December 30 2024
OASIS

3 New Home Health Quality Measures on Care Compare in Jan. 2025!

by Marian Essey, RN, BSN, COS-C

January 2025 Care Compare

The January 2025 refresh of Care Compare will include three new home health quality measures. HHAs can review their measure results for these measures now on their iQIES Provider Preview Report. The January 2025 refresh of the CMS website, Care Compare, will include these new quality measures:

Transfer of Health Information (TOH) to the Provider
Transfer of Health Information (TOH) to the Patient
Discharge Function Score

HHAs now have the “preview” of these measure results in their October 2024 Care Compare Provider Preview Report in iQIES.

Measures Snapshot

The following table provides an overview of each measure.

Quality Measure	Measure Type	Measure Description	Numerator	Denominator	Measure Exclusions	OASIS Items Used
TOH – Provider	Process Measure	The measure assesses the timeliness of the transfer of health information, specifically transfer of a reconciled medication list. This measure evaluates for the transfer of information when a patient is transferred or discharged to a subsequent provider. For this measure, the subsequent provider is defined as a short term general hospital, a SNF, intermediate care, home under care of an organized home health service organization or hospice, hospice in an institutional facility, an IRF, an LTCH, a Medicaid nursing facility, an inpatient psychiatric facility, or a critical access hospital.	Number of home health quality episodes ending in discharge or transfer for which the OASIS indicated that the following is true: At the time of discharge / transfer, the agency provided a current reconciled medication list to the subsequent provider.	The denominator is the number quality episodes ending in discharge or/transfer to a short-term general hospital, a SNF, intermediate care, home under care of another organized home health service organization or hospice, hospice in an institutional facility, a swing bed, an IRF, a LTCH, a Medicaid nursing facility, an inpatient psychiatric facility, or a critical access hospital	Patients who die during the episode. Patients discharged to a location not specified in denominator statement.	A2120 (Provision of Current Reconciled Medication List to Subsequent Provider at Transfer) A2121 (Provision of Current Reconciled Medication List to Subsequent Provider at Discharge) A2122 (Route of Current Medication List Transmission to Subsequent Provider) M2420 (Discharge Disposition) M0100 (Reason for Assessment)
TOH – Patient	Process Measure	his measure assesses for and reports on the timely transfer of health information, i.e., a current reconciled medication list, to the patient when discharged from home health to a private home/apartment, board and care home, assisted living, group home, or transitional living.	The number of quality episodes ending in a discharge from the agency for which the OASIS indicated that the following is true: At the time of discharge, the agency provided a current reconciled medication list to the patient, family, and/or caregiver.	Number of quality episodes ending in discharge to a private home/ apartment, board/care, assisted living, group home, or transitional living.	Patients who die during the episode. Patients discharged to a location not specified in denominator statement.	A2123 (Provision of Current Reconciled Medication List to Patient) A2124 (Route of Current Medication List Transmission to Patient) M2420 (Discharge Disposition M0100 (Reason for Assessment)
Discharge Function Score	Outcome Measure	The percentage of home health patients who achieve or exceed a risk-adjusted expected function score at discharge. Functional status evaluates a patient’s capacity to perform daily activities related to self-care (GG0130) and mobility (GG0170).	umber of home health quality episodes where the observed discharge function score for Section GG function items is equal to or greater than the calculated expected discharge function score.	Number of home health quality episodes ending with a discharge during the reporting period, other than those covered by generic or measure-specific exclusions.	Home health quality episodes that end in a transfer, death at home, or, or the quality episode is less than 3 days. Home health quality episodes where the patient is considered to be non-responsive in which the primary diagnosis or other diagnoses indicate the patient has a diagnosis of coma, persistent vegetative state, has complete tetraplegia, locked-in state, severe anoxic brain damage, cerebral edema, or compression of the brain. Home health quality episodes where the patient is discharged to hospice (home or institutional facility).	(GG0130A) Eating (GG0130B) Oral Hygiene (GG0130C) Toileting Hygiene (GG0170A) Roll Left and Right (GG0170C) Lying to Sitting on Side (GG0170D) Sit to Stand (GG0170E) Chair/Bed-to-Chair Transfer (GG0170F) Toilet Transfer (GG0170I) Walk 10 Feet (GG0170J) Walk 50 Feet with 2 Turns (GG0170R) Wheel 50 Feet with 2 Turns (M1021) Primary diagnosis (M1023) Other diagnoses (M1700) Cognitive functioning (M2420) Discharge Disposition (M0100) Reason for Assessment

Measure Uses

The only use of the TOH-Patient and TOH- Provider measures is to be publicly reported on Care Compare for the Home Health Quality Reporting Program (HH QRP). However, in addition to being reported on Care Compare, the Discharge Function Score measure will be used in the calendar year (CY) 2025 expanded Home Health Value-Based Purchasing (HHVBP) Model applicable measure set, will be used to calculate the agency’s Total Performance Score, and will count toward the agency’s applicable payment adjustment for Medicare fee-for-service payments.

Learn more about the recent CMS updates in the upcoming Quarterly OASIS Update webinar.  For a limited time, order the Quarterly OASIS Update Bundle and get a FREE 2025 INSTANT OASIS Answers Book!