Thank you for your question regarding CMS871v3, Hospital Harm – Severe Hyperglycemia. 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 when the transition between these encounters and the inpatient encounter are within an hour or less of each other), excluding the last period before inpatient discharge from the hospital if that period is less than 24 hours. To illustrate this concept, we have provided an example patient scenario, using encounter start and end dates and times to show how the measure determines eligible hospital days. Because the last period before hospital discharge is 23 hours and 59 minutes (less than 24 hours), day index 7 would not be counted as an eligible hospital day. Therefore, there are 5 eligible hospital days in the scenario provided.