NHQI Methodology Finalized for 2020

The Department of Health (DOH) has finalized the 2020 methodology for the Nursing Home Quality Initiative (NHQI), otherwise known as the Quality Pool. The revisions are relatively minor and affect the scoring for three quality measures (QMs).

Specifically, the following three QMs will be scored based on a threshold rather than on quintile scoring of results:

1. residents experiencing one or more falls with major injury;
2. residents who self-report moderate to severe pain; and
3. residents with a urinary tract infection.

DOH believes that the scores for these QMs have “topped out,” meaning there has been a convergence of the scores near the top of the rating scale, and that a threshold measure would be more effective for scoring purposes. Accordingly, nursing homes with rates on these QMs at or below 5 percent will receive the full five points for each QM, while those above 5 percent will receive zero points. These QMs will not be eligible for extra points for improvement over 2019 results, given the change in scoring method. Additional background on 2019 results and the 2020 methodology is provided here.

All other aspects of the NHQI methodology will remain unchanged from 2019. DOH expects to complete the 2019 scoring and release 2019 facility-specific results for feedback no later than January. Meanwhile, rate adjustments based on the 2018 NHQI results are still in executive review and expected to move forward once approved.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866