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  2. CQM-3674

Query regarding CMS130v8 Cumulative days

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
    • Icon: Major Major
    • Measure
    • Thank you for your question. In scenario #6, the null END Date should default to the end of the measurement period. However, in the example provided, scenario #6 overlaps with scenario #5. Therefore, total cumulative days equals 23.
    • EP
    • CMS130v8/NQF113

      Hi Team,

      We have query related to understanding the calculation of cumulative days for denominator exclusion condition:

      *Denominator Exclusions *

      Hospice."Has Hospice"
      or exists "Malignant Neoplasm"
      or exists "Total Colectomy Performed"
      or FrailtyLTI."Advanced Illness and Frailty Exclusion Including Under Age 80"
      or ( exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
      where ( Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 65 )
      and FrailtyLTI."Has Spent More Than 90 Days in Long Term Care"

      FrailtyLTI.Has Spent More Than 90 Days in Long Term Care

      "Days Spent in Long Term Care During Measurement Period" > 90

      FrailtyLTI.Days Spent in Long Term Care During Measurement Period

      "CumulativeDays"("Long Term Care Periods During Measurement Period")

      +FrailtyLTI.Long Term Care Periods During Measurement Period +
      ( ["Encounter, Performed": "Care Services in Long-Term Residential Facility"]
      union ["Encounter, Performed": "Nursing Facility Visit"] ) LongTermFacilityEncounter
      where LongTermFacilityEncounter.relevantPeriod overlaps "Measurement Period"
      return LongTermFacilityEncounter.relevantPeriod
      intersect "Measurement Period"

      For the above function please consider below cases for measurement period 01/01/2019 - 12/31/2019:

      1. LongTermFacilityEncounter = 12/28/2018 - 01/04/2019

      2. LongTermFacilityEncounter = 02/01/2019 - 02/06/2019

      3. LongTermFacilityEncounter = 05/01/2019 - 05/06/2019

      4. LongTermFacilityEncounter = 05/04/2019 - 05/07/2019

      5. LongTermFacilityEncounter = 12/26/2019 - 01/03/2020

      6. LongTermFacilityEncounter = 12/26/2019 - END DATE (NULL)

      So while calculating the cumulative days for above LongTermFacility encounters below days will be taken into consideration i.e.,
      1. 4 days (since 12/28/2018 - 12/31/2018 is before measurement period)
      2. 6 days
      3. 6 days
      4. 1 day (since 05/04/2019 - 05/06/2019 is overlapping with the 3rd LongTermFacility encounter)
      5. 6 days (since 01/01/2020 - 01/03/2020 is after measurement period)
      6. This visit will not be considered as END DATE is NULL and to calculate cumulative days we need LongtermFacility.relevant period i.e., start and end date both

      So the total cumulative days of LongtermFacility is 23 days

      Request you to please confirm if our understanding is correct or not

            edave Mathematica EC eCQM Team
            vinaykumarp Vinay (Inactive)
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