Skilled Nursing Facilities

CKPI Overview and Access

The Clinical Key Performance Indicators assist with ongoing review and evaluation of facility performance and resident outcomes. The CKPIs provide additional clinical quality metrics to monitor the facility population for opportunities of improvement. These CKPIs are straight occurrence rates based on each resident's MDS. The CKPIs provide the quality committee with facility metrics, and also offer direct care staff information for appropriate resident assessment and care planning.

Clinical Key Performance Indicators are populated for all residents from the most recent MDS that is in exported, export ready, or accepted status.

You must have appropriate security access to see the Analytics tab available in the menu bar. To access the Analytics module click on Analytics. The Analytics landing page appears where you can access CKPI.

Table 1. Single Clinical Calculations for Clinical Conditions (# of residents with condition/total number of residents)

Clinical Condition - Description

MDS calculation – MDS 3.0

MDS Calculation - RAI MDS 2.0

Skin Conditions (% residents with Pressure Ulcers – any stage)

M02100 > 0

M2A > 0

Decline in ADLs (% of residents with ↑ADL score)

G0110A - J1

current > previous

G1A - J1A current scores > previous

Readmission Rate (% Medicare readm to hosp in 30 days with one of 3 DX – Heart attack, heart failure, pneumonia)

[A1600 < 30 days from A2000] + [A1800 + A2100 = 3] + [I0400 or I0600 or I2000 = 1] +   A1600 < A2400C

[AB2a < 30days from DC =07 date] + [ I1f or I2f =1]

Pain (% residents reporting pain issues)

J0300 or J0700 > 0

J2a > 0

Mood (% residents with declined PHQ9 score)

D0300 (or D0600 if D0300 = 99)

current < previous

E3 = 2

Behaviors (% residents’ behaviors self/others)

E0300=1 or E0800 > 0 or E0900 > 0

E4aA-eA > 0

Restorative (% residents participating in restorative programs)

O0500A-J > 0

P3A-K > 0

Therapy (% residents receiving therapy and; declining ADLs)

O0400A,B,C4 > 0 + G0110A-J1 current > previous

P1ba-fA > 0 + G1a-j1A current scores > previous

Urinary Incontinence (% residents)

H0300 > 0

H1b > 0

Cognition Declined (% residents with ↓ BIMS score)

C0500 differs current/previous

B6 > 0

Nutritional (% residents with unplanned wt. loss issues)

K0300 = 2

K3a or b > 0

Antipsychotic Drugs (% residents receiving Antipsychotic drugs)

NO410a > 0 + I4800=selected

O4a > 0

Physical Restraints (% residents with any restraints, any time)

P0100a-h > 0

P4a-e > 0

% New Diagnosis (DX on target MDS not present on previous MDS)

# of  section I diagnosis on recent MDS but not prior (I0100-I6300 selected on current assessment, but not prior, or an ICD-9 or ICD-10 code in I8000A-I8000G that was not in the prior assessment)

I1a-uux = 1 on current and 0 on previous

Falls % resident with a current or previous fall

J1800 = 1

J4a = 1