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 8 of a series, presents test data and interpretations of the results for data elements developed for non-communicative patients.
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 8 of the final report on the National Beta Test, which includes the identification and testing of candidate SPADEs developed specifically for patients and residents who are unable to communicate (staff assessments of mental status, mood, and pain). 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 Observational Assessment of Cognitive Function, the Staff Assessment of Patient/Resident Mood, and the Observational Assessment of Pain or Distress. All three data element sets performed reasonably well, with some variability in performance.