What does the CHESS scale measure in InterRAI LTCF?

• A. Sleep disturbances and circadian rhythm.
• B. Nutritional risk based on intake.
• C. Health instability and risk of health decline; higher scores indicate greater instability and risk of adverse outcomes.
• D. Social isolation.

Answer: (C)

The CHESS scale is about health instability and the risk of health decline. It combines information on changes in health, end-stage disease, and accompanying signs and symptoms to produce a single score. A higher CHESS score signals greater instability and a higher likelihood of adverse outcomes such as rapid decline, increased care needs, or death. It’s a measure used to flag residents who may need closer monitoring and more proactive care planning. This focus is different from sleep problems, nutritional risk, or social isolation, which are captured by other parts of the assessment.