The Joint Commission
Section 2: Aggregate Data Dictionary (ALC)
Joint Commission Guide for Data Entry of ChartAbstracted Measures for Assisted Living Community (ALC)
Applicable calendar years:
 010123 (1Q2023) through 123123 (4Q2023)
 010124 (1Q2024) through 123123 (4Q2024); as of March 2024
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Introduction
This section of the manual describes the aggregate data elements assisted living organizations must calculate prior to entering their chartabstracted measure data into the Direct Data Submission Platform (DDSP). It includes the definition and allowable values for each aggregate data element. In addition, data edits and statistical equations are provided as appropriate.
Data Edits and Statistical Equations
For each aggregate data element, data edits and statistical equations are provided below as appropriate. The statistical equations have been provided to assist in your proper calculation of these data element. The edits will be executed on the DDSP and will result in an error message. In addition, the DDSP will ensure data is entered correctly from the perspective of allowable values and whole numbers.
Stratified Measures
Stratified measures are classified into several groups (strata) to assist in the analysis and interpretation of the measure. The overall or unstratified measure evaluates all the strata together. The stratified measure or each stratum consists of a subset of the overall measure.
Measures which are stratified require the appropriate aggregate data to be entered for each stratum associated to the measure. Currently, only ALC05 is stratified.
Attestation Of Zero Cases
Assisted living organizations will be capable of attesting to having zero denominator cases.
Denominator: If a zero is entered into the Denominator field for a month, the user will be promoted to check the Zero Denominator Attestation box to attest that the zero Denominator count is valid.
Aggregate Data Elements Overview
Currently, all the ALC measures are proportion measures. The aggregate data elements in this Guide define what is to be inputted into each field.
The DDSP calculates the following data elements based upon the aggregate data entered for each measure, or strata and reporting time period.
Numerator (ALC05):
Refer to the data element Numerator below for how this data element is being calculated for ALC05.
Observed Rate (all measures):
Observed rates are used to measure assisted living organization performance. It is based on the aggregated data entered by the ALC organization.
The Observed Rate is calculated as the number of Numerator cases divided by the number of Denominator cases (Numerator / Denominator). The Observed Rate is calculated to 4 decimals and rounded to 3 decimals where 5 rounds up.
For ALC05, an Observed Rate is multiplied by 100 (Numerator / Denominator) *100 and a separate Rate is calculated for both stratum (ALC05a and ALC05b).
Data Element Dictionary Terms
Name:  A short phrase identifying the aggregate data element. 
Aggregated For:  Identifies the type of measure this data element is aggregated for. 
Definition:  A detailed explanation of the data element, including statistical equations when appropriate. 
Allowable Values:  A list of acceptable responses for this data element. 
Edits:  Data integrity edits and other actions that the DDSP will apply to the aggregate data. 
Alphabetical List of All Data Elements
Data Element Name  Aggregated For 
Denominator  Proportion measures 
Number of Direct Care Staff Employed  Proportion measures â€“ ALC05b 
Number of Staff Employed  Proportion measures â€“ ALC05a 
Numerator  Proportion measures 
Proportion Measures
Proportion measures are measures in which the value of each measurement is expressed as a proportion where the numerator is expressed as a subset of the denominator.
The following aggregate data elements are required to be entered for proportion measures:
Denominator
Number of Direct Care Staff Employed
Number of Staff Employed
Numerator
Name:  Denominator 
Aggregated For:  Proportion measures 
Definition:  Summation of denominator cases (proportion) for the measure's population during the month. Do not eliminate or suppress outliers. ALC01, 02, 03, 04, 05a, and 05b: The Denominator must be entered for the month. The values of the following measure data elements are entered into the Denominator field within the DDSP for the associated measure. ALC01: Assisted Living Community Resident ALC02: Assisted Living Community Resident ALC03: New Resident ALC04: New Resident ALC05a: Number of Positions ALC05b: Number of Direct Care Staff Positions Note: The definitions of the above measure data elements is provided within the Specification Manual for Joint Commission Assisted Living Community Quality Measures. 
Allowable Values:  0 through 199 (whole numbers only) Note: Assisted living organizations entering a zero for this data element will be required to attest that they have no cases in the denominator (i.e., â€˜zero denominatorâ€™) for the measure for the month. Organizations with denominator cases are expected to enter the appropriate value for each measure or strata. 
Edits:  ALC05a:
ALC05b:

Name:  Number of Direct Care Staff Employed 
Aggregated For:  Proportion measures â€“ ALC05b 
Definition:  The definition of Number of Direct Care Staff Employed is provided within the Specification Manual for Joint Commission Assisted Living Community Quality Measures. Do not eliminate or suppress outliers. Note: This measure data element is used to calculate the ALC05b Numerator. See Numerator below for more information. 
Allowable Values:  0 through 199 (whole numbers only) 
Edits: 

Name:  Number of Staff Employed 
Aggregated For:  Proportion measures â€“ ALC05a 
Definition:  The definition of Number of Staff Employed is provided within the Specification Manual for Joint Commission Assisted Living Community Quality Measures. Do not eliminate or suppress outliers. Note: This measure data element is used to calculate the ALC05a Numerator. See Numerator below for more information. 
Allowable Values:  0 through 199 (whole numbers only) 
Edits:  None 
Name:  Numerator 
Aggregated For:  Proportion measures 
Definition:  Summation of numerator cases in a measure's population during the month. Do not eliminate or suppress outliers. ALC01, 02, 03, and 04: The Numerator must be entered for the month. The values of the following measure data elements are entered into the Numerator field within the DDSP for the associated measure. ALC01: OffLabel Antipsychotic Drug Prescribed ALC02: Fall with Transfer to Hospital ALC03: Resident Preferences and Goals of Care ALC04: Advanced Care Plan / Surrogate Decision Maker ALC05: The Numerator is calculated by the DDSP as follows: ALC05a calculation: (Number of Staff Employed â€“ Denominator) ALC05b calculation: (Number of Direct Care Staff Employed â€“ Denominator) Note:

Allowable Values:  0 through 199 (whole numbers only) 
Edits:  ALC01, 02, 03, and 04:
ALC05a:
ALC05b:

Continue to the next section: Section 3: Measure Exclusions
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