Understand Why Discharged Residents Trigger QMs   

A question asked regularly regarding MDS 3.0 Quality Measures (QMs) is why a discharged resident continues to trigger after leaving the facility. The answer to this question is explained in section two of the MDS 3.0 Quality Measures User’s Manual, available in the Downloads section of the Centers for Medicare and Medicaid Services’ QM webpage. Below is an example of the sample selection logic that clarifies that residents are selected if their latest episode of care either ends during the target period or is ongoing at the end of the target period.

 
Section 2: Selecting the QM Samples
Two resident samples are selected for computing the QMs: a short-stay sample and a long-stay sample. These samples are selected using the following steps:

• Select all residents whose latest episode either ends during the target period or is ongoing at the end of the target period. This latest episode is selected for QM calculation

• For each episode that is selected, compute the [cumulative days in facility] CDIF

• If the CDIF is less than or equal to 100 days, the resident is included in the short-stay sample 

• If the CDIF is greater than or equal to 101 days, the resident is included in the long-stay sample

For short-stay residents, the target period is the most recent six months, while the long-stay target period is the most recent three months. This means that for short-stay residents whose discharge ended their episode of care, if the resident’s latest episode of care ended within the most recent six months, the resident is considered in the short-stay sample. Whereas, for long-stay residents, if the episode of care ended in the most recent three months, the resident is still included in the long-stay sample.