_1_3.4a-b Home health care patients who get better at getting in and out of bed, by State, United States, 2010, by:

  1. Race.
  2. 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 HHQI measures is available at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/index.html

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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 (NHQI).

National Tables

2_11_1_4.1 Long-stay nursing home residents whose need for help with daily activities increased, United States, 2007-2010

2_11_1_4.2 Long-stay nursing home residents whose need for help with daily activities increased, United States, 2000-2006

2_11_1_4.3 Long-stay nursing home residents whose need for help with daily activities increased, by race/ethnicity, United States, 2010

National Data Source

CMS, Nursing Home Minimum Data Set (MDS).

National Denominator

Medicare chronic care nursing home residents with a valid target assessment and a valid prior assessment, excluding residents who cannot get worse 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 or more 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

2_11_1_4.4 Long-stay nursing home residents whose need for help with daily activities increased, by race/ethnicity and State, United States, 2010

State Data Source

CMS, MDS.

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 NHQI measures, refer to the documentation available at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/index.html

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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 (NHQI).

National Tables

2_11_1_5.1 Long-stay nursing home residents who spend most of their time in bed or in a chair, United States, 2007-2010

2_11_1_5.2 Long-stay nursing home residents who spend most of their time in bed or in a chair, United States, 2000-2006

2_11_1_5.3 Long-stay nursing home residents who spend most of their time in bed or in a chair, by race/ethnicity, United States, 2010

National Data Source

CMS, Nursing Home Minimum Data Set (MDS).

National Denominator

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

National Numerator

Subset of the denominator who were bedfast on target assessment.

State Table

2_11_1_5.4 Long-stay nursing home residents who spend most of their time in bed or in a chair, by race/ethnicity and State, United States, 2010

State Data Source

CMS, MDS.

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 NHQI measures, refer to the documentation available at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/index.html

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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 (HHQI).

National Tables

2_11_1_6.1 Home health care patients who get better at bathing, United States, 2010

2_11_1_6.2 Home health care patients who get better at bathing, United States, 2002-2009

2_11_1_6.3a-b Home health care patients who get better at bathing, United States, 2010, by:

  1. Race.
  2. 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 people 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

2_11_1_6.4a-b Home health care patients who get better at bathing, by State, United States, 2010, by:

  1. Race.
  2. 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 HHQI measures is available at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/index.html

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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 (HHQI).

National Tables

2_11_1_7.1 Home health care patients who get better at taking their medication correctly, United States, 2010

2_11_1_7.2 Home health care patients who get better at taking their medication correctly, United States, 2002-2009

2_11_1_7.3a-b Home health care patients who get better at taking their medication correctly, United States, 2010, by:

  1. Race.
  2. 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 people who are at the highest performance level and cannot improve any more and people taking injectable or IV medications.

National Numerator

Subset of the denominator in which a person showed improvement in ability to manage oral medications compared with a prior assessment.

State Tables

2_11_1_7.4a-b Home health care patients who get better at taking their medication correctly, by State, United States, 2010, by:

  1. Race.
  2. 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 HHQI measures is available at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/index.html

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Page last reviewed June 2013
Internet Citation: 2012 National Healthcare Quality and Disparities Reports : Effectiveness of Care: Functional Status Preservation and Rehabilitati. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/measurespec/rehabilitation.html