Achieving improvement through nursing home quality measurement

CMS has initiated the Nursing Home Quality Initiative (NHQI) to improve the quality of nursing home care. Central to the NHQI is the public reporting of nursing home quality measures that serve as the basis for the Initiative's communication and quality improvement program. This article provides an overview of the NHQI, focusing on the role of nursing home quality measures in achieving improvements in nursing home care. We also describe the evolution of quality measurement in nursing homes, a recent CMS project to improve measures through risk adjustment and other refinements, the use of these measures in a pilot of the NHQI, and the lessons learned for future work in this area.