Thank you for your inquiry regarding CMS871v3 and CMS871v4, Hospital Harm - Severe Hyperglycemia. In this measure, inpatient hospitalizations include time in the emergency department and observation when the transition between these encounters (if they exist) and the inpatient encounter are within an hour or less of each other. In the example provided, the start time of the emergency department encounter is 18:37 on September 28, 2024. The start time of the inpatient encounter is at 20:18 on September 28, 2024. Because there is no discrete end time specified for the emergency department encounter in the example provided, it appears that the emergency department encounter ended at 20:17 on September 28, 2024 – immediately prior to the start of the inpatient encounter. Therefore, because the transition time between the end of the emergency department encounter and the start time of the inpatient encounter is less than one hour, time in the emergency department is included in the inpatient hospitalization period. The inpatient hospitalization period therefore begins at the start time of the emergency department encounter (at 18:37 on September 28, 2024).

I would like clarification on the exact start date/time of the encounter for HH severe hyperglycemia. Is it the inpatient admit order date/time or the time the patient was actually roomed in the ED? I have added an attachment of an ADT event. In the attached example, is the start date/time of the encounter the admission at 9/28/1837 in ED or the 9/28/ 2018 to inpatient? Thank you