1. What is the metric?


This measure records the Number of Hospitalizations per 1,000 Long-Stay Resident Days. 


The metric business rules are based on the CMS Claims Based Quality Measure: Number of Hospitalizations per 1,000 Long-Stay Resident Days. 


  1. What does the metric mean?


This metric measures the number of Inpatient Hospitalizations that occurred among long-stay residents of a nursing home during a selected period, expressed as the number of Inpatient Hospitalizations for every 1,000 days that the long-stay residents were admitted to the nursing home.

  1. How do we calculate the metric?


The Numerator is the number of hospital admissions of long-term nursing home residents during a selected time period, including inpatient and observation stays at acute care hospitals that occurred during the resident's stay at the nursing home.


An inpatient hospitalization is any of the following:

  1. A patient who was discharged to a hospital inpatient unit in PCC’s census ADT.

  2. A patient who was discharged to an Emergency Department in PCC’s census ADT and:

    1. Had an outcome of "Admitted, Status Uncertain," "Admitted, Observation," or "Admitted, Inpatient" entered in PCC.
      OR

    2. Had no outcome entered in PCC and did not return to the SNF within 72 hours of discharge to the ED

  3. Was discharged to the community and returned to the SNF from a hospital.


The Denominator is the total number of days that long-stay nursing home residents spent in the facility during the target period, after they had been residents for 100 cumulative days or more. Cumulative days are the sum of days within an episode of care uninterrupted by a break of 30 days or more living in the community or another institution. This number is expressed per 1000 resident days (resident days/1000).

The date finder selects all hospitalizations and long term days of care occurring during the period.

 

  1. References 


            Nursing Home Compare ClaimsBased Quality Measure Technical Specifications