The Centers for Medicare & Medicaid Services is seeking public input on a draft quality measure that would estimate the rate of healthcare-associated infections acquired during care at a skilled nursing facility and result in hospitalization. 

Under the proposal, that rate would be identified using the principal diagnosis on the SNF resident’s Medicare hospital claims during a window that starts on day four of their admission to day three after their discharge.

“The purpose of risk adjustment is to account for risk factor differences across SNFs, when comparing quality of care between them. In other words, risk adjustment “levels the playing field” and allows for fairer quality-of-care comparisons between SNFs by controlling for differences in resident case-mix,” the draft document states

The project is a part of the agency’s “Meaningful Measures” framework initiative that was launched in 2017. It aims to streamline current measure sets by identifying the highest priorities for quality measurement and improvement. 

CMS contracted with California-based policy research company Acumen, LLC, to develop an HAIs quality measure for the SNF Quality Reporting Program under the “Making Care Safer by Reducing Harm Caused in the Delivery of Care” meaningful measure domain. 

“Making Care Safer by Reducing Harm Caused in the Delivery of Care is one of the six meaningful measure domains and is a companion priority for quality assurance and improvement work at CMS. The meaningful measure area of HAIs is under this domain,” the agency stated.

Other project objects include specifying the target population, including the exclusion criteria, identifying risk adjustment variables and the approach for risk adjustment, gathering feedback, and recognizing additional guidance required for implementation in the SNF QRP.

The public comment period runs through Oct. 14. Feedback can be submitted to [email protected]