Thank you for your inquiry regarding the CMS986, Global Malnutrition Composite Score. The function "Measure Observation 1" does constrain the Malnutrition Screen results within the encounter as displayed here with the ‘contains Encounter’ constraint. define function "Measure Observation 1"(Encounter "Encounter, Performed"): if ( "Encounter with Malnutrition Risk Screening and Identified Result or with Hospital Dietitian Referral" contains Encounter and ( "Encounter with Malnutrition Screening Not At Risk Result" contains Encounter or ( "Encounter with Malnutrition Screening At Risk Result" contains Encounter ) ) or exists ( "Encounter with Hospital Dietitian Referral" ) ) then 1 else 0 This was verified during testing with malnutrition screenings occurring outside of the inpatient encounter without an observation and ED visit. The measure developer team appreciates your review and feedback.

Expression "Encounter with Malnutrition Screening Not At Risk Result" does not include a function to constrain data considered to the current encounter. As the algorithm is currently defined Malnutrition Screening from another episode of care can be evaluated. Please consider adding a function to this expression.