This measure estimates the risk-adjusted change in mobility score between admission and discharge among LTCH patients requiring ventilator support at admission.
Measure Specs
General Information
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.
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.
Measure Record
Point of Contact
Not applicable
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