On April 11, 2022, the Centers for Medicare & Medicaid Services issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System for fiscal year 2023.
In addition, the rule includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Program (VBP) for FY 2023 and future years.
Also included in this proposed rule was a Request for Information that therapy teams should take note of. Specifically, the inclusion of the CoreQ: Short Stay Discharge Measure in a Future SNF QRP Program Year.
We know that ensuring that patients and families are engaged as partners is an effective way to measure the quality of patient care.
In this year’s proposed rule, CMS is requesting stakeholder feedback on the inclusion of the CoreQ: Short Stay Discharge measure in the SNF QRP in future program years, including whether there are any challenges or impacts we should consider for a potential future proposal.
The CoreQ survey instrument is used to assess the level of satisfaction among SNF patients.
Why is CoreQ’s addition an important consideration for QRP?
Remember that SNF QRP furthers CMS’s mission to improve the quality of healthcare for beneficiaries through measurement, transparency and public reporting of data. The SNF QRP and CMS’s other quality programs are foundational for contributing to improvements in healthcare, enhancing patient outcomes and informing consumer choice.
In October 2017, CMS launched the Meaningful Measures Framework. This framework captures their vision to address healthcare quality priorities and gaps, including emphasizing digital quality measurement, reducing measurement burden, and promoting patient perspectives, while also focusing on modernization and innovation.
Meaningful Measures 2.0 builds on the initial framework by establishing a goal of increasing Patient Reported Outcomes Measures (PROMs) by 50%.
What should you know about Meaningful Measures 2.0?
Collection of patient experience data aligns with the person-centered care domain of CMS’s Meaningful Measures 2.0 Framework, and addresses an aspect of patient experience that is not currently included in the SNF QRP.
CMS believes collecting and assessing satisfaction data from SNF patients is important for understanding patient experiences and preferences, while ensuring the patient can easily and discretely share their information and provide information to help consumers choose a trusted SNF.
So how does CMS define a Patient Reported Outcome Measure (PROM)?
Patient Reported Outcome (PRO) is any report of the status of a patient’s health condition or health behavior that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else.
Therefore, they are an important component of assessing whether healthcare providers are improving the health and well-being of patients.
Great! What should I know about CoreQ?
The CoreQ: Short Stay Discharge Measure calculates the percentage of individuals discharged in a six-month period from a SNF, within 100 days of admission, who are satisfied with their SNF stay.
This patient-reported outcome measure is based on the CoreQ: Short Stay Discharge questionnaire that utilizes four items:
- In recommending this facility to your friends and family, how would you rate it overall;
- Overall, how would you rate the staff;
- How would you rate the care you receive;
- How would you rate how well your discharge needs were met.
The CoreQ questionnaire uses a 5-point Likert Scale:
Poor (1); Average (2); Good (3); Very Good (4); and Excellent (5).
The numerator is the sum of the individuals in the facility that have an average satisfaction score of greater than or equal to 3 for the four questions on the CoreQ: Short Stay Discharge questionnaire.
The denominator includes all patients, regardless of payer, that are admitted to the SNF for post-acute care and are discharged within 100 days, receive the survey and who respond to the CoreQ: Short Stay Discharge questionnaire within two months of receiving the questionnaire.
The CoreQ: Short Stay Discharge Measure excludes certain patients from the denominator, such as patients who die during their SNF stay, patients discharged to another hospital, another SNF, psychiatric facility, IRF or LTCH, patients with court-appointed legal guardians for all decisions, patients who have dementia impairing their ability to answer the questionnaire, patients discharged on hospice, and patients who left the SNF against medical advice.
Ready to learn more? For additional information about the CoreQ: Short Stay Discharge Measure, please visit https://cmit.cms.gov/CMIT_public/ViewMeasure?MeasureId=3436.
Renee Kinder, MS, CCC-SLP, RAC-CT, is Executive Vice President of Clinical Services for Broad River Rehab and a 2019 APEX Award of Excellence winner in the Writing–Regular Departments & Columns category. Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association’s (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty and is an advisor to the American Medical Association’s Current Procedural Terminology CPT® Editorial Panel. She can be reached at [email protected].
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
