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CMS Quality Measure: Patients who had to be admitted to the hospital

Under CMS Category: Incidence of Patient Emergencies

Why is this measure important?
According to Medicare, some patients may need to go into the hospital while they are getting home health care. In some cases--like incurable chronic medical conditions--going into the hospital may not be avoidable even with good home health care.

However, some inpatient hospital care may be avoided if home health care staff is doing a good job at checking the patient's health condition at each visit (so problems are detected early). Home care staff also need to check how well the patient is eating, drinking, taking medicines, and how safe the home is. Home health care staff must coordinate care. This involves communicating regularly with patient, informal caregivers, the patient's doctor, and anyone else who provides care for the patient. It is critical that the home care staff informs the patient's doctor when a patient's condition declines.

The national average of home care patients who had to be admitted to the hospital is 29%

What is your state’s rate for patients who had to be admitted to the hospital from homecare? Select your state and click the search button below to find out.

Some of the top state averages:

Utah: 22 %	Oregon: 25 %	Kansas: 25 %
Montana: 23 %	Alaska: 25 %	Maine: 25 %
North Dakota: 23 %	California: 25 %	Vermont: 25 %
South Dakota: 23 %

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Assessment Score

How a patient's assessment score is calculated:
Patients that are transferred to an acute care hospital inpatient facility are compared to patients that transfer to all types of inpatient care facilities such as rehabilitation, skilled nursing, and hospice. It is the rate of acute care facility transfers.

How a home care provider's assessment score is calculated:
It is the percentage of patients who were admitted to the hospital. Lower percentages are better.

The measures on hospitalization and urgent care look at how services are used rather than the outcome of care provided.

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Learn more about CMS Quality Measures:

CMS Home Care Quality Measures

1. How Home Care Ends
A. Patients who stay at home after an episode of home health care ends
B. Patients whose wounds improved or healed after an operation

2. Improvement in Getting Around
A. Patients who get better at walking or moving
B. Patients who get better at getting in and out of bed
C. Patients who have less pain when moving around

3. Incidence of Patient Emergencies
A. Patients who need urgent, unplanned medical care
B. Percentage of patients who need unplanned medical care related to a wound that is new, is worse, or has become infected

4. Meetings the activities of patient’s daily living
A. Patients whose bladder control improves
B. Patients who get better at bathing
C. Patients who get better at taking their medicines correctly (by mouth)
D. Patients who are short of breath less often

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Have questions about home care? Check out these resources:

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How to Select the Best Home Care

Home Care Quality Information

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