OT Skilled Nursing Facility Evaluation Checklist & Quality Measures

OT Skilled Nursing Facility
Evaluation Checklist &

Quality Measures
Use the checklist below during the evaluation as a reminder of areas to address. AOTA encourages practitioners to print off the
checklist and bring it with you to help guide client evaluations, as well as to educate and train your colleagues regarding the
occupational therapy evaluative process. The checklist supports high quality OT evaluations that lead to occupation-based, client-
centered interventions.
A comprehensive occupational therapy evaluation is based on a theoretical model and follows the Occupational Therapy Practice
Framework. A top-down approach identifies occupations that are challenging and important to the client and then assesses related
performance skills, client factors, environments and context, and performance patterns. This checklist does not replace the clinical
judgment of an occupational therapist. The checklist should be used as a reminder of baseline areas that should be addressed
during the OT evaluation process. The areas below relate to occupation-based practice and quality performance measures.
For more information on the Patient Driven Payment Model (PDPM), this checklist, and the important role of occupational therapy
click on “SNF” at www.aota.org/value.
Occupational Profile:
Each element of the occupational profile is considered from the client’s perspective. Download the template at www.aota.org/
profile.
Client’s Concerns
Successful occupations
Interests & Values
Occupational History
Performance Patterns
Habits  Routines  Roles  Rituals
Environment: Supports & Barriers (Physical, Social)
Context: Supports & Barriers (Cultural, Personal, Temporal, Virtual)
Client’s Priorities and Desired Outcomes
Analysis of Occupational Performance

Click on the Quality Toolkit at www.aota.org/value for links to standardized assessments and screening tools used in each of the
areas below.
Addressed Is this area a Priority Addressed Is this area a Priority

Occupations
ADLs   IADLs  
Performance Skills
Psychosocial/Behavior Skills   Fall Prevention/Fear of Falling  
Client Factors—In addition to areas identified while addressing ADLs and IADLs (e.g., motor, sensation, pain)
Vision   Functional Cognition  
Performance Patterns
Habits, Routines, Roles  
Contexts & Environments  
Include Safety Screen
Rate this resource and provide feedback at surveys.aota.org/s3/checklist

SNF Quality Measures (2019)
Download details and read more about the Value Based Payment and Quality Reporting Programs in SNF at www.aota.org/value.
SNFs are scored based on the measures below. Talk to your administration/team to identify your facility’s current scores and
which measures are priorities for your team. Scores are available on CASPER reports. Consider the ways in which your practice
contributes to your facility scores on priority measures.
Value-Based Payment Program

Measure Facility Score as of _________(date) Notes
Skilled Nursing Facility 30-Day Potentially Preventable Readmission
Measure (SNFPPR)
Skilled Nursing Facility 30-Day All-Cause Readmission Measure
(SNFRM)
Quality Reporting Program

Application of Percent of Residents Experiencing One or More Falls
with Major Injury (Long Stay)
Percent of Patients or Residents with Pressure Ulcers that are New
or Worsened
Application of Percent of Long-Term-Care Hospital Patients with an
Admission and Discharge Functional Assessment and a Care Plan
that Addresses Function
Discharge to Community—Post-Acute Care (PAC) Skilled Nursing
Facility (SNF) Quality Reporting Program (QRP)
Potentially Preventable 30-Days Post-Discharge Readmission
Measure for Skilled Nursing Facility (SNF) Quality Reporting
Program (QRP)
Medicare Spending Per Beneficiary—Post-Acute Care (PAC) Skilled
Nursing Facility Measure

SNF QRP Measures Required on FY 2020 Claims
The following measures will be implemented on October 1, 2019.

Spending Per Beneficiary (MSPB)—Post-Acute Care (PAC) Skilled
Nursing Facility (SNF) Quality Reporting Program (QRP).
Discharge to Community Post-Acute Care SNF Quality Reporting
Program
Potentially Preventable 30-Day Post-Discharge Readmission
Measure for SNF Quality Reporting Program
Percent of Residents or Patients With Pressure Ulcers That Are New
or Worsened (Short Stay) (NQF #0678)
Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury
Application of Percent of Residents Experiencing One or More
Falls with Major Injury (Long Stay) (NQF #0674)
Application of Percent of Long-Term-Care Hospital (LTCH) Patients
with an Admission and Discharge Functional Assessment and a
Care Plan That Addresses Function (NQF #2631)
Application of Inpatient Rehabilitation Facility (IRF) Functional
Outcome Measure: Change in Mobility Score for Medical
Rehabilitation Patients (NQF #2634)
Application of IRF Functional Outcome Measure: Discharge Mobility
Score for Medical Rehabilitation Patients (NQF #2636)
Application of the IRF Functional Outcome Measure: Change in Self-
Care Score for Medical Rehabilitation Patients (NQF #2633)
Application of IRF Functional Outcome Measure: Discharge Self-
Care Score for Medical Rehabilitation Patients (NQF #2635)
Drug Regimen Review Conducted With Follow-Up for Identified
Issues—Post Acute Care (PAC) Skilled Nursing Facility (SNF) Quality
Reporting Program (QRP).
www.aota.org

OT Skilled Nursing Facility Evaluation Checklist & Quality Measures

Uploaded by

Copyright:

Available Formats

OT Skilled Nursing Facility Evaluation Checklist & Quality Measures

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

OT Skilled Nursing Facility Evaluation Checklist & Quality Measures

Uploaded by

Copyright:

Available Formats

OT Skilled Nursing Facility

Evaluation Checklist &

Analysis of Occupational Performance

Addressed Is this area a Priority Addressed Is this area a Priority

Rate this resource and provide feedback at surveys.aota.org/s3/checklist

Value-Based Payment Program

Quality Reporting Program

Rate this resource and provide feedback at surveys.aota.org/s3/checklist

Measure Facility Score as of _________(date) Notes

Rate this resource and provide feedback at surveys.aota.org/s3/checklist

You might also like