D.C. Mun. Regs. r. 29-6526
Nursing facilities electing to participate in the NFQII will be assessed for the performance payment based on the facility:
DHCF will establish performance benchmarks for attainment based on data collected in the baseline period. The performance payment program's baseline period will be the period from February 1, 2018 to September 30, 2018, in which nursing facility performance is initially measured. For each subsequent measurement year, benchmarks will be based on data collected from the prior measurement year. If a participating nursing facility did not attain its goal, then DHCF shall assess whether the participating nursing facility's performance with regard to measures set forth in § 6524 improved from the previous measurement year.
For domain measures where attainment is measured, an eligible nursing facility must achieve the attainment benchmark of the seventy- fifth (75th) percentile for the initial baseline period or for the previous measurement year to receive the points allotted for those measures in accordance with § 6526.6. Setting the threshold at the seventy-fifth (75th) percentile means that only nursing facilities performing at the level of the top quartile for the previous year would earn points for attainment. Participating nursing facilities performing below the attainment benchmark will also be able to receive the total points allotted for that measure if they have improved measure performance from the previous year by any amount.
DHCF will determine an annual performance score using the data available in the measurement year for each eligible nursing facility. The score is based on the number of points that a facility earns for its performance in meeting the benchmarks for each measure described in §§ 6524.3 and 6524.4.
For domain measures where improvement can be measured, the improvement benchmark will be any improvement in performance of the measure compared to the prior year's performance by any margin.
DHCF shall determine the distribution of points to calculate annual performance score based on a maximum of one hundred (100) points. DHCF shall apply weights to each of the domains and measures. Each measure in the domain is assigned points by dividing the total points amongst measures in each domain as outlined below:
Nursing Facility Performance Measure Point Distribution Methodology | |||
Domains | Measures | MY 2019 | MY 2020 |
Quality of Care | Pressure Ulcers | 6 | 6 |
Anti-psychotic Medications | 6 | 6 | |
Urinary Tract | 6 | 6 | |
Loss of bowels or bladder | 6 | 6 | |
Falls w/ injury | 6 | 6 | |
Domain Total | 30 | 30 | |
Quality of Life | Resident survey | 8 | 10 |
End of Life Program | 2 | 10 | |
Domain Total | 10 | 20 | |
Utilization | Low-Acuity Non-emergent ED Visits | 3.3 | 3.3 |
All-cause 30-day Readmissions | 3.3 | 3.3 | |
Potentially Preventable Hospital Admissions | 3.3 | 3.3 | |
Domain Total | 10 | 10 | |
Infrastructure | Staff Continuing Education in MDS Training | 5 | 6 |
Staff Turnover Rate | 5 | 6 | |
RN Nursing Hours per Resident Day | 5 | 6 | |
EHR Adoption | 10 | 11 | |
HIE Connectivity | 10 | 11 | |
Quality Improvement Plan | 15 | N/A | |
Domain Total | 50 | 40 | |
Total | Total NFQII Points | 100 | 100 |
If a nursing facility attests to compliance with or completion of a given measure, attains the seventy- fifth (75th) percentile for a given measure, or improves performance on a given measure, as appropriate, then the nursing facility will be awarded the total amount of points allotted for that measure as set forth in § 6526.6. If a nursing facility neither attest to compliance or completion of a given measure, attains the seventy- fifth (75th) percentile for a given measure, nor improves performance on a given measure, as appropriate, no points will be awarded for that measure. The total score for a nursing facility will be the sum of the total points earned through either attainment, attestation, or improvement across measures set forth in §§ 6524.3 and 6524.4.
A transmittal will be issued to each nursing facility no later than ninety (90) calendar days after the start of the measurement year with information on the benchmarks that will be used to measure a facility's performance (attainment or improvement).
DHCF shall provide written notification of the attainment and individualized improvement thresholds to each eligible nursing facility no later than one hundred eighty (180) calendar days after the conclusion of the previous measurement year after all performance measures are received and validated.
D.C. Mun. Regs. r. 29-6526