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Improving Care in Nursing Homes Using Quality Measures/Indicators and Complexity Science

In the past 20 years, more information has become available about clinical outcomes in nursing homes. Since 1991, nursing homes have been mandated to collect and submit the Minimum Data Set (MDS) on Medicare and Medicaid recipients. The uniform data collection allowed the creation of 24 quality indicators (QIs), which reflect the quality of chronic care in individual nursing homes at the state and national levels. Since 1998, MDS records have been transmitted to a national repository to be used to assist in the survey process. MDS data gathering is completed on admission, quarterly, annually, and when a significant change in the resident’s condition occurs. It is also used to determine payment levels in some states for nursing homes certified for Medicare and Medicaid.