Measure: CMS139
Falls: Screening for Future Fall Risk
Measure Versions
eMeasure Code |
Measure Year |
Full Version Number |
Title |
CMS139v12 |
2024 |
12.0.000 |
Falls: Screening for Future Fall Risk |
CMS139v11 |
2023 |
11 |
Falls: Screening for Future Fall Risk |
CMS139v10 |
2022 |
10.0.000 |
Falls: Screening for Future Fall Risk |
CMS139v9 |
2021 |
9.2.000 |
Falls: Screening for Future Fall Risk |
CMS139v8 |
2020 |
8.1.000 |
Falls: Screening for Future Fall Risk |
CMS139v7 |
2019 |
7.2.000 |
Falls: Screening for Future Fall Risk |
CMS139v6 |
2018 |
6.1.000 |
Falls: Screening for Future Fall Risk |
CMS139v5 |
2017 |
5.0.000 |
Falls: Screening for Future Fall Risk |
Description
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Guidance
None
Patient Group Definitions
Group |
Description |
Instructions Links |
Initial Population | Patients aged 65 years and older with a visit during the measurement period | Webchart Instructions |
Denominator | Equals Initial Population | Webchart Instructions |
Denominator Exclusions | None | |
Numerator | Patients who were screened for future fall risk at least once within the measurement period | Webchart Instructions |
Numerator Exclusions | Not Applicable | Webchart Instructions |
Denominator Exceptions | Documentation of medical reason(s) for not screening for fall risk (eg, patient is not ambulatory) | Webchart Instructions |
Details
Full eMeasure Code |
eMeasure Identifier |
Measure Year |
Version |
NQF # |
GUID |
CMS139v5 |
139 |
2017 |
5.0.000 |
0101 |
bc5b4a57-b964-4399-9d40-667c896f31ea |
Steward |
Developer |
Endorsed By |
American Medical Association (AMA) |
National Committee for Quality Assurance |
National Quality Forum |
Scoring Method |
Measure Type |
Stratification |
Risk Adjustment |
Proportion |
PROCESS |
None |
None |
Rate Aggregation
None
Improvement Notation
A higher score indicates better quality.
Rationale
As the leading cause of both fatal and nonfatal injuries for older adults, falls are one of the most common and significant health issues facing people aged 65 years or older (Schneider, Shubert and Harmon 2010). Moreover, the rate of falls increases with age (Dykes et al. 2010). Older adults are five times more likely to be hospitalized for fall-related injuries than any other cause-related injury. It is estimated that one in every three adults over 65 will fall each year (Centers for Disease Control and Prevention 2015). In those over age 80, the rate of falls increases to fifty percent (Doherty et al. 2009). Falls are also associated with substantial cost and resource use, approaching $30,000 per fall hospitalization (Woolcott et al. 2011). Identifying at-risk patients is the most important part of management, as applying preventive measures in this vulnerable population can have a profound effect on public health (al-Aama 2011). Family physicians have a pivotal role in screening older patients for risk of falls, and applying preventive strategies for patients at risk (al-Aama 2011).
Clinical Recommendation Statement
All older persons who are under the care of a heath professional (or their caregivers) should be asked at least once a year about falls. (AGS/BGS/AAOS)
Older persons who present for medical attention because of a fall, report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should have a fall evaluation performed. This evaluation should be performed by a clinician with appropriate skills and experience, which may necessitate referral to a specialist (eg, geriatrician). (AGS/BGS/AAOS)
Older people in contact with health care professionals should be asked routinely whether they have fallen in the past year and asked about the frequency, context, and characteristics of the falls. (NICE) (Grade C)
Older people reporting a fall or considered at risk of falling should be observed for balance and gait deficits and considered for their ability to benefit from interventions to improve strength and balance. (NICE) (Grade C)
Definition
Screening for Future Fall Risk: Assessment of whether an individual has experienced a fall or problems with gait or balance. A specific screening tool is not required for this measure, however potential screening tools include the Morse Fall Scale and the timed Get-Up-And-Go test.
Fall: A sudden, unintentional change in position causing an individual to land at a lower level, on an object, the floor, or the ground, other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force.
Transmission Format
TBD
Applicable Value Sets
Category |
Value Set |
OID |
Encounter, Performed |
Annual Wellness Visit |
2.16.840.1.113883.3.526.3.1240 |
Encounter, Performed |
Audiology Visit |
2.16.840.1.113883.3.464.1003.101.12.1066 |
Encounter, Performed |
Care Services in Long-Term Residential Facility |
2.16.840.1.113883.3.464.1003.101.12.1014 |
Encounter, Performed |
Face-to-Face Interaction |
2.16.840.1.113883.3.464.1003.101.12.1048 |
Encounter, Performed |
Home Healthcare Services |
2.16.840.1.113883.3.464.1003.101.12.1016 |
Encounter, Performed |
Nursing Facility Visit |
2.16.840.1.113883.3.464.1003.101.12.1012 |
Encounter, Performed |
Office Visit |
2.16.840.1.113883.3.464.1003.101.12.1001 |
Encounter, Performed |
Ophthalmological Services |
2.16.840.1.113883.3.526.3.1285 |
Encounter, Performed |
Preventive Care Services - Established Office Visit, 18 and Up |
2.16.840.1.113883.3.464.1003.101.12.1025 |
Encounter, Performed |
Preventive Care Services-Individual Counseling |
2.16.840.1.113883.3.464.1003.101.12.1026 |
Encounter, Performed |
Preventive Care Services-Initial Office Visit, 18 and Up |
2.16.840.1.113883.3.464.1003.101.12.1023 |
Patient Characteristic Ethnicity |
Ethnicity |
2.16.840.1.114222.4.11.837 |
Patient Characteristic Payer |
Payer |
2.16.840.1.114222.4.11.3591 |
Patient Characteristic Race |
Race |
2.16.840.1.114222.4.11.836 |
Patient Characteristic Sex |
ONC Administrative Sex |
2.16.840.1.113762.1.4.1 |
Risk Category Assessment |
Falls Screening |
2.16.840.1.113883.3.464.1003.118.12.1028 |
Risk Category Assessment |
Medical Reason |
2.16.840.1.113883.3.526.3.1007 |
Risk Category Assessment |
Patient not ambulatory |
2.16.840.1.113883.3.464.1003.118.12.1009 |
References
al-Aama, T. 2011. "Falls in the Elderly: Spectrum and Prevention." Can Fam Physician 57(7):771-6.
Centers for Disease Control and Prevention. 2015. "Important Facts about Falls" (December 14, 2015) http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html
Doherty, M., and J. Crossen-Sills. 2009. "Fall Risk: Keep your patients in balance." The Nurse Practitioner: The American Journal of Primary Health Care 34(12):46-51.
American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention: Guideline for the prevention of falls in older persons. Journal of the American Geriatrics Society. 2001; 49: 664-672.
National Institute for Clinical Excellence (NICE). Falls: the assessment and prevention of falls in older people. November 2004; clinical guideline 21. Available at: https://www.nice.org.uk/guidance/cg161
Dykes, P.C., D.L. Carroll DL, A. Hurley A, S. Lipsitz S, A. Benoit A, F. Chang F, S. Meltzer S, R. Tsurikova R, L. Zuyov L, B. Middleton B. 2010. "Fall Prevention in Acute Care Hospitals: A Randomized Trial." JAMA . 2010;304(17):1912-1918.
Schneider, E.C., T.E. Shubert, and K.J. Harmon. 2010. "Addressing the Escalating Public Health Issue of Falls Among Older Adults." NC Med J 71(6):547-52.
Woolcott, J.C., K.M. Khan, S. Mitrovic, A.H. Anis, C.A. Marra. 2011. "The Cost of Fall Related Presentations to the ED: A Prospective, In-Person, Patient-Tracking Analysis of Health Resource Utilization." Osteporos Int [Epub ahead of print].
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Source:
https://ecqi.healthit.gov/ecqm/measures/cms139v5