Ask Proactive – Let’s say I have a resident fall with injury on January 1st. How many days have to pass before it will drop off and not count against us as far as our 5-star rating?

Let’s say I have a resident fall with injury on January 1st. How many days have to pass before it will drop off and not count against us as far as our 5-star rating?

A:

The fall with major injury will be included in the QM % for the quarter if it was coded on a MDS in the look-back period of 275 days prior to the last MDS completed during the quarter. 4 quarters of data are used for calculating the 5 star QM rating. So, as an example, for your July NH compare update, it will include Q2 2022, Q1 2022, Q4 2021, Q3 2021. The Q3 2021 QM report could contain a fall with major injury that occurred 275 days prior to July 2021, which will still impact your star rating until Oct 2022.