AHCA Identifies Conflicting Quality Measure Reporting

The American Health Care Association (AHCA) recently became aware of confusion over conflicting antipsychotic use rates between the CASPER report and the MDS 3.0 Nursing Home Compare measure.  AHCA contacted the Centers for Medicare & Medicaid Services (CMS) and requested that the CASPER measure be removed from the CMS website before the Nursing Home Compare site went live and until it could be replaced with one having the same specifications as the updated Nursing Home Compare measure.  While CMS understands that having two antipsychotic measures with different specifications can be confusing, the agency has indicated that they are unable to replace the CASPER measure with the new measure at this time.

As an interim solution, CMS hss developed a guidance document.  CMS believes the information contained in the document may help until the CASPER report measure is changed and is the same as the Nursing Home Compare measure.

The CMS document offers a description of the antipsychotic medication quality measures on Nursing Home Compare and identifies the difference between this measure and the one that is currently referred to as the “Survey QI” found in the CASPER Reports.  The difference primarily involves conditions that are excluded from the measure.  The CASPER measure excludes from the denominator residents with Schizophrenia, Tourette’s syndrome, Huntington’s disease, Manic Depression (Bipolar disease), hallucinations, and delusions.  The new MDS 3.0 measure appearing on NH Compare only excludes residents with Schizophrenia, Tourette’s syndrome, and Huntington’s disease.  AHCA recommends that providers educate their staff, physicians and others, and refer to the CMS document when explaining the measure differences.  Additionally, inform staff and physicians that CMS will eventually replace the CASPER measure with the new long-stay prevalence measure.