Rehabilitation services assessed
Measure purpose: Ensure patients are assessed for occupational, physical, and/or speech rehabilitation services and assessment results were used to recommend appropriate next level of care.
The numerator: patients aged 18 years and older with a diagnosis of ischemic stroke or spontaneous intracerebral hemorrhage or subarachnoid hemorrhage who were assessed for the need for occupational, physical, and/or speech rehabilitation services at or prior to acute inpatient discharge AND
Following assessment, documentation that results were used to recommend appropriate next level of care; either ambulatory or home-based rehabilitation, or referral to LTCH, IRF, SNF, or HHA or documentation that no rehabilitation is necessary
is divided by
the denominator: patients aged 18 years and older with a diagnosis of ischemic stroke or spontaneous intracerebral hemorrhage or subarachnoid hemorrhage.
Exclusions are removed from the denominator:
- Patient elected hospice services within 48 hours of admission
- Patient documentation indicates no noted rehabilitation needs
- Death during acute inpatient
- Discharged/transferred to another acute care facility (comprehensive stroke center, another acute hospital).
- Patient declined treatment including left AMA
Key Phrases
Examples of key phrases you could use to meet the measure include:
- Occupational, physical, and speech rehab services assessed
- Reviewed rehab assessment to develop appropriate next level of care
To meet the measure both components must be documented.
Measure Calculation Example
Dr. Silva had 100 patients between January 1 and December 31 admitted with a diagnosis of ischemic stroke, spontaneous intracerebral hemorrhage or subarachnoid hemorrhage. This is the denominator.
Three patients elected hospice services within 48 hours of admission, four died during acute inpatient care, and three were transferred to another acute care facility. These 10 (3+4+3) patients are removed from the denominator as they meet exclusions.
Of the remaining 90 patients, Dr. Silva documents occupational, physical, and speech rehabilitation assessments for 58 patients. Of these 58 patients, Dr. Silva documents these assessments were used to develop next level of care recommendations for 23 patients. This is the numerator.
Quality of patient care = 23/(100-10). Dr. Silva has a score of 25.6% for this measure.