CMS 506v7 - Hospice Care Referral or Admission

XMLWordPrintable

    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Bethany A. Castagna
    • Cheshire Medical Center
    • Hide
      Thank you for your question regarding CMS506v7, Safe Use of Opioids – Concurrent Prescribing. Although skilled nursing facilities (SNFs) are not included in the measure’s denominator exclusions, patients with a discharge disposition of “Hospice Care Referral or Admission” are excluded from the denominator based on the measure logic (see below).

                or ( InpatientEncounter.dischargeDisposition in "Discharge To Acute Care Facility"

                or InpatientEncounter.dischargeDisposition in "Hospice Care Referral or Admission"

                or InpatientEncounter.dischargeDisposition in "Patient Expired"

                or InpatientEncounter.dischargeDisposition in "Left Against Medical Advice"
      Show
      Thank you for your question regarding CMS506v7, Safe Use of Opioids – Concurrent Prescribing. Although skilled nursing facilities (SNFs) are not included in the measure’s denominator exclusions, patients with a discharge disposition of “Hospice Care Referral or Admission” are excluded from the denominator based on the measure logic (see below).           or ( InpatientEncounter.dischargeDisposition in "Discharge To Acute Care Facility"           or InpatientEncounter.dischargeDisposition in "Hospice Care Referral or Admission"           or InpatientEncounter.dischargeDisposition in "Patient Expired"           or InpatientEncounter.dischargeDisposition in "Left Against Medical Advice"
    • CMS0506v7
    • Patents discharged to a SNF for Hospice or CMO Medicare funded care are not excluded from measure.

      We assign the discharge disposition code of 03: Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification for patients discharged to a SNF for Hospice or CMO Medicare funded care.  SNF's are not included in the denominator exclusion.  How do we address this, so they are properly removed from the denominator.   

        1. image-2025-11-13-11-11-35-493.png
          image-2025-11-13-11-11-35-493.png
          4 kB

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Bethany Castagna
            Votes:
            0 Vote for this issue
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: