Risk-standardised rate of patients who are discharged to the community following an long-term care hospital (LTCH) stay, and do not have an unplanned readmission to an acute care hospital or LTCH in the 31 days following discharge to community, and who remain alive during the 31 days following discharge to community. Community is defined as home/selfcare, with or without home health services.

The risk-adjusted estimate of the number of patients/residents who are discharged to the community, do not have an unplanned readmission to an acute care hospital or long-term care hospital in the 31-day post-discharge observation window, and who remain alive during the post-discharge observation window. This estimate starts with the observed discharges to community, and is risk adjusted for patient/resident characteristics and a statistical estimate of the facility effect beyond case mix.

The risk-adjusted expected number of discharges to community. This estimate includes risk adjustment for patient/resident characteristics with the facility effect removed.

1. Age under 18 years 2. No short-term acute care stay within the 30 days preceding an IRF, SNF, or LTCH admission 3. Discharges to psychiatric hospital 4. Discharges against medical advice 5. Discharges to disaster alternative care sites or federal hospitals 6. Discharges to court/law enforcement 7. Patients/residents discharged to hospice, and those with a post-discharge hospice benefit 8. Patients/residents not continuously enrolled in Part A fee-for-service Medicare for the 12 months prior to the post-acute admission date, and at least 31 days after post-acute discharge date 9. Patients/residents whose prior short-term acute care stay was for non-surgical treatment of cancer 10. Post-acute stays that end in transfer to the same level of care 11. Post-acute stays with Claims that are problematic (e.g., anomalous records for stays that overlap wholly or in part, or are otherwise erroneous or contradictory) 12. Planned discharges to an acute or LTCH setting 13. Medicare Part A benefits exhausted 14. Swing Bed Stays in Critical Access Hospitals (SNF setting only) 15. Baseline NF residents.

Age and Sex groups, end stage renal disease; principal diagnosis (Clinical Classifications Software Groups); Surgical procedure categories; Dialysis in prior acute stay; Length of prior acute hospital stay in days for patients whose prior acute stay was in a nonpsychiatric hospital; Number of intensive/cardiac care days during the prior acute stay; Ventilator use during the LTCH stay; Comorbidities based on prior acute stay in the past 30 days or based on a one-year look-back, depending on the specific comorbidity. Comorbidities are clustered using the Hierarchical Condition Categories groups used by CMS; Number of prior acute hospital discharges in the past year, not including the hospitalisation in the 30 days before the LTCH stay.

Medicare claims data submitted for Medicare Fee-For-Service patients.

Long-Term Care Hospital Quality Reporting Program (CMS and Providers) CMS Care Compare - Long-term care hospitals and Provider Data Catalogue (Publicly reported) www.cms.gov/medicare/quality/long-term-care-hospital/ltch-quality-public-reporting.

www.cms.gov/medicare/quality/long-term-care-hospital/ltch-quality-reporting-measures-information

cmit.cms.gov/cmit/#/MeasureView?variantId=1986&sectionNumber=1 Technical specifications: www.cms.gov/files/document/ltch-qm-calculations-and-reporting-users-manual-v50.pdf www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/LTCH-Quality-Reporting/Downloads/Final-Specifications-for-LTCH-QRP-Quality-Measures-and-SPADEs.pdf