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. RAND was tasked by CMS with developing and testing the data elements. This report, Volume 6 of a series, presents results for data elements in the categories of (1) impairments and (2) special services, treatments, and interventions.
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 6 of the final report on the National Beta Test. It describes the identification and testing of candidate SPADEs in the clinical categories of (1) impairments and (2) special services, treatments, and interventions (SSTIs). 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. Impairments data elements included (1) Hearing and Vision and (2) Bladder and Bowel Continence (both patient interview and chart review). SSTI data elements included (1) Nutritional Approaches and (2) Special Treatments. All five data element sets performed fairly well, showing feasibility, acceptable reliability, and moderate support from assessors.
Standardized Assessment of Impairments and Special Services, Treatments, and Interventions in Post-Acute Care
Sensory Impairments: Hearing and Vision
Impairments: Continence Interview
Impairments: Continence Chart Review