Skip to main content

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

CBE ID
2632
Endorsement Status
1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Spring 2025
1.3 Measure Description

This measure estimates the risk-adjusted change in mobility score between admission and discharge among LTCH patients requiring ventilator support at admission.

        • 1.5 Measure Type
          1.7 Electronic Clinical Quality Measure (eCQM)
          1.8 Level Of Analysis
        • 1.14 Numerator

          The measure does not have a simple form for the numerator and denominator. This measure estimates the risk-adjusted change in mobility score between admission and discharge among LTCH patients requiring ventilator support at admission. The change in mobility score is calculated as the difference between the discharge mobility score and the admission mobility score.

        • 1.15 Denominator

          The target population (denominator) for this quality measure is the number of LTCH patients requiring ventilator support at the time of admission to the LTCH.

        • Exclusions

          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.

        • OLD 1.12 MAT output not attached
          Attached
        • Most Recent Endorsement Activity
          Endorsed Patient Experience and Function Spring Cycle 2019
          Initial Endorsement
          Last Updated
        • Steward
          Centers for Medicare & Medicaid Services
          Steward Organization POC Email
          Steward Organization Copyright

          Not applicable

              • Risk Adjustment
                Risk adjustment approach
                Off
                Risk adjustment approach
                Off
                Conceptual model for risk adjustment
                Off
                Conceptual model for risk adjustment
                Off