100-Day Community Discharge Rates Among Medicare Nursing Home Residents

Abstract

developed a risk-adjusted, claims-based measure of outpatient ED visits that CMS incorporated into the Five Star Quality Rating System in 2016. This measure addresses a gap in the current measures, increasing the number of short-stay measures and adding a measure that does not rely on self-reported data. Overall, 9.5% of residents had an ED visit within 30 days of the start of their stay. Average risk-adjusted rates were lower at homes with better Five-Star ratings. They were higher among smaller, for-profit nursing homes not located in a hospital. We will present trends on the measure's performance during its first year of public reporting on Nursing Home Compare. Many nursing home residents enter skilled nursing facilities (SNF) for rehabilitation services. For many residents, return to the community is an important outcome. The IMPACT Act of 2014 requires the development and reporting of a measure of community discharges (CD) among SNF residents. We developed a risk-adjusted measure of successful CDs within 100 days of the start of a nursing home episode, which CMS incorporated into the Five-Star Quality Rating System in 2016. We used information on discharge date and status from the MDS to measure episode length and identify CDs. Overall, 62.5% of episodes resulted in a successful CD within 100 days. Average risk-adjusted rates were higher at facilities with better overall, staffing, and inspection ratings, but not quality ratings. Riskadjusted rates were higher among facilities that are smaller, nonprofit, and in a hospital. We will present trends on the measure's performance during its first year of public reporting. 100-DAY COMMUNITY DISCHARGE RATES AMONG USER INPUT IN IMPROVING THE NURSING HOME COMPARE WEBSITE: USABILITY TESTING OF WEBSITE ENHANCEMENTS A. Edwards, A. Muma, Abt Associates, Durham, North CarolinaConsumer usability testing was conducted on the Nursing Home Compare (NHC) website to assess ease of use and clarity of information. Across four different tests, average user score for ease of use was 4.3 on a 5-point scale with a value of 5 considered 'very easy' and 0 considered 'very difficult.' Google Analytic data supported user testing findings, showing a significant decrease in the number of pages per visit from 7 to 3, an indicator of a reduction in steps necessary to find target content. Average score for clarity of the information was 4.2, where a value of 5 represents 'very clear. NHC website usability testing provides key lessons on how to disseminate information in ways that help improve healthcare decisionmaking for the target audience. Strategic analysis and planning for the website builds on the usability testing to further enhance the website and the consumer experience on the site. To support the growing ranks of family caregivers attending to older adults, social services are looking to technology for solutions. Online support services are desirable because they offer the opportunity to reach broad swaths of family caregivers, who can then access supports that meet their needs on...