What is the metric?
Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased (Long Stay)
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.
How do we calculate the metric?
The Numerator is the number of long-stay residents with selected target and prior assessments that indicate the need for help with late-loss Activities of Daily Living (ADLs) has increased when the selected assessments are compared. The four late-loss ADL items are: Sit to Lying, Sit to Stand, Eating, and Toilet Transfer.
An increase in need for help is defined as:
i. A decrease of two or more coding points in one late-loss ADL item
ii. A decrease of one coding point in two or more late-loss ADL items
The Denominator is all long-stay residents with a selected target and prior assessment, except those with exclusions.
Exclusions include residents who meet any of the following criteria:
All four late-loss ADLs indicate dependence or ‘activity not attempted’ on the prior assessment
Three of the late-loss ADLs indicate dependence or ‘activity not attempted’ on the prior assessment and the fourth indicates a need of substantial/maximal assistance
The resident is coded comatose on the target assessment
The resident’s life expectancy is less 6 months on the target assessment
The resident is coded as receiving hospice care on the target assessment
The resident is not in the numerator and any of the late-loss ADLs have not been filled out on either assessments
References
MDS 3.0 Quality Measures User's Manual V16
Page 39, Table 2-24