Nursing Homes Urged to Review Quality Score Sheets

Draft 2014 Nursing Home Quality Initiative score sheets along with an updated explanation of the methodology and a guide to help interpret the score sheet are posted on the Health Commerce System (HCS). DOH is accepting questions on the data at NHQP@health.ny.gov and is requesting providers communicate issues or concerns that they may have with the calculations to DOH by Tues., Dec. 2.

Please note that the way that the long stay resident vaccination rate quality measures are calculated in 2014 differ from the previous year. In 2013, residents who refused vaccination or for whom vaccination was contraindicated were excluded from the calculation. In 2014 they are included. As a result many homes see a lower rate for these measures than the CMS 5-star methodology would suggest. In addition, the influenza vaccination measure for 2014 is scored using quintiles; for 2013 homes scored full points for meeting an 85 percent threshold. The pneumococcal vaccination rate scoring continues to use the 85 percent threshold. A more complete explanation of the vaccination rate calculation from DOH is copied below.  Note that 2014 quality measure scores are based on 2013 data.

The hospitalization score calculations are not yet final (and do not appear on the score sheet) making it impossible for DOH to assign homes a final score and quintile at this time.

Because 2013 NHQI scores required reissuance to perfect the initial calculations, we recommend that members review the score sheets and let DOH as well as LeadingAge NY know if you note errors. We will be communicating our observations to DOH.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841

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From DOH Office of Quality and Patient Safety: 

2013 NHQI

1. Percent of Long Stay Residents Assessed and Given, Appropriately, the Seasonal Influenza Vaccine

Numerator

• Long stay residents who received the influenza vaccine during the current or most recent influenza season, either in the facility or outside the facility
• Long stay residents who were offered and declined the influenza vaccine
• Long stay residents who were ineligible due to contraindications

Denominator

• All long stay residents with a selected target assessment, except those with exclusions
• Exclusions: Individuals who were not residents of the facility during the current or most recent influenza season

2. Percent of Long Stay Residents Assessed and Given, Appropriately, the Pneumococcal Vaccine

Numerator

• Long stay residents who have an up-to-date PPV status
• Long stay residents who were offered and declined the vaccine
• Long stay residents who were ineligible due to contraindications 

Denominator

• All long stay residents with a selected target assessment 

2014 NHQI

1. Percent of Long Stay Residents Who Received the Seasonal Influenza Vaccine

Numerator

• Long stay residents who received the seasonal influenza vaccine during the current or most recent influenza season, either in the facility or outside the facility

Denominator

• All long stay residents with a selected target assessment, except those with exclusions
• Exclusions: Individuals who were not residents of the facility during the current or most recent influenza season

2. Percent of Long Stay Residents Who Received the Pneumococcal Vaccine 

Numerator

• Long stay residents who have an up-to-date PPV status

Denominator

• All long stay residents with a selected target assessment

In the 2013 NHQI, both resident vaccination measures were awarded points based on thresholds of 85% or higher. In this 2014 NHQI, the pneumococcal vaccination measure is still based on the 85% threshold. However, the influenza vaccination measure is quintiled. Quintile 1 receives 5 points, quintile 2 receives 3 points, quintile 3 receives 1 point, and quintiles 4 and 5 receive 0 points.