1. What is the metric?

Percent of Residents With New or Worsened Bowel or Bladder Incontinence (LS)

  1. What does the metric mean?

    This measure reports the percent of long-stay residents with new or worsened bowel or bladder incontinence between the prior assessment and target assessment.


  1. How do we calculate the metric?

The Numerator is the number of Long-stay residents with a  selected target and prior assessments that indicate a new or worsened case of bowel or bladder incontinence has occurred when the selected assessments are compared


Residents meet the definition of new or worsened bowel or bladder incontinence if any of the following conditions are true:


  1. An increase in one or more coding points on the bowel continence item from always continent to either occasionally, frequently, or always incontinent (defined as a new case)

  2.  An increase in one or two coding points on the bowel continence item from occasionally incontinent to frequently or always incontinent or from frequently incontinent to always incontinent (defined as a worsened case)

  3. An increase in one or more coding points on the bladder continence item from always continent or occasionally incontinent to frequently or always incontinent (defined as a new case)

  4. An increase in one coding point on the bladder continence item from frequently incontinent to always incontinent (defined as a worsened case)


The Denominator is the number of all long-stay residents with a selected target and prior assessment, except those with exclusions.


Exclusions for this metric include Residents satisfying any of the following conditions:

  1. The target assessment is an admission assessment or a PPS 5-day assessment

  2. The resident is not in numerator and bowel continence OR bladder continence are missing from either assessments

  3. Resident is comatose or comatose status is missing on either assessment

  4. Resident has an indwelling catheter or indwelling catheter status is missing from either assessment

  5. Resident has an ostomy or ostomy status is missing from either assessment 

  6. No prior assessment is available to assess a change in condition

  7. Prior or target assessment dates before 10/01/2023.



  1. References 

    MDS 3.0 Quality Measures User’s Manual V16

Pages 51-52, Table 2-31