1. What is the metric?

Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased (Long Stay)

  1. What does the metric mean?

This measure reports the percent of long-stay residents whose need for help with late-loss Activities of Daily Living (ADLs) has increased when compared to the prior assessment.

  1. How do we calculate the metric?

    1. The Numerator is the number of long-stay residents that indicate their need for help with late-loss Activities of Daily Living (ADLs) has increased when the selected target and prior  assessments are compared. The four late-loss ADL items are bed mobility, transfer , eating, and toileting.

An increase is defined as:

      i. An increase of two or more coding points in one late-loss ADL item OR

      ii. A one point increase in coding points in two or more late-loss ADL items

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

  2. Exclusions include residents who meet any of the following criteria:

    1. All four ADLs indicate total dependence on the prior assessment

    2. Three of the ADLs indicate total dependence on the prior assessment and the fourth indicates need of extensive assistance

    3. The resident is coded as comatose on the target assessment

    4. The resident’s life expectancy < 6 months on the target assessment

    5. The resident is coded as receiving hospice care on the target assessment

    6. The resident is not in the numerator and any of the ADLs have not been filled out on either the prior or the target assessment

  1. References 

MDS 3.0 Quality Measures User's Manual V15

Page 49, Table 2-26