MDS Alert

Whether the entire list will fly with CMS remains to be seen, says expert.

The National Quality Forum recently released a set of 21 endorsed measures that CMS can use for the MDS 3.0, although CMS' finalized list isn't a done deal.

CMS isn't required to use the NQF-recommended measures, says consultant Judy Wilhide Brandt, RN, RAC-MT, C-NE, noting the "ball is in CMS' court" now. Brandt notes she's "happy that CMS is including the NQF, which has clinicians and people very familiar with the industry" rather than "designing the QMs in a bubble." Brandt is principal of Judy Wilhide MDS Consulting Inc. in Virginia Beach, Va.

The 21 measures (see page 42) include some that CMS did not recommend to the NQF, says Brandt, in Virginia Beach, Va. These include a resident, family, and discharge resident satisfaction survey. "Based on the data set on the NQF for those measures, facilities will have to pay for contractors to administer the surveys, which is a cost and a concern," she says.

In her view, "doing the satisfaction surveys as part of the QM process would be cumbersome, duplicative and expensive for providers. Most folks I know have been using resident satisfaction surveys for some time."

Another new measure is physical therapy for new balance problems, which comes from G0300 (balance assessment) on the MDS 3.0, says Brandt, who notes she can "think of a hundred reasons you would have to code someone as unsteady who is not appropriate for PT or restorative nursing."

Generally speaking, however, the rest of the NQFendorsed QMs are equivalent to the former ones -- and they appear to be fairer in many ways, Brandt observes. For example, the QM looking at weight loss wouldn't include physician-prescribed weight loss, she points out. The NQF does list the technical specs for the endorsed QMs, which could change, says Brandt. Hopefully, soon "CMS can give a date for when they will release a 'matrix' as they have in the past to show the exact calculations for numerators, denominators, exclusions and risk factors," adds Peter Arbuthnot, RAC-CT, regulatory analyst with American HealthTech in Jackson, Miss. "The NQF information does in fact have the algorithms, but CMS could make slight modifications for reporting purposes."

"CMS reportedly anticipates posting the new quality measures on Nursing Home Compare by the first quarter of 2012," says Iara Woody, with LeadingAge (formerly the American Association of Homes & Services for the Aging).