Quality Measures

By Ryan Squire

Matt Sivret and Sally Brooks, MD addressed why outcomes matter greatly to Kindred Healthcare, measuring our organizational success through patient success, how to address outcomes across the continuum and why outcomes matter to our customers. Matt started by identifying the top seven reasons why outcomes matter:

  • Improved care for patients
  • Assessing quality of the program
  • Provide direction for performance improvement committees
  • Research and development
  • Marketing programs and services
  • Managed care contacts
  • Identify re-hospitalization trends


Matt SivretMatt Sivret


Matt shared that RehabCare has historically measured success through functional change in the patient. RehabCare therapists rate patients' abilities to complete specific functional tasks as part of assessments in both the long-term acute care hospitals and skilled nursing facilities. For example, therapists measure eating, walking, bathing, dressing, and communication at specific intervals (evaluation, discharge, before they were sick-prior level [through interviews with family members]). One of the obstacles Matt sees is that as an industry, there is not a widely used unified system to measure functional outcomes. At the same time, Matt points out one of the strengths that RehabCare and Kindred have is that they can measure these outcomes throughout the continuum, not just in each location.

Matt said that measuring these outcomes and grouping patients together to report outcomes allows us to measure success by facility, region, and division. It also allows us to report to payer sources value they are getting for their money, which Matt says, helps us prove that the payer is getting what they paid for, an increasingly important metric.

Measuring across the continuum is important because it shows overall progress. On average, RehabCare patients arrive at the facility with about 50% of their prior-level and as they leave the LTACH they are reaching about 63%, remarkable given that patients in the LTACH are managing many active medical issues. By the time they leave the skilled nursing facility, they are averaging 78% of prior-level function.

In Kindred's Nursing Center Division, quality is measured by scoring:

  • Re-hospitalization
  • Length of Stay
  • Patient Satisfaction
  • 5-Star
  • QI/QMs


Sally Brooks, MDSally Brooks, MD


Dr. Sally Brooks said that each customer type has a different reason why outcomes matter and understanding those reasons is important for our caregivers.

Broken down by customer type and reason:

  • Patient-concerned with health quality and restoration of function.
  • Family-as caregivers and/or responsible party they are concerned with health quality, function and cost.
  • Referring physician-concerned with quality and satisfaction.
  • Referring hospital or Health Care System-concerned with quality, function, and avoidable re-admissions.
  • Payer-concerned with quality (CMS and JCAHO metrics), avoidable re-admissions, and cost benefit.