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Nursing Home Quality Award Criteria - New Mexico

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Nursing Home recipients of the 2017 HealthInsight Quality Award will be selected based upon the following criteria:

Part One: Using the MDS 3.0 quality measures reported on www.medicare.gov, ALL of the long stay quality measures will be selected for analysis. Facilities that have obtained a ranking at or above 70 percent and have an overall star rating of three or higher, will meet part one of the award criteria. Achievement of this ranking, at or above 70 percent, is not based on each individual measure, but on a cumulative basis of all quality measures in this analysis.

  • Percent of long-stay residents experiencing one or more falls with major injury
  • Percent of long-stay residents who had a urinary tract infection
  • Percent of long-stay residents who self-report moderate to severe pain
  • Percent of high-risk residents who have pressure ulcers
  • Percent of long-stay low-risk residents who lose control of their bowels or bladder
  • Percent of long-stay residents who have/had a catheter inserted and left in their bladder
  • Percent of long-stay residents who were physically restrained
  • Percent of long-stay residents whose ability to move independently worsened
  • Percent of long-stay residents whose need for help with daily activities has increased
  • Percent of long-stay residents who lose too much weight
  • Percent of long-stay residents who have depressive symptoms
  • Percent of long-stay residents who received an antianxiety or hypnotic medication
  • Percent of long-stay residents assessed and given the seasonal influenza vaccine
  • Percent of long-stay residents assessed and given the pneumococcal vaccine
  • Percent of long-stay residents who received an antipsychotic medication

The rankings and applicable star ratings are based on the May 2017 update of Nursing Home Compare and represent the time period 1/1/2016 - 12/31/2016. Please note that any nursing home who has received a deficiency citation rated at scope and severity 'G' or more severe will be excluded from eligibility.

For additional information on the Centers for Medicare & Medicaid Services (CMS) publicly reported quality measures please visit www.medicare.gov or healthinsight.org.

Part Two: Nursing home facilities that meet the criteria in part one must demonstrate how they have achieved improvement in one of the 11 quality measures by sharing qualitative and quantitative data with HealthInsight. The data must represent a minimum of two-full quarters within the previous 12 months.

The measures are:

  • Percent of long-stay residents experiencing one or more falls with major injury
  • Percent of long-stay residents who had a urinary tract infection
  • Percent of long-stay residents who self-report moderate to severe pain
  • Percent of high-risk residents who have pressure ulcers
  • Percent of long-stay low-risk residents who lose control of their bowels or bladder
  • Percent of long-stay residents who have/had a catheter inserted and left in their bladder
  • Percent of long-stay residents who were physically restrained
  • Percent of long-stay residents whose need for help with daily activities has increased
  • Percent of long-stay residents who lose too much weight
  • Percent of long-stay residents who have depressive symptoms
  • Percent of long-stay residents who received an antipsychotic medication

The application will include a description of improvement efforts related to how your facility organized around this national initiative and what your results were. Positive trending is required to meet this portion of the award criteria but all positive trends are welcome (no minimum improvement is required). Data shared must represent a minimum of two-full quarters and must occur within the previous twelve months. At a minimum, facilities will need to share:

  • How the need for improvement was identified.
  • How your facility organized itself around the effort. Was a team formed? Who were the members? What role did leadership play in the project?
  • How was performance measured? How did your facility know that the interventions were appropriate? How did your facility know if the interventions were working or not working?
  • What were the interventions? What did you do and how did you do it? What is different today as a result of this project that was not occurring before it began?
  • What were the results? What percentage of improvement did you experience? What was your rate before the initiative (baseline) and what were your results after the initiative (remeasurement)?
  • Did you partner with any local hospitals or other community health care providers? If so, please share your experience.

Certificate for Excellence in Care Coordination: Using the three short-stay Medicare claims-based measures to calculate rankings, nursing homes that rank in the top 25 percent for at least two measures will receive an certificate.

HealthInsight 2017 Nursing Home Quality Award Application Deadlines:

New Mexico: Friday, July 21, 2017

Nevada: Monday, August 14, 2017

Utah: Monday, August 14, 2017

Click here to complete the application for The HealthInsight Nursing Home Quality Award

If you have questions, please contact: