Thank you for your question. The measure is checking if Comfort Measures start after the start of the ED encounter. As further explanation, in the measure, the timing in the logic states the intervention starts after the start of the ED encounter. If it were to end before or concurrent with the discharge date of the ED, DURING would have been used as the timing operator in place of the "STARTS AFTER START", and if it were to end with the discharge date of the Inpatient Encounter, the two phrases (the ED and the Inpatient Encounter) would have to have used logic similar to this: AND: "Occurrence A of Intervention, Performed: Comfort Measures" starts after start of "Occurrence A of Encounter, Performed: Emergency Department Visit" AND NOT: "Occurrence A of Intervention, Performed: Comfort Measures" ends before end of "Encounter, Performed: Encounter Inpatient"