NevadaChronic Care Quality Measures Compared to Achievable Benchmarks

The NHQDR quality measures specific to Chronic Care are compared to achievable benchmarks, which are derived from the top-performing States. Better performance of a State can mean higher or lower values of a measure, depending on the desired outcome. For example, low values are desirable for measures such as infant mortality, whereas high values are desirable for measures such as preventative screening. The categories of achievement have been standardized across the measure definitions so that:

Measures That Achieved Benchmark or Better

Measure	Estimate	Benchmark	Distance to Benchmark
Short-stay nursing home patients with pressure ulcers that are new or worsened	0.3	0.3	Achieved: 4% better
Long-stay nursing home residents with too much weight loss	5.3	5.4	Achieved: 1% better
Adult hemodialysis patients with adequate dialysis - (Kt/V) 12 or higher	96.3	96.5	0.2%
Short-stay home health patients who had diabetic foot care and patient education	97.6	98.6	1.0%
Adults who did not have any problem with the care they received from their home health providers in the last 2 months of care	91.1	94.0	3.1%
Home health patients who had timely initiation of care	92.2	95.3	3.3%
Adults who reported that home health providers always treated them with courtesy and respect in the last 2 months of care	91.7	95.0	3.5%
Family caregivers who would definitely recommend this hospice to their friends and family	84.9	88.4	4.0%
Family caregivers who received right amount of emotional and spiritual supports from hospice care team	87.3	90.9	4.0%
Hospice patients whose hospice care team always treated them with dignity and respect, and really cared about them	88.3	92.1	4.1%
Adults who reported that home health providers talk about pain in the last 2 months of care	87.0	91.2	4.7%
Family caregivers who rated the hospice care for their family member best (9-10) on a scale of 0-10 (where 0 is the worst and 10 is the best)	80.0	83.9	4.7%
Adults who reported being told what care and services they would get when they first started getting home health care	87.0	91.3	4.7%
Home health care patients whose pain when moving around decreased	70.0	73.8	5.1%
Adults who reported that home health providers always treated them as gently as possible in the last 2 months of care	87.6	92.5	5.3%
Adults who reported that home health providers always explained things in a way that was easy to understand in the last 2 months of care	81.6	86.8	6.0%
Hospice patients whose hospice care team always communicated well with their family caregivers about taking care them	78.1	83.3	6.2%
Adults who reported a home health provider talking with them about all the prescription and over-the-counter medicines they were taking when they first started getting home health care	82.6	88.2	6.4%
Long-stay nursing home residents with a urinary tract infection	3.5	3.3	6.7%
Family members who definitely received trainings about taking care their family member from hospice care team	73.1	78.4	6.7%
Adults who reported that home health providers always kept them informed about when they would arrive at their home in the last 2 months of care	77.4	83.3	7.1%
Hospice patients who always received enough helps for pain, sadness, breathing, or constipations from hospice care team	73.4	79.0	7.1%
Hospice patients and family caregivers who always got help as soon as they need from hospice care team	76.4	82.3	7.2%
Home health care patients whose bathing improved	69.9	75.4	7.2%
Adults who reported that home health providers always listen carefully to them in the last 2 months of care	81.0	87.9	7.9%
Adults who reported a home health provider asking to see all the prescription and over-the-counter medicines they were taking, when they first started getting home health care	78.6	85.5	8.1%
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year	68.9	75.2	8.3%
Home health care patients who stayed at home after an episode of home health care	71.0	77.5	8.4%
Home health care patients whose management of oral medications improved	60.0	66.0	9.1%
Adults who reported a home health provider talking with them about how to set up their home so they can move around safely when they first started getting home health care	72.4	80.1	9.6%
Home health patients who had improvement in upper body dressing	69.7	77.4	9.9%

Measures That Are Close to Benchmark

Measure	Estimate	Benchmark	Distance to Benchmark
Home health care patients whose surgical wound was improved	88.4	80.3	10.0%
Adult hemodialysis patients who use arteriovenous fistulas as the primary mode of vascular access	64.8	72.8	10.9%
Adults who reported getting the help or advice they needed when they contacted their home health providers in the last 2 months of care	26.4	30.4	13.2%
Adults who reported that home health providers talked with them about the purpose for taking their new or changed prescription medicines in the last 2 months of care	31.1	35.9	13.4%
Home health care patients whose ability to get in and out of bed improved	60.8	70.3	13.5%
Home health care patients whose shortness of breath decreased	66.6	77.0	13.6%
Home health care patients whose ability to walk or move around improved	61.5	71.5	14.0%
Adults home health patients age 18 and over who reported that home health providers talked with them about the side effects of medicines in the last 2 months of care	25.2	29.5	14.7%
Adults who reported that home health providers talked with them about when to take medicines in the last 2 months of care	28.9	33.9	14.7%
Adults who reported that home health providers always seem informed and up-to-date about all the cares or treatments they got at home in the last 2 months of care	57.3	67.6	15.2%
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year	69.3	84.0	17.5%
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year	65.2	79.5	18.0%
Ratio of observed deaths to expected deaths among Medicare hemodialysis patients	1.0	0.9	22.4%
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year	45.9	65.8	30.3%
Long-stay nursing home patients experiencing one or more falls with major injury	0.5	0.4	31.7%
Long-stay nursing home residents whose need for help with daily activities increased	14.3	10.6	34.7%
Adult end stage renal disease (ESRD) patients who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy	30.3	54.1	44.0%
Short-stay nursing home residents with moderate to severe pain	15.9	10.8	47.0%
Long-stay nursing home residents whose ability to move independently worsened	20.6	13.7	49.9%

Measures That Are Far From Benchmark

Measure	Estimate	Benchmark	Distance to Benchmark
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure	11.0	28.8	61.7%
Dialysis patients who were registered on a waiting list for transplantation	8.9	28.2	68.4%
Long-stay nursing home residents with physical restraints	0.4	0.2	78.3%
Long-stay nursing home residents have depressive symptoms	2.3	1.1	99.1%
High-risk, long-stay nursing home patients with pressure ulcer	7.7	3.4	126.8%
Long-stay nursing home residents with moderate to severe pain	11.3	4.7	140.0%
Low-risk, long-stay nursing home residents with a catheter inserted and left in the bladder	6.4	2.5	153.5%
Low-risk, long-stay nursing home residents with loss of control of bowels or bladder	46.6	16.7	179.0%

Measures With No Available Benchmark Information or Supplemental Measures

Measure	Estimate	Benchmark	Distance to Benchmark
Short-stay home health patients who had drug education on all medications	97.3
Tamoxifen or third generation aromatase inhibitor was recommended or administered within 1 year of diagnosis for women with AJCC T1cN0M0 or stage IB to stage III hormone receptor-positive breast cancer	87.8
Percent of hemodialysis patients whose hemoglobin level is less than 10 g/dL	18.8
Patients with end stage renal disease due to diabetes	43.6