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CMS Quality Measure Shuffle: What’s in Store for April 2019

The new MDS 3.0 Quality Measures User’s Manual Version 12.0, effective Jan. 1, 2019, has been posted to the Centers for Medicare and Medicaid Services (CMS) website. Click here to download the manual.

The manual contains many updates, including changes to the specifications for these quality measures:

  • Long and Short Stay Pressure Ulcers
  • Long and Short Stay Influenza Vaccination
  • Long Stay Weight Loss
  • Short Stay Improvement in Function

The most significant and comprehensive change is adoption of the Quality Reporting Program (QRP) Pressure Ulcer Measure to replace the Short Stay Pressure Ulcer Measure. The technical specifications for the QRP Pressure Ulcer Measure can be found in Chapter 7, Table 7-1 of the Skilled Nursing Facility (SNF) QRP Measure Calculations and Reporting User’s Manual Version 2.0, available here.

Since Oct. 1, 2018, when MDS 3.0 Version 1.16 became effective, CMS has known that it would have to change the short stay measure “Percent of Residents with Pressure Ulcers That are New or Worsened, Short Stay” due to retirement of MDS item M0800. April 2019 reports the fourth quarter of 2018, the first quarter without item M0800 and the first quarter to use the QRP measure to calculate the Quality Measure domain of the Five-Star Quality Rating System.

Check your QRP Pressure Ulcer Measure rate on Nursing Home Compare by selecting “Quality of resident care” and then “Short-stay residents.” The QRP measure will be listed under “Additional quality measures.”

Contact: Susan Chenail, schenail@leadingageny.org, 518-867-8383 ext. 116