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

CBE ID
2636
Endorsed
Endorsement Status
1.1 New or Maintenance
Is Under Review
No
Next Planned Maintenance Review
Spring 2025
1.3 Measure Description

This measure estimates the percentage of IRF patients who meet or exceed an expected discharge mobility score.

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

          The numerator is the number of patients in an IRF with an observed discharge mobility score that is equal to or higher than a calculated expected discharge mobility score.

        • 1.15 Denominator

          IRF patients included in this measure are at least 21 years of age, Medicare Part A and Medicare Advantage beneficiaries, and have complete stays.

        • Exclusions

          This quality measure has five 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 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 items.

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

          4) 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.

          5) Patients who are not Medicare Part A or 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.

        • OLD 1.12 MAT output not attached
          Attached
        • Most Recent Endorsement Activity
          Endorsed Patient Experience and Function Spring Cycle 2019
          Initial Endorsement
          Last Updated
              • Risk Adjustment
                Risk adjustment approach
                Off
                Risk adjustment approach
                Off
                Conceptual model for risk adjustment
                Off
                Conceptual model for risk adjustment
                Off