Major Nursing Home Quality Measurement Sets

NQF-Endorsed Measures

The National Quality Forum (NQF) has endorsed a set of voluntary consensus standards for nursing home care. Measures reflecting these standards are among the information presented by most sponsors of nursing home reports, including the Center for Medicare & Medicaid Services (CMS) Nursing Home Compare Web site.

The NQF is a multistakeholder organization established to standardize health care quality measurement and reporting. Learn about the National Quality Forum.

Measures Based on the Minimum Data Set

All nursing homes that participate in either the Medicare or Medicaid program, which includes nearly all nursing homes in the United States, must submit periodic resident-level data on a wide range of variables. These include:

• The health and functioning of the resident.
• The services being provided to the resident.
• Changes in the resident’s status.

This data goes into a database known as the Minimum Data Set (MDS), which is maintained by CMS.

The MDS has proven to be a gold mine source of information for the development of performance measures and for the collection of data for those measures. The NQF-endorsed measures for nursing homes are all derived from the MDS.

The MDS 3.0 database, which includes manuals, forms, software links, and historical information, is available from CMS at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30.html.

For information about the MDS, go to http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/index.html?redirect=/NursingHomeQualityInits/.

CAHPS^® Measures

The CAHPS Nursing Home Surveys assess the experiences of nursing home residents and family members:

• The Long-Stay Resident Instrument captures both quality of life and quality of care from the residents’ perspective. The questionnaire asks residents to report on the nursing home environment, care, communication and respect, autonomy, and activities. It is designed to be administered in person.
• The Short-Stay Resident Instrument assesses the experiences of residents who stayed less than 30 days and have been recently discharged. Like the instrument for long-stay residents, this instrument asks the former residents to report on the nursing home environment, care, communication and respect, autonomy, and activities.
• The Family Member Instrument is designed to gather information from family members who have had direct experience observing the nursing home care provided to their relative. In addition to asking for an overall rating of care, this questionnaire asks family members to report on:
  • Whether and how the nursing home meets the resident’s basic needs.
  • The kindness and respectfulness of nurses and aides.
  • Whether the nursing home provides families with information and encourages their involvement.
  • The level of staffing, care of belongings, and cleanliness.

Also in "Measures of Quality in Nursing Homes, Home Health Agencies, and Hospice"

• Nursing Home Care
  • Examples of Nursing Home Quality Measures for Consumers
  • Major Nursing Home Measurement Sets and Databases
• Home Health Care
• Hospice Care