What You Need to Know About the Discharge Function Score
As of January 2025, the Discharge Function Score will officially factor into the Five-Star Quality Rating System for skilled nursing facilities (SNFs). While it has already played a role in the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) program, this new development significantly raises the stakes for providers.
This measure assesses how well a resident regains—or maintains—functional independence during their SNF stay. A strong performance can boost your facility’s star rating, while a weak one could reduce reimbursement and harm your reputation.
With reimbursement and quality ratings increasingly tied to functional outcomes, Health Advisory Partners by Aegis Therapies® will explain how to ensure that your team understands this score—and how to influence it.
What Is the Discharge Function Score?
The Discharge Function Score measures whether a resident met or exceeded their expected level of functional ability by the time they were discharged. It is based on Section GG of the Minimum Data Set (MDS), which captures a resident’s ability to perform everyday activities.
What’s Measured?
The score includes 10 functional items, grouped into two key categories:
1. Transfers & Mobility (GG0170)
These items assess the resident’s ability to move safely and independently:
Roll left and right
Lying to sitting on side of bed
Sit to stand
Bed/chair transfer
Toilet transfer
Walk 10 feet
Walk 50 feet with 2 turns
Wheel 50 feet with 2 turns (used if resident is unable to walk)
2. Daily Activities (GG0130)
These items focus on basic daily self-care:
Eating
Oral hygiene
Toileting hygiene
Each of these items is scored on a scale from 01 to 06, based on how much help the resident needs to complete the activity. These raw scores are translated into a composite score ranging from 10 to 60.
Not every item applies to every resident. For instance, if a resident is unable to walk, walking-related items are replaced with comparable wheelchair-based assessments. The goal is to measure improvement based on what’s realistic for each individual.
Why This Measure Matters
The addition of the Discharge Function Score to the Five-Star Quality Rating System reflects a broader shift in how long-term care quality is defined. It's no longer just about avoiding rehospitalizations or medication errors—functional improvement is now a direct indicator of quality care.
Failing to properly document functional performance can lead to:
Lower Five-Star ratings
Missed financial incentives through VBP
Reduced marketability to referral partners
Potential audit risks
In contrast, high performance on this measure showcases your facility as a leader in rehabilitation, patient-centered care, and outcomes-based performance.
How Facilities Can Improve Their Score
Improving your Discharge Function Score requires a proactive, interdisciplinary approach. Here’s how to get started:
1. Train Your Team on Section GG Scoring
Ensure staff understand how to accurately score each item and avoid overuse of dashes or non-applicable codes.
Clarify the distinctions between scoring levels—what qualifies as “supervision” vs. “partial/moderate assistance,” for example.
Consistency is key. A small error can make a big difference in the calculated score.
2. Observe and Document Correctly
Use the full 3-day assessment window to gather accurate observations.
Interview CNAs, therapists, and nursing staff if direct observation isn’t possible.
Cross-reference care plans and therapy notes to ensure documentation reflects true performance.
3. Master the Risk Adjustments
Your expected score depends on how well you document the resident’s baseline condition.
Ensure all comorbidities, functional limitations, and device use are captured during admission.
Incomplete or vague documentation lowers your expected score—and sets an unfair benchmark for your facility.
Beyond the Numbers: Why It Really Matters
At its core, the Discharge Function Score is more than just a metric—it’s a reflection of resident outcomes and quality of life. Higher scores are linked to:
Greater resident independence at discharge
Reduced hospital readmissions
Better long-term functional health
Higher satisfaction among residents and families
Facilities that prioritize this measure are not just improving ratings—they’re improving lives.
Support for a Smooth Transition
The shift to including the Discharge Function Score in your Five-Star Rating represents both a challenge and an opportunity.
Health Advisory Partners by Aegis Therapies is here to help you prepare. From staff training and MDS coaching to operational best practices, our team can help you get ahead of the change and turn this measure into a competitive advantage.
Ready to learn more? Contact Health Advisory Partners today to schedule a training or consultation.
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