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Study: Only 57% of Falls with Injury Reported

A study conducted by Prachi Sanghavi, PhD and other colleagues at the University of Chicago found that falls with injury are underreported. This is based on comparing Medicare hospital inpatient claims to the Minimum Data Set (MDS) assessments/Nursing Home Compare Data. 

The study found that only 57.5% of the falls on hospital claims were reported on the MDS. Falls were the focus for this study due to the fact they are a leading cause of death among older adults. 

Falls are identified in MDS item J1900C for the quality measure. The report clarifies the definition of a fall, saying: “Though the MDS rules may appear complex, the context of the chief MDS fall item of interest, J1900C, is simple: If a person falls during nursing home residency and is admitted to a hospital with major injury, we expect the nursing home to report the fall under this item on a discharge assessment.” 

The report provides greater detail on all areas of the MDS and claims reviewed. MDS accuracy should be an ongoing internal auditing process for an organization. The accidents critical element pathway is a tool that should be used to audit falls. Ensure the QAPI committee is reviewing falls and implementing a performance improvement plan (PIP) as needed. 

The LTC survey pathways can be found on the CMS Nursing Home webpage, under the download section and within the zip file called LTC Survey Pathways. LeadingAge Ohio will be providing education, tools & best pracrtices on falls on March 11, 2020 during the In The Know Nursing Home Regulatory & Quality Update.

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