Inpatient Rehabilitation Facility (IRF) Functional Outcome Measure: Change in Mobility Score for Medical Rehabilitation Patients

This quality measure has six 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 (Short-stay Acute Hospital, Critical Access Hospital, Inpatient Psychiatric Facility, or Long-term Care Hospital); patients who die or leave an Inpatient Rehabilitation Facility (IRF) against medical advice; and patients with a length of stay less than 3 days.

2) Patients who are independent with all mobility activities at the time of admission.
Rationale: Patients who are independent with all the mobility items (with the exception of the wheelchair items GG0170R and GG0170S) at the time of admission are assigned the highest score on all the mobility items, and thus, would not be able to show functional improvement on this same set of items at discharge.

3) Patients with the following medical conditions on admission: coma, persistent vegetative state; complete quadriplegia; locked-in syndrome or severe anoxic brain damage, cerebral edema or compression of brain.
Rationale: These patients are excluded because they may have limited or less predictable mobility improvement with the selected mobility items.

4) Patients younger than age 21.
Rationale: There is only limited evidence published about functional outcomes for individuals with Medicare who are younger than 21.

5) Patients discharged to hospice.
Rationale: Patient goals may change during the IRF stay, and functional improvement may no longer be a goal for a patient discharged to hospice.

6) Patients who are not Medicare Part A and Medicare Advantage beneficiaries.
Rationale: IRF-PAI data for patients not covered by the Medicare program are not submitted to the Centers for Medicare and Medicaid Services.

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