Proposed Quality Measure Includes Focus on Care Transitions

CMS recently released their report “List of Measures under Consideration for December 1, 2017”. One proposed measure directly applicable to transitional care is the CoreQ: Short Stay Discharge Measure. The measure calculates the percentage of individuals discharged in a six-month time period from a SNF, within 100 days of admission, who are satisfied. This patient reported outcome measure is based on the CoreQ: Short Stay Discharge questionnaire that utilizes four items. The following are the four patient reported items:

In recommending this facility to your friends and family, how would you rate it overall? (Poor, Average, Good, Very Good, or Excellent)
Overall, how would you rate the staff? (Poor, Average, Good, Very Good, or Excellent)
How would you rate the care you receive? (Poor, Average, Good, Very Good, or Excellent)
How would you rate how well your discharge needs were met? (Poor, Average, Good, Very Good, or Excellent)

The numerator is the sum of the individuals in the facility that have an average satisfaction score of greater than or equal to 3 for the four questions on the CoreQ. The denominator includes all of the patients that are admitted to the SNF, regardless of payor source, for post-acute care, that are discharged within 100 days; who receive the survey (e.g. people meeting exclusions do not receive a questionnaire) and who respond to the CoreQ: Short Stay Discharge questionnaire within two months of receiving the questionnaire.

Statistics show that more than half of all elders cared for in nursing homes are now discharged home (approximately 1.6 million residents; CMS, 2009). As this percentage increases, more scrutiny is likely going be placed on the transition from skilled nursing to home. The proposed question “How would you rate how well your discharge needs were met?” is likely just one of the first steps in measuring how skilled groups perform with this transition.

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