Thank you for your inquiry regarding CMS986v5, the Malnutrition Care Score. The measure development team evaluated the exclusion criteria for hospice status and, as defined the National Cancer Institute (NCI) Dictionary of Cancer Terms, “Comfort care may include palliative care, supportive care, and hospice care.” Palliative care, as defined by CMS refers to care that “eases symptoms of serious illnesses and may accompany treatments to cure the illness” ( https://www.cms.gov/training-education/partner-outreach-resources/american-indian-alaska-native/ltss-ta-center/focus-areas/hospice-palliative-care ). Palliative care has not been included within the measure because its objectives may include curing and improving symptoms, all which can be negatively affected by the presence of malnutrition, especially when malnutrition is not identified, diagnosed, and treated. Therefore, comfort care will not be pursued as an exclusion population for the Malnutrition Care Score quality measure at this time.