With the removal of Section G, the Quality Measure (QM) for Ability to Walk Independently Worsened – Long Stay is replacing the QM for Ability to Move (locomotion) Independently Worsened. This measure impacts Care Compare and Five Star; although currently it is frozen on Care Compare until January 2025. This measure may also impact Medicaid reimbursement dependent on the State. A decline in a resident's ability to walk can also have a negative impact during a State Survey.
The measure looks at the percentage of long-stay residents whose ability to walk has worsened. This measure compares status from the prior assessment. It is triggered if a resident experiences a decrease of one or more points on the Walk 10 feet MDS item (GG0170I). It is also triggered if the values are recoded. This is the numerator.
The denominator for this measure is all residents with one or more prior assessments, except those with exclusions.
Exclusions for this measure include:
· Resident dependent or activity was not attempted during prior assessment
· Comatose is coded or data is missing for comatose on the target assessment
· Prognosis of life expectancy is coded as less than 6 months on the target assessment
· Hospice care is being provided per the target assessment
· No prior assessment is available
· Priorassessment is a discharge with or without return anticipated
· Missing data on target or prior assessment
In addition to the type of assessment coded on the MDS, the following items impact this measure as noted above:
This measure is also risk-adjusted based on multiple co-variates related to:
State Surveyors use the Positioning, Mobility, & Range of Motion Critical Element Pathway when reviewing performance with walking. Aspects reviewed include comprehensive assessments focused on Section C, E, F, GG, I, J, and O of the MDS, Physician orders, pertinent diagnoses, and care planning. Staff assistance and interventions are observed across shifts, and interviews are conducted across shifts with residents, their representatives, and family and with staff including OT, PT, SLP, and RNP. Failure to comply can lead to various F-tags.
Stay tuned for our next blog discussing ways to improve performance for this quality measure…