Long-Term Care Hospital (LTCH) Functional Outcome Measure: Change in Mobility Among Patients Requiring Ventilator Support

This quality measure has following patient-level exclusion criteria:

1) Patients with incomplete stays:
Rationale: When a patient has an incomplete stay, for example, the patients leave urgently due to a medical emergency, it can be challenging to gather accurate discharge functional status data. Patients with incomplete stays include patients who are unexpectedly discharged to an acute-care setting (Inpatient Prospective Payment System or Inpatient Psychiatric Hospital or unit) because of a medical emergency or psychiatric condition; patients transferred to another LTCH; patients who leave the LTCH against medical advice; patients who die; and patients with a length of stay less than 3 days.

2) Patients discharged to hospice:
Rationale: Patients discharged to hospice are excluded because functional improvement may not be a goal for these patients.

3) Patients with progressive neurological conditions, including amyotrophic lateral sclerosis, multiple sclerosis, Parkinson’s disease, and Huntington’s chorea:
Rationale: These patients are excluded because they may have functional decline or less predictable function trajectories.

4) Patients in coma, persistent vegetative state, complete tetraplegia, and locked-in syndrome:
Rationale: The patients are excluded because they may have limited or less predictable mobility recovery.

5) Patients younger than age 21:
Rationale: There is only limited evidence published about functional outcomes for individuals younger than 21.

6) Patients who are coded as independent on all the mobility items at admission:
Rationale: These patients are excluded because no improvement in mobility skills can be measured with the mobility items used in this quality measure.

Facility-level quality measure exclusion: For LTCHs with fewer than 20 patient stays, data for this quality measure are not publicly reported.