DMINHo
Development, Maintenance, and Implementation of Nursing Home Quality of Care Measures
Funded by: Centers for Medicare & Medicaid Services
Project Period: 10/06 - 09-07
Abstract
Objectives: 1) To reevaluate the nursing home quality measures (QMs)
that are currently publicly reported by the Centers for Medicare & Medicaid Services (CMS)
on Nursing Home Compare. 2) To identify and empirically test needed refinements to the
measures. 3) To provide CMS with final recommendations regarding the value of the current
as well as the refined measures.
Methods: The currently reported QMs will be evaluated through three
independent methods: 1) a clinical review, 2) an empirical review, and 3) a review of
current literature and research findings. The objective of the clinical review is to
acquire clinical opinion on the currently reported nursing home QMs. As part of this
review, a group of experts in quality measurement and nursing home care assessed the
appropriateness of the measures in light of the current standard of nursing home care.
In the empirical review, the reliability, validity, and usefulness of each measure will be
examined and risk-adjustment procedures refined. For each measure, relevant literature
will be reviewed and potential refinements to the current measures identified. The findings
and recommendations resulting from these three independent activities will be synthesized and
suggestions for the refinement of the current measures identified. All proposed revisions
will undergo empirical testing to examine the triggering rates, variability, sensitivity,
reliability, and validity of each proposed measure. Final recommendations will be presented
to CMS. For selected measures, measure endorsement by the National Quality Forum (NQF) and
public reporting will be pursued.
Current Project Status: The clinical review of measures has been
completed. The empirical and literature reviews are underway. In August 2007, empirical
testing of proposed measures will begin.
Key Staff: Brega, A, PI; Kramer, A; Hittle, D; Eilertsen, T; Goodrich, G; Levy, C.
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