Nov 15, 2019
The Improving Medicare Post-Acute Care Transformation Act of 2014 mandates that the Centers for Medicare & Medicaid Services (CMS) use standardized patient assessment data elements across post-acute care settings. CMS tasked RAND with developing and testing the data elements. This report, Volume 4 of a series, presents quantitative and qualitative data gathered during testing and interpretations of the results for cognitive status data elements.
The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to evaluate candidate standardized patient assessment data elements (SPADEs) in a national field test titled the National Beta Test. The National Beta Test was conducted to evaluate the performance of candidate SPADEs in the clinical categories of (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories, for use in four post-acute care (PAC) settings: home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities.
This is Volume 4 of the final report on the National Beta Test, which includes the identification and testing of candidate SPADEs in the cognitive status clinical category. This volume provides results and significance tests on the feasibility, reliability, validity, stability and change over time, and sensitivity to national representativeness of the candidate SPADEs. The data elements tested include the Brief Interview for Mental Status (BIMS), the Confusion Assessment Method (CAM), Expression and Understanding, and Behavioral Signs and Symptoms. All four cognitive status data elements performed reasonably well, showing feasibility, acceptable reliability, and substantial support from assessors.
Standardized Assessment of Cognitive Function in Post-Acute Care
Brief Interview for Mental Status
Confusion Assessment Method (CAM)
Expression and Understanding
Behavioral Signs and Symptoms