Usefulness of the nursing home quality measures and quality indicators for assessing skilled nursing facility rehabilitation outcomes

APHA Scientific Session and Event Listing

4228.0: Tuesday, November 06, 2007 - 3:10 PM

Abstract #158581

Burton Silverstein, PhD, HCR Manor Care, 333 N Summit, 9th Floor, Toledo, OH 43604, (419) 252-5719, bsilverstein@verizon.net

Design: Retrospective

Setting/Participants: 211 Nation-wide Skilled Nursing Facilities

Main Outcome Measures: Nursing Home Quality Indicators (QI) , Quality Measures (QM), FIM Motor Score, Percent of Patients Discharged to Community, Percent of Patients Reporting “Quite a Lot” or “Completely” prepared to manage their care at discharge from skilled care.

Results: Spearman correlations identified no significant relationships between nursing home indicators and rehabilitation outcomes. Nursing home QIs and QMs, most notably the impairment or disability related Prevalence of Activities of Daily Living Impairment (QI 17), Incidence of Need for Help Increase (QM1), and Decrease in Range of Motion (QI18), are uncorrelated with functional independence outcomes as measured by functional status gains, achievement of community discharge goals, and self report of preparedness to manage care needs after discharge.

Conclusion: Patients and referrers choosing SNF-based medical rehabilitation need tools that differentiate among prospective providers from a rehabilitation outcomes perspective. Data in this study indicate that nursing home QIs and QMs are inadequate for this purpose.

Learning Objectives:

describe the differences in assessing quality of care for skilled nursing facility (SNF) residents and post-acute rehabilitation patients and (
understand why the measure for SNF residents is inadequate for selecting a post-acute rehabilitation program in a nursing home setting.

Keywords: Nursing Homes, Quality of Life

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Public Policy in Aging

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA