Hello JIRA,

Hospice / Palliative Care.

Patients Who are admitted to hospice in our acute care hospital usually do not get Labs / Vital Signs. This places them in the denominator.

Most of these patients have two separate encounters – one for the initial encounter, and one for the hospice encounter.  In the instances impacted – these patients do not get transferred to another floor or bed. Only their billing is changed.

The Specs do not address this. This is being counted as a readmission.

If the patient expires in the hospital - it is captured in the mortality.

The specs:

Inpatient Encounters

from

  ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter,

 ["Patient Characteristic Payer": "Medicare payer"] Payer,

  ["Patient Characteristic Birthdate": "Birth date"] BirthDate

  where Global."HospitalizationWithObservationLengthofStay" ( InpatientEncounter ) < 365

   and InpatientEncounter.relevantPeriod ends during day of "Measurement Period"

   and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of InpatientEncounter.relevantPeriod ) >= 65

 return InpatientEncounter

There are no exclusion or exceptions in the specs.

Example patient: (readmission and Mortality)

(For the second encounter)

Final Principle Dx is “Encounter for Palliative care”.

With their Primary insurance as:

• • • • • • • • HOSPICE OF NORTHEAST FLORIDA/ *********** HOSPICE OF NORTHEAST FLORIDA

And a secondary insurance of Medicare.

This impacts a number of patients.

Will this be considered in future updates?

Thanks,

Kim