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  2. CQM-6057

CMS122 Diabetes A1C Poor Control Lives in Nursing Home finding

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      Thank you for your inquiry about the advanced illness and frailty exclusion in CMS122v11. A swing bed does not meet the intent of this exclusion. While we understand the importance of swing beds for care, especially in rural areas, the intent of this exclusion is to identify individuals who are likely to be living in a nursing home any time on or before the end of the measurement period. and receiving institutionalized long-term care services.
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      Thank you for your inquiry about the advanced illness and frailty exclusion in CMS122v11. A swing bed does not meet the intent of this exclusion. While we understand the importance of swing beds for care, especially in rural areas, the intent of this exclusion is to identify individuals who are likely to be living in a nursing home any time on or before the end of the measurement period. and receiving institutionalized long-term care services.
    • CMS0122v11
    • Guidance needed

      CMS 122 Diabetes A1C Poor Control has an exclusion for a "Lives in a nursing home (finding). If these are identified using CPT codes, we find that sometimes swing bed encounters would be included in our measures. Does the measure intend to exclude patients staying in a swing bed as part of the exclusion for the Lives in a nursing home (finding) exclusions?

            edave Mathematica EC eCQM Team
            jklesmith Jill
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