Thank you for your question regarding CMS871v3, Hospital Harm – Severe Hyperglycemia. When evaluating for days with a hyperglycemic event, the first 24-hour period after admission to the hospital is not evaluated to account for potentially poor glucose control outside of the hospital setting or that preceded the start of hospital care. As the glucose result in the first scenario presented was found within the first 24 hours of the hospitalization, the measure calculation would not include this glucose result as a qualifying hyperglycemic event. For this measure, hospital days are not defined as midnight-to-midnight. Rather, they are defined as full 24-hour periods that start at the time of admission to the hospital (including emergency department and observation), excluding the last period before inpatient discharge from the hospital if that period is less than 24 hours. To illustrate how hospital days are defined, the second scenario is outlined in the attached table by eligible hospital days. The glucose result described in the second scenario was found during the last period before discharge. As noted in the attached table, because this last period before discharge was less than a 24-hour period, it would not be considered an eligible hospital day, and therefore the measure calculation would not include the glucose result from this period as a qualifying hyperglycemic event.