Long-Term Care and Assisted Living Directory – Definitions of Indicators for Long-Term Care
Definitions of Indicators – Assisted Living
If you have questions about the data in the Long-Term Care Directory, contact our office at 1-877-952-3181.
The B.C. values for these indicators are calculated using only those facilities included in the Long-Term Care and Assisted Living Directory and may vary slightly from the provincial values reported by the Canadian Institute for Health Information (CIHI).
Resident Profile
All measures are based on resident assessments performed within the time period included in the report, except the average length of stay which is based on residents discharged within this time period.
Average age of population – average resident age.
Percent female – the percent of residents that are female.
Percent 85 years or older – the percent of residents that are aged 85 years or older.
Percent younger than 65 years – the percent of residents younger than 65 years of age.
Average length of stay (days) – the average length of stay for residents discharged within the measurement time period.
Percent of residents diagnosed with depression – the percent of residents that have been clinically diagnosed with depression (e.g. depression, anxiety, sad mood).
Percent of residents dependent in activities of daily living – the percent of residents that were somewhat or totally dependent in their activities of daily living (ADL) during the observation period, seven days for RAI-MDS 2.0 and three days for interRAI-LTFC, prior to assessment. ADLs are assessed based on a person’s ability to perform seven activities: locomotion, eating, toilet use and personal hygiene. (ADL score>=5)
Percent of residents in a wheelchair – the percent of residents whose primary mode of locomotion is a wheelchair or scooter. For interRAI LTCF, this reflects the resident’s primary indoor locomotion over the past three days. For RAI MDS 2.0, it reflects residents who primarily rely on a wheelchair in the past seven days, even if they walk at times. The wheelchair may be motorized, self-propelled, or pushed by another person.
Percent of residents with dementia (mild to severe) – the percent of residents that have been clinically diagnosed with Alzheimer’s disease or other types of dementia.
Percent of residents with severe cognitive impairment (includes severe dementia) – the percent of residents assessed at moderate/severe, severe or very severe cognitive impairment. Cognitive performance is assessed based on five factors over the past seven days for RAI-MDS 2.0: coma, cognitive skills for daily decision-making, short-term memory, ability to make oneself understood, and eating. For interRAI-LTCF, it is based on four factors over the past three days: cognitive skills for daily decision-making, short-term memory, ability to make oneself understood, and eating. (CPS score>=4).
Percent of residents with physically abusive behaviour – the percent of residents that showed physically abusive behavioural symptoms (e.g. others were hit, shoved, scratched, sexually abused) within the observation period, seven days for RAI-MDS 2.0 and three days for interRAI-LTFC, prior to assessment.
Average index of social engagement – it describes a resident’s sense of initiative and social involvement within the facility. For RAI-MDS 2.0, it is the average index of social engagement (ISE) across all residents in the facility, scored zero to six based on the presence of six indicators in the past seven days: at ease interacting with others, at ease doing planned or structured activities, at ease doing self-initiated activities, establishes own goals, pursues involvement in the life of the facility, and accepts invitations into most group activities. For interRAI-LTCF, it is the average revised index of social engagement (RISE) across all residents in the facility, also scored zero to six , based on the presence of six factors in the past three days: at ease interacting with others, at ease doing planned or structured activities, accepts invitations into most group activities, pursues involvement in the life of the facility, initiates interaction(s) with others, and reacts positively to interactions initiated by others. These indicators are not directly comparable across the two systems; therefore, this report presents data only from RAI-MDS 2.0.
Percent of residents with low social engagement – the percent of residents where two or fewer of the six ISE factors were present within the seven days prior to assessment.
Case mix index (CMI) – a value calculated by grouping individuals into categories based on similar use of resources. A higher value indicates higher resource needs within the facility. For RAI-MDS 2.0, CMI is derived from RUG-III, while for interRAI-LTCF, it is based on RUG-III Plus. CMI is not directly comparable between these two systems; therefore, this report presents data only from RAI-MDS 2.0.
Care Services and Quality Indicators
Percent of residents receiving physical (PT) / recreational (RT) / occupational (OT) therapy – the percent of residents receiving therapy within the seven days prior to assessment. Facilities are required to report, through regular clinical assessments of individuals, whether a resident received various types of therapies from a qualified therapist, or their supervised therapy assistant in the last 7 days prior to the assessment date. Occupational and physical therapy may not be required for every resident in a facility but the calculation is based on the total number of residents regardless of who needs these therapies. Reported recreational therapy must be beyond the usual activities programming provided by a facility and be provided by a qualified therapist (or an assistant under their supervision) and include measurable objectives and progress evaluations.
Percent of residents receiving depression medication – the percent of residents taking antidepressants in the last seven days.
Percent of residents taking antipsychotics without a diagnosis of psychosis – the percent of residents given an antipsychotic medication for a purpose other than for its approved use to manage psychosis. Antipsychotics drugs are sometimes used to manage symptoms in residents such as dementia, anxiety, agitation, or responsive behaviour arising from dementia. Some antipsychotic medications are also prescribed at low doses as a sleep aid.
Percent of residents taking antipsychotics with or without a diagnosis of psychosis – the percent of residents taking an antipsychotic medication in the last seven days.
Percent of residents taking nine or more medications – the percent of residents taking nine or more different medications administered by any route (e.g. oral, IV, injections, patch) in the past seven days for RAI-MDS 2.0 and three days for InterRAI-LTCF. “Medications” can also include topical preparations, ointments, creams used in wound care (e.g. Elase), eyedrops, vitamins and suppositories.
Percent of resident with daily physical restraints – the percent of residents with daily use of physical restraint, which includes limb and trunk restraints and use of a reclining chair from which a resident cannot rise. CIHI states that, “restraints are sometimes used to manage behaviours or to prevent falls. There are many potential physical and psychological risks associated with applying physical restraints to older adults, and such use raises concerns about safety and quality of care.”
Percent of residents with falls in the last 30 days – the percent of residents that fell in the 30 days leading up to the date of the assessment. Falls are the leading cause of injury for seniors and contribute to a significant burden on the health care system. Residents are at a higher risk of falling if they have a history of falls or are taking certain medications. Preventing falls increases the safety and quality of care of residents.
Percent of residents with a worsened pressure ulcer – the percent of residents whose pressure ulcer had worsened since the previous assessment. Pressure ulcers can happen when a resident sits or lies in the same position for a long period of time. Immobility may be due to many physical and psychological factors, neurological diseases like Alzheimer’s and improper nutrition or hydration. Careful monitoring is required to ensure good quality of care.
Percent of residents with four or more emergency room visits – the percent of residents who have four or more unscheduled emergency room visits in one year.