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

CBE ID
2632
Endorsed
New or Maintenance
Is Under Review
No
Measure Description

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

  • Measure Type
    Electronic Clinical Quality Measure (eCQM)
    Level Of Analysis
    MAT output not attached
    Attached
    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.

    All information required to stratify the measure results
    Off
    All information required to stratify the measure results
    Off
  • Risk Adjustment
    Risk adjustment approach
    Off
    Risk adjustment approach
    Off
    Conceptual model for risk adjustment
    Off
    Conceptual model for risk adjustment
    Off
  • Most Recent Endorsement Activity
    Endorsed Patient Experience and Function Spring Cycle 2019
    Initial Endorsement
    Next Planned Maintenance Review
    Spring 2025
    Endorsement Status
    Last Updated
  • Detailed Measure Specifications
    No
    Logic Model
    Off
    Impact and Gap
    No
    Feasibility assessment methodology and results
    No
    Address health equity
    No
    Measure’s use or intended use
    No
    508 Compliance
    Off
    If no, attest that all information will be provided in other fields in the submission.
    Off