Thank you for your question regarding CMS826, Hospital Harm - Pressure Injury. We appreciate you raising concerns about the currentness and alignment of the clinical guidelines cited in this measure. Performance measures are not intended to be used as clinical guidelines or establish a standard of medical care. Measures may cite publicly published clinical guidelines, like the American College of Physicians (ACP) guideline, to reference evidence related to the outcomes or care evaluated by the measures. We acknowledge your concern that the ACP guideline referenced in the measure documentation may not reflect the most current evidence and may differ from the National Pressure Injury Advisory Panel (NPIAP) clinical practice guidelines also cited in the measure. CMS does not have the authority to revise the content of externally published clinical guidelines, and we do not have an active point of contact at ACP associated with the original guideline citation. We will consider updates to the clinical guidelines cited in this measure in future updates to the measure.

The ACP guideline recommendations for pressure injury prevention are outdated and conflict with the NPIAP Clinical Practice Guidelines listed below. This information could cause facilities to rent other specialty beds unnecessarily, or in a legal case, the use of an alternating pressure surface could reflect against a facility