Minor NHQI Changes Proposed for 2020
During the annual meeting of the Nursing Home Quality Initiative (NHQI) Workgroup on Nov. 27th, the Department of Health (DOH) provided an overview of the results of the 2019 NHQI and described several changes being proposed for 2020. Highlights of the discussions are provided below.
- Starting with the 2019 NHQI, the staffing hours per day measure and the percentage of contract/agency staff used measure will both be based on Payroll-Based Journal (PBJ) data instead of cost report data. The impact of the shift is that the statewide average staffing figure is higher: 3.8 (2019 PBJ-based) versus 3.5 (2018 cost report-based figure). The percentage of homes using more than 10 percent of contract staff increased slightly (from 28.7 percent in 2018 based on cost report data to 30.5 percent in 2019 based on PBJ data).
- Due to the change in staffing data source, no improvement points are available for the staffing measure in 2019.
- 93 percent of homes received at least one improvement point (as compared to 96 percent in 2018), and most statewide quality measure average scores improved.
- 99.5 percent of homes received full points for timely cost report filing, while 94.7 percent filed employee influenza immunization data on time.
- For 2020, DOH proposes to shift three quality measures from quintile scoring to threshold scoring. DOH believes that the three have “topped out” and would be more effective if points were scored based on whether a home’s rate was above or below 5 percent. Providers with rates at or below 5 percent would receive the full five points, while those above 5 percent would receive zero points. The three measures are: (1) residents experiencing one or more falls with major injury; (2) residents who self-report moderate to severe pain; and (3) residents with a urinary tract infection.
- The wording of question S7000 in section S of the Minimum Data Set (MDS) on dental care is being revised to better capture when dental care is provided but will not appear on the MDS until October 2020.
- DOH is exploring whether to add a measure for outpatient emergency department visits by long-stay residents.
- The Department expects to finalize the 2019 NHQI and release facility-specific results for feedback no later than January.
Meanwhile, rate adjustments based on the 2018 NHQI results are still in executive review and expected to move forward once approved.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841