Skip to main content

The AHRQ National Quality Measures Clearinghouse (NQMC, qualitymeasures.ahrq.gov) Web site will not be available after July 16, 2018 because federal funding
through AHRQ will no longer be available to support the NQMC as of that date. For additional information, read our full announcement.
  • Measure Summary
  • NQMC:010734
  • Oct 2015
  • NQF-Endorsed Measure

Long-stay nursing home care: percent of residents who lose too much weight.

RTI International. MDS 3.0 quality measures user's manual, v9.0. Baltimore (MD): Centers for Medicare & Medicaid Services (CMS); 2015 Oct 1. 80 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: RTI International. MDS 3.0 quality measures user's manual. v8.0. Baltimore (MD): Center for Medicare & Medicaid Services (CMS); 2013 Apr 15. 80 p.

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percent of long-stay residents who had a weight loss of 5% or more in the last month or 10% or more in the last two quarters who were not on a physician prescribed weight-loss regimen noted in a Minimum Data Set (MDS) assessment during the selected quarter.

Rationale

Unintended and excessive weight loss is a significant problem among long-stay nursing home residents. Weight loss of 5% or more in one month or 10% or more over six months is usually considered unhealthy (Thomas et al., 2000), and prior studies suggest that weight loss is associated with increased mortality (Murden & Ainslie, 1994; Ryan et al., 1995; Sullivan et al., 2002; Stack et al., 2013; Keller et al., 2015).

Excessive, rapid weight loss may be a sign of depression, medical or dental problems that make eating difficult, end of life, or resident refusal to eat. At the same time, it may be a sign of problems with nutritional care within the nursing home. To help prevent unintended weight loss, it is important that the resident's diet be balanced and nutritious, and that staff spend enough time feeding residents who cannot feed themselves. Empirical evidence indicates that organizational factors (structures) and care processes influence the nutritional intake and risk of weight loss for the elderly (Sanders, 1990; Van Ort & Phillips, 1995; Lange-Alberts & Shott, 1994; Kayser-Jones & Schell, 1997; Amella, 1999; Simmons et al., 2001; Altus, Engelman, & Matthews, 2002; Pelletier, 2004; Milne et al., 2005; Simmons et al., 2003; Beattie et al., 2014). Higher staffing levels and staff training, positive relationships and better communication between staff and residents, and a quieter and more private dining environment may increase residents' food consumption and improve their nutritional status (Sanders, 1990; Van Ort et al., 1995; Lange-Alberts et al., 1994; Kayser-Jones et al., 1997; Amella, 1999; Simmons et al., 2001; Altus, Engelman, & Matthews, 2002; Pelletier, 2004; Beattie et al., 2014). Some nutrition and dining programs may potentially reduce the risk of weight loss for nursing home residents. For example, a Cochrane meta-analysis found that supplementation produces small but consistent weight gain in older people (Milne et al., 2005). Another study found that facilities with verbal prompting and social interaction during meals had lower rates of weight loss (Simmons et al., 2003). Appropriate management of clinical conditions for people at higher risk for weight loss, e.g., those with depression, is also a potentially effective way to prevent unintended weight loss (Fawcett & Barkin, 1998; Malone, 2005; Rigler et al., 2001).

A review study demonstrated that weight loss is the most objective and reproducible marker of nutritious status for nursing home residents (Bell et al., 2013). By monitoring and publicly reporting nursing facility performance in preventing weight loss, nursing facilities will have incentives to focus on monitoring and maintaining residents' weight and nutritional status.

Nutritional issues have been identified as a priority area for practice change and research in long-term care (Keller et al., 2015; Morley et al., 2014; Rolland et al., 2011). In long-term care, the primary cause of malnutrition is poor food and fluid intake (Keller et al., 2014, Bell et al., 2013). Nursing home residents often have chronic diseases and functional impairments that may impair proper nutrition and hydration (Morley, 2007; Sloane et al., 2008; Bourdel-Marchasson, 2010) and require interventions by facility staff (Morley, 2007). Between 40% and 60% of nursing home residents have swallowing disorders, often related to dementia (Kayser-Jones & Pengilly, 1999). Various chronic illnesses are associated with malnutrition, including cancer, diabetes, depression, and chronic obstructive pulmonary disease (COPD) (Huffman, 2002). Medications, oral health problems (such as missing teeth), dysphagia, and dementia can complicate nutrition and hydration. Medications may cause nausea, anxiety, constipation, and lack of appetite. Depression has been identified as the "most common reversible illness" associated with malnutrition (Sloane et al., 2008). Dehydration is a major factor in weight loss in about 10% of nursing home residents (Kaldy et al., 2000; Feinsod et al., 2004; Smith, 2006). A review study demonstrated that weight loss is the most objective and reproducible marker of nutritious status for nursing home residents (Bell et al., 2013).

Using Minimum Data Set (MDS) 2.0 data for April to June 2009, the national prevalence of too much weight loss in nursing homes was 9.2%, ranging from a low of an average of 7.0% in Alaska to a high of an average of 11.4% in North Carolina (Centers for Medicare & Medicaid Services [CMS], n.d.). The national percentage of too much weight loss fluctuated somewhat between 2003 and 2009, with a modest downward trend (American Health Care Association, 2009). RTI analysis of MDS 3.0 in Q3 2014 shows that 5.7% of the long-stay residents experienced a weight loss of 5% or more in the past 30 days or 10% or more in the past 6 months.

Elderly individuals with excessive and rapid weight loss are at higher risk for functional decline, hip fracture (Langlois et al., 1996; Langlois et al., 2001; Ensrud et al., 2003) and mortality (Ryan et al., 1995; Covinsky et al., 1999; Kiely & Flacker, 2000; Sullivan et al., 2002; Wedick et al., 2002; Keller & Ostbye, 2005; Amador et al., 2006; Stack et al., 2013). Detecting and preventing weight loss is central to ensure appropriate nutritional intake.

Evidence for Rationale

Altus DE, Engelman KK, Mathews RM. Using family-style meals to increase participation and communication in persons with dementia. J Gerontol Nurs. 2002 Sep;28(9):47-53. PubMed External Web Site Policy

Amador LF, Al Snih S, Markides KS, Goodwin JS. Weight change and mortality among older Mexican Americans. Aging (Milano). 2006 Jun;18(3):196-204. PubMed External Web Site Policy

Amella EJ. Factors influencing the proportion of food consumed by nursing home residents with dementia. J Am Geriatr Soc. 1999 Jul;47(7):879-85. PubMed External Web Site Policy

Beattie E, O'Reilly M, Strange E, Franklin S, Isenring E. How much do residential aged care staff members know about the nutritional needs of residents?. Int J Older People Nurs. 2014 Mar;9(1):54-64. PubMed External Web Site Policy

Bell CL, Tamura BK, Masaki KH, Amella EJ. Prevalence and measures of nutritional compromise among nursing home patients: weight loss, low body mass index, malnutrition, and feeding dependency, a systematic review of the literature. J Am Med Dir Assoc. 2013 Feb;14(2):94-100. PubMed External Web Site Policy

Bourdel-Marchasson I. How to improve nutritional support in geriatric institutions. J Am Med Dir Assoc. 2010 Jan;11(1):13-20. [74 references] PubMed External Web Site Policy

Centers for Medicare and Medicaid Services (CMS). CMS MDS quality measure/indicator report. [internet]. Baltimore (MD): Centers for Medicare & Medicaid Services (CMS);

Covinsky KE, Martin GE, Beyth RJ, Justice AC, Sehgal AR, Landefeld CS. The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients. J Am Geriatr Soc. 1999 May;47(5):532-8. PubMed External Web Site Policy

Ensrud KE, Ewing SK, Stone KL, Cauley JA, Bowman PJ, Cummings SR. Intentional and unintentional weight loss increase bone loss and hip fracture risk in older women. J Am Geriatr Soc. 2003 Dec;51(12):1740-7. PubMed External Web Site Policy

Fawcett J, Barkin RL. Review of the results from clinical studies on the efficacy, safety and tolerability of mirtazapine for the treatment of patients with major depression. J Affect Disord. 1998 Dec;51(3):267-85. PubMed External Web Site Policy

Feinsod FM, Levenson SA, Rapp K, Rapp MP, Beechinor E, Liebmann L. Dehydration in frail, older residents in long-term care facilities. J Am Med Dir Assoc. 2004 Mar-Apr;5(2 Suppl):S35-41. [38 references] PubMed External Web Site Policy

Huffman GB. Evaluating and treating unintentional weight loss in the elderly. Am Fam Physician. 2002 Feb 15;65(4):640-50. [43 references] PubMed External Web Site Policy

Kayser-Jones J, Pengilly K. Dysphagia among nursing home residents. Geriatr Nurs. 1999 Mar-Apr;20(2):77-82; quiz 84. PubMed External Web Site Policy

Kayser-Jones J, Schell E. The mealtime experience of a cognitively impaired elder: ineffective and effective strategies. J Gerontol Nurs. 1997 Jul;23(7):33-9. PubMed External Web Site Policy

Keller H, Beck AM, Namasivayam A, International-Dining in Nursing home Experts (I-DINE) Consortium. Improving food and fluid intake for older adults living in long-term care: a research agenda. J Am Med Dir Assoc. 2015 Feb;16(2):93-100. PubMed External Web Site Policy

Keller HH, Ostbye T. Body Mass Index (BMI), BMI change and mortality in community-dwelling seniors without dementia. J Nutr Health Aging. 2005 Sep-Oct;9(5):316-20. PubMed External Web Site Policy

Kiely DK, Flacker JM. Resident characteristics associated with mortality in long-term care nursing homes: is there a gender difference. J Am Med Dir Assoc. 2000 Jan-Feb;1(1):8-13. PubMed External Web Site Policy

Lange-Alberts ME, Shott S. Nutritional intake. Use of touch and verbal cuing. J Gerontol Nurs. 1994 Feb;20(2):36-40. PubMed External Web Site Policy

Langlois JA, Harris T, Looker AC, Madans J. Weight change between age 50 years and old age is associated with risk of hip fracture in white women aged 67 years and older. Arch Intern Med. 1996 May 13;156(9):989-94. PubMed External Web Site Policy

Langlois JA, Mussolino ME, Visser M, Looker AC, Harris T, Madans J. Weight loss from maximum body weight among middle-aged and older white women and the risk of hip fracture: the NHANES I epidemiologic follow-up study. Osteoporos Int. 2001;12(9):763-8. PubMed External Web Site Policy

Malone M. Medications associated with weight gain. Ann Pharmacother. 2005 Dec;39(12):2046-55. PubMed External Web Site Policy

Morley JE, Caplan G, Cesari M, Dong B, Flaherty JH, Grossberg GT, Holmerova I, Katz PR, Koopmans R, Little MO, Martin F, Orrell M, Ouslander J, Rantz M, Resnick B, Rolland Y, Tolson D, Woo J, Vellas B. International survey of nursing home research priorities. J Am Med Dir Assoc. 2014 May;15(5):309-12. PubMed External Web Site Policy

Morley JE. Weight loss in the nursing home. J Am Med Dir Assoc. 2007 May;8(4):201-4. PubMed External Web Site Policy

Murden RA, Ainslie NK. Recent weight loss is related to short-term mortality in nursing homes. J Gen Intern Med. 1994 Nov;9(11):648-50. PubMed External Web Site Policy

National Quality Forum measure information: percent of residents who lose too much weight (long stay). Washington (DC): National Quality Forum (NQF); 2015. 31 p.

Pelletier CA. What do certified nurse assistants actually know about dysphagia and feeding nursing home residents?. Am J Speech Lang Pathol. 2004 May;13(2):99-113. PubMed External Web Site Policy

Rigler SK, Webb MJ, Redford L, Brown EF, Zhou J, Wallace D. Weight outcomes among antidepressant users in nursing facilities. J Am Geriatr Soc. 2001 Jan;49(1):49-55. PubMed External Web Site Policy

Rolland Y, Aquino JP, Andrieu S, Beard J, Benetos A, Berrut G, Coll-Planas L, Dartigues JF, Dong B, Forette F, Franco A, Franzoni S, Hornez T, Metais P, Ruault G, Stephan E, Swagerty D, Tolson D, Volicer L, Vellas B, Morley J. Identification of the main domains for quality of care and clinical research in nursing homes. J Nutr Health Aging. 2011 May;15(5):410-24. PubMed External Web Site Policy

Ryan C, Bryant E, Eleazer P, Rhodes A, Guest K. Unintentional weight loss in long-term care: predictor of mortality in the elderly. South Med J. 1995 Jul;88(7):721-4. PubMed External Web Site Policy

Sanders HN. Feeding dependent eaters among geriatric patients. J Nutr Elder. 1990;9(3):69-74. PubMed External Web Site Policy

Simmons SF, Alessi C, Schnelle JF. An intervention to increase fluid intake in nursing home residents: prompting and preference compliance. J Am Geriatr Soc. 2001 Jul;49(7):926-33. PubMed External Web Site Policy

Simmons SF, Garcia ET, Cadogan MP, Al-Samarrai NR, Levy-Storms LF, Osterweil D, Schnelle JF. The minimum data set weight-loss quality indicator: does it reflect differences in care processes related to weight loss?. J Am Geriatr Soc. 2003 Oct;51(10):1410-8. PubMed External Web Site Policy

Simmons SF, Osterweil D, Schnelle JF. Improving food intake in nursing home residents with feeding assistance: a staffing analysis. J Gerontol A Biol Sci Med Sci. 2001 Dec;56(12):M790-4. PubMed External Web Site Policy

Sloane PD, Ivey J, Helton M, Barrick AL, Cerna A. Nutritional issues in long-term care. J Am Med Dir Assoc. 2008 Sep;9(7):476-85. [68 references] PubMed External Web Site Policy

Smith PA. Nutrition, hydration, and dysphagia in long-term care: Differing opinions on the effects of aspiration. J Am Med Dir Assoc. 2006 Nov;7(9):545-9. PubMed External Web Site Policy

Stack S, Chertow GM, Johansen KL, Si Y, Tamura MK. Pre-ESRD changes in body weight and survival in nursing home residents starting dialysis. Clin J Am Soc Nephrol. 2013 Oct;8(10):1734-40. PubMed External Web Site Policy

Sullivan DH, Morley JE, Johnson LE, Barber A, Olson JS, Stevens MR, Yamashita BD, Reinhart SP, Trotter JP, Olave XE. The GAIN (Geriatric Anorexia Nutrition) registry: the impact of appetite and weight on mortality in a long-term care population. J Nutr Health Aging. 2002;6(4):275-81. PubMed External Web Site Policy

Thomas DR, Ashmen W, Morley JE, Evans WJ. Nutritional management in long-term care: development of a clinical guideline. Council for Nutritional Strategies in Long-Term Care. J Gerontol A Biol Sci Med Sci. 2000 Dec;55(12):M725-34. PubMed External Web Site Policy

Van Ort S, Phillips LR. Nursing intervention to promote functional feeding. J Gerontol Nurs. 1995 Oct;21(10):6-14. PubMed External Web Site Policy

Wedick NM, Barrett-Connor E, Knoke JD, Wingard DL. The relationship between weight loss and all-cause mortality in older men and women with and without diabetes mellitus: the Rancho Bernardo study. J Am Geriatr Soc. 2002 Nov;50(11):1810-5. PubMed External Web Site Policy

Primary Health Components

Nursing home; long-stay; weight loss

Denominator Description

Long-stay nursing home residents with a selected target assessment, except those with exclusions (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Long-stay nursing home residents with a selected target assessment which indicates a weight loss of 5% or more in the last month or 10% or more in the last 6 months who were not on a physician prescribed weight-loss regimen (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence
  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • A systematic review of the clinical research literature (e.g., Cochrane Review)
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Race

At the resident level, the developer compared the scores of this quality measure among different racial/ethnic groups. The lowest rate of weight loss was found among Hispanic residents (4.7%), and the highest rate was among white residents (5.8%). Differences in the rate of weight loss by racial/ethnic group were found to be statistically significant (p less than 0.0001).

Analyses at the facility level examined differences in the percent of residents who experienced a weight loss of 5% or more of the baseline weight in the last 30 days or 10% or more of the baseline weight in the last 6 months across two groups: facilities with proportions of white residents that were greater than or equal to the median proportion (87.5%) among facilities with sufficient sample size to meet minimum public reporting requirements, and facilities with fewer white residents than the median. The developer cross-tabulated racial composition (above/below median) with quality measure (QM) score (above/below median) and ran a 2-way Chi-square test for statistical dependence (with one degree of freedom). The results showed that the QM score was not statistically significantly different between the two groups of nursing homes (5.7% compared to 5.8%, p=0.06). A follow-up nonparametric test on the median-split data did not find a statistically significant relationship between facility-level racial composition and median facility scores on QM# 0689 (chi-square = 3.7, p =0.05).

Socioeconomic Status

To examine the potential for a relationship between socioeconomic disparity and weight loss, the developer examined the performance of this measure in facilities stratified by the proportion of residents who are Medicaid eligible, a proxy measure of low socioeconomic status. For this analysis, facilities were stratified into two groups: facilities with greater than 75% of residents who are Medicaid eligible and facilities with less than 75% of residents who are Medicaid eligible (75% of facilities have 75% or more of residents included in this measure who are Medicaid eligible). In Quarter 3 2014, no statistically significant difference was detected between the two groups (5.7% vs. 5.7%, F [1, 15145] = 0.0, p = 0.96). Thus, there is no disparity in this measure by socioeconomic status, as stratified by the proportion of residents who are Medicaid eligible.

Evidence for Additional Information Supporting Need for the Measure

National Quality Forum measure information: percent of residents who lose too much weight (long stay). Washington (DC): National Quality Forum (NQF); 2015. 31 p.

Extent of Measure Testing

A joint RAND/Harvard team engaged in a deliberate iterative process to incorporate provider and consumer input, expert consultation, scientific advances in clinical knowledge about screening and assessment, Centers for Medicare & Medicaid Services (CMS) experience, and intensive item development and testing by a national Veteran's Health Administration (VHA) consortium. This process allowed the final national testing of Minimum Data Set (MDS) 3.0 to include well-developed and tested items.

The national validation and evaluation of the MDS 3.0 included 71 community nursing homes (NHs) (3,822 residents) and 19 VHA NHs (764 residents), regionally distributed throughout the United States. The evaluation was designed to test and analyze inter-rater agreement (reliability) between gold-standard (research) nurses and between facility and gold-standard nurses, validity of key sections, response rates for interview items, anonymous feedback on changes from participating nurses, and time to complete the MDS assessment.

Analysis of the test results showed that MDS 3.0 items had either excellent or very good reliability even when comparing research nurse to facility-nurse assessment. In most instances these were higher than those seen in the past with MDS 2.0. In addition, for the cognitive, mood and behavior items, national testing included collection of independent criterion or gold-standard measures. These MDS 3.0 sections were more highly matched to criterion measures than were MDS 2.0 items.

Improvements incorporated in MDS 3.0 produced a more efficient assessment: better quality information was obtained in less time. Such gains should improve identification of resident needs and enhance resident-focused care planning. In addition, including items recognized in other care settings is likely to enhance communication among providers. These significant gains reflect the cumulative effect of changes across the tool, including use of more valid items, direct inclusion of resident reports, improved clarity of retained items, deletion of poorly performing items, form redesign, and briefer assessment periods for clinical items.

Refer to Development & Validation of a Revised Nursing Home Assessment Tool: MDS 3.0. for additional information.

Evidence for Extent of Measure Testing

Saliba D, Buchanan J. Development & validation of a revised nursing home assessment tool: MDS 3.0. Baltimore (MD): Quality Measurement and Health Assessment Group, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services; 2008 Apr. 263 p.

State of Use

Current routine use

Current Use

Decision-making by consumers about health plan/provider choice

Internal quality improvement

National reporting

Public reporting

Measurement Setting

Skilled Nursing Facilities/Nursing Homes

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Specified

Target Population Age

All ages

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Making Care Safer
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Safety

Case Finding Period

Quarterly

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Diagnostic Evaluation

Institutionalization

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Long-stay* nursing home residents with a selected target assessment, except those with exclusions

*Long-stay: An episode with cumulative days in facility (CDIF) greater than or equal to 101 days as of the end of the target period.

Exclusions

  1. Target assessment is an Omnibus Budget Reconciliation Act (OBRA) admission assessment or a prospective payment system (PPS) 5-day or readmission/return assessment
  2. Weight loss item is missing on target assessment

Note: Refer to the original measure documentation for details.

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Long-stay nursing home residents with a selected target assessment which indicates a weight loss of 5% or more in the last month or 10% or more in the last 6 months who were not on a physician prescribed weight-loss regimen

Note: Refer to the original measure documentation for details.

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Administrative clinical data

Type of Health State

Adverse Health State

Instruments Used and/or Associated with the Measure

Center for Medicare & Medicaid Services (CMS) Minimum Data Set (MDS) - Resident Assessment Instrument (Version 3.0)

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a lower score

Allowance for Patient or Population Factors

Does not apply to this measure

Standard of Comparison

External comparison at a point in, or interval of, time

Internal time comparison

Original Title

Percent of residents who lose too much weight (long-stay).

Measure Collection Name

Nursing Home Quality Initiative Measures

Measure Set Name

Long-stay Quality Measures

Submitter

Centers for Medicare & Medicaid Services - Federal Government Agency [U.S.]

Developer

Centers for Medicare & Medicaid Services - Federal Government Agency [U.S.]

RTI International - Nonprofit Research Organization

Funding Source(s)

United States (U.S.) Government

Composition of the Group that Developed the Measure

United States (U.S.) Government Staff, Clinical Experts, Researchers, and Statisticians

Financial Disclosures/Other Potential Conflicts of Interest

No conflicts of interest exist.

Endorser

National Quality Forum

NQF Number

0689

Date of Endorsement

2015 Dec 10

Measure Initiative(s)

Nursing Home Compare

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2015 Oct

Measure Maintenance

Annual and (every three years) endorsement

Date of Next Anticipated Revision

Quarter 2 2016

Measure Status

This is the current release of the measure.

This measure updates a previous version: RTI International. MDS 3.0 quality measures user's manual. v8.0. Baltimore (MD): Center for Medicare & Medicaid Services (CMS); 2013 Apr 15. 80 p.

Source(s)

RTI International. MDS 3.0 quality measures user's manual, v9.0. Baltimore (MD): Centers for Medicare & Medicaid Services (CMS); 2015 Oct 1. 80 p.

Measure Availability

Source available from the Centers for Medicare & Medicaid Services (CMS) Web site External Web Site Policy.

For more information, refer to the CMS Web site at www.cms.gov External Web Site Policy.

Companion Documents

The following are available:

  • Saliba D, Buchanan J. Development & validation of a revised nursing home assessment tool: MDS 3.0. Baltimore (MD): Quality Measurement and Health Assessment Group, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services; 2008 Apr. 263 p. Available from the Centers for Medicare & Medicaid Services (CMS) Web site External Web Site Policy.
  • Nursing Home Compare. [internet]. Baltimore (MD): Centers for Medicare & Medicaid Services (CMS). 2000- [updated 2012 Nov 15]; [cited 2012 Nov 27]. This tool is available from the Medicare Web site External Web Site Policy.

NQMC Status

The NQMC summary was completed by ECRI on November 28, 2005. The information was verified by the measure developer on February 8, 2006 and again on October 17, 2007.

This NQMC summary was retrofitted into the new template on June 28, 2011.

This NQMC summary was updated by ECRI Institute on August 15, 2013. The information was verified by the measure developer on December 3, 2013.

This NQMC summary was updated again by ECRI Institute on May 31, 2016. The information was not verified by the measure developer.

Copyright Statement

No copyright restrictions apply.

NQMC Disclaimer

The National Quality Measures Clearinghouse™ (NQMC) does not develop, produce, approve, or endorse the measures represented on this site.

All measures summarized by NQMC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public and private organizations, other government agencies, health care organizations or plans, individuals, and similar entities.

Measures represented on the NQMC Web site are submitted by measure developers, and are screened solely to determine that they meet the NQMC Inclusion Criteria.

NQMC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or its reliability and/or validity of the quality measures and related materials represented on this site. Moreover, the views and opinions of developers or authors of measures represented on this site do not necessarily state or reflect those of NQMC, AHRQ, or its contractor, ECRI Institute, and inclusion or hosting of measures in NQMC may not be used for advertising or commercial endorsement purposes.

Readers with questions regarding measure content are directed to contact the measure developer.