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Continuing Care performance report

Measure: Nursing facility quality of care score by participation in the DHS Nursing Facility Performance-based Incentive Payment Program (PIPP).

In the average Minnesota nursing facility, quality of care for resident conditions has improved each year since DHS began tracking in 2004. A revised assessment was introduced in October 2010. DHS and the University of Minnesota revised the quality of care score. The new baseline stated in 2011.

The average nursing facility improved from 61 to 66 out of 100 possible total quality score points. Facilities participating in PIPP were initially slightly behind other facilities in care quality. Since the start of the new baseline, PIPP facilities improved by 9 percent versus 7 percent for other facilities.

Why this measure is important?

Nursing facility quality of care is a concern to consumers, families, providers, legislators and health department inspectors. This measure is an important indication of the effectiveness of the nursing facility PIPP program. It shows the need to share knowledge gained by PIPP facilities and to encourage non-PIPP facility participation.

What is included in the measure?

The measure includes 26 quality indicators (QIs) across ten care domains (psychosocial functioning, restraint use, continence, infections, accidents, nutrition, pain, skin care, psychotropic drugs and physical functioning). The data is a cumulative score of those indicators out of 100 possible points.

What does it mean?

The PIPP program increases Medical Assistance payments for provider-run quality improvement projects. Since launching PIPP in 2007 and until the assessment change in 2010, participating facilities continuously improved at seven times the rate of other facilities.

Under the new assessment, other facilities have done better, but PIPP facilities continue to outperform non-PIPP facilities. In 2012, DHS will introduce a PIPP mentorship option, in which successful facilities help facilities that are new to the program to improve.

How is it calculated?

Nursing facility staff assess residents during their stay in the facility. The assessment is done at admission, quarterly, annually and whenever the resident has a significant change in status. DHS selected certain assessment indicators to reflect the quality of care provided to residents.

These indicators are averaged to create a facility QI score on a quarterly basis. The QI scores are averaged over four quarters. They are statistically adjusted using resident characteristics that put them at particular risk for certain conditions. These adjustments provide a more accurate picture of care quality.
More details are available on the technical user guide.

Total nursing facility Quality of Care Scores by PIPP participation by graph


Graph of total nursing facility Quality of Care Scores by PIPP participation

Total nursing facility Quality of Care Scores by PIPP participation by table

Year

2011Q2-2012Q1

2011Q3-2012Q2

2011Q4-2012Q3

2012Q1-2012Q4

2012Q2-2013Q1

2013Q3-2014Q2

Statewide

61.4

62.9

63.9

65.1

66.3

69.2

PIPP Facilities (177)

61.8

63.7

64.7

66.0

67.2

70.0

Non-PIPP Facilities (202)

60.7

61.8

62.7

63.9

65.0

68.1

Data source

Minimum Data Set (MDS) resident assessments

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