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Looking at the numbers: Measuring Skilled Nursing Facilities on Quality and Value

Percentage of short-stay residents who were successfully discharged to the community

Two recent Medicare changes will measure the quality and value of the care provided by skilled nursing facilities (SNF) in new ways. The programs make more quality data publicly available and place a focus on outcomes through value-based payments.

Skilled Nursing Facility Quality Reporting Program (SNF QRP)

Recognizing that patients receive care in different places, through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, CMS has standardized six patient assessment data measures across post-acute care settings—long-term care hospitals, hospital-based inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies:

  • Falls with major injury
  • Pressure ulcers that are new or worsened
  • Assessments and care planning relating to a resident’s level of function
  • Medicare spending per beneficiary postacute care
  • Discharge to community
  • Potentially preventable readmissions

For SNFs, the first three measures will be captured in the Minimum Data Set (MDS) and the last three will come from Medicare fee for service (FFS) claims data.

Percentage of short-stay residents who were re-hospitalized after a nursing home admission

The measures aim to improve person-centered, goal-driven discharge planning; enhance ability to exchange data; and help with coordinated care across the post-acute care spectrum. Public reporting of SNF QRP quality data is scheduled to begin fall 2018, through Nursing Home Compare.

Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP)

Medicare has added SNFs to the health care settings being reimbursed using a value modifier. Starting October 1, 2018, SNFs can earn two percent (2%) of their Medicare incentive payments relative to national performance on two readmission measures:

  • 30-Day All-Cause Readmission Measure
  • 30-Day Potentially Preventable Readmission Measure

The data comes from Medicare FFS claims data. CMS has started baseline data collection to be used to establish performance standards and scoring methodology.

These four tables, based on data from Nursing Home Compare, offer a proxy to show how Minnesota skilled nursing facilities will fare in the new programs compared to facilities across the country. Stratis Health conducts analytical work in support of assessing and improving health care quality and patient safety.

Percentage of long-stay residents experiencing one or more falls with major injuryPercentage of short-stay residents with pressure ulcers that are new or worsened