Risk-standardised rate of patients who are discharged to the community following an Inpatient Rehabilitation Facility stay, and do not have an unplanned readmission to an acute care hospital or long-term care hospital 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 or self-care, 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 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. Patients/residents who received care from a facility located outside of the United States, Puerto Rico or a U.S. territory 15. Exclude baseline nursing facility residents.

Demographic and eligibility characteristics; principal diagnoses; types of surgery or procedures from the prior short-term acute care stay; comorbidities; length of stay and intensive care utilisation from the prior short-term acute care stay; dialysis in the prior acute stay; and number of prior hospitalisations in the year preceding the post-acute care admission.

Medicare claims data submitted for Medicare Fee-For-Service (FFS) patients.

Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (CMS, and providers) CMS Care Compare - Inpatient rehabilitation facilities and Provider Data Catalogue (CMS, providers and publicly reported).

Cary MP Jr, Prvu Bettger J, Jarvis JM, Ottenbacher KJ, Graham JE. Successful Community Discharge Following Postacute Rehabilitation for Medicare Beneficiaries: Analysis of a Patient-Centered Quality Measure. Health Serv Res. 2018 Aug;53(4):2470-2482. doi: 10.1111/1475-6773.12796. Epub 2017 Nov 13. PMID: 29134630; PMCID: PMC6052014. Middleton A, Graham JE, Prvu Bettger J, Haas A, Ottenbacher KJ. Facility and Geographic Variation in Rates of Successful Community Discharge After Inpatient Rehabilitation Among Medicare Fee-for-Service Beneficiaries. JAMA Netw Open. 2018 Nov 2;1(7):e184332. doi: 10.1001/jamanetworkopen.2018.4332. PMID: 30646352; PMCID: PMC6324386. www.cms.gov/medicare/quality/inpatient-rehabilitation-facility/irf-quality-reporting-measures-information

cmit.cms.gov/cmit/#/MeasureView/?variantId=1988&sectionNumber=1 www.cms.gov/files/document/irf-qm-calculations-and-reporting-users-manual-v50.pdf www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/IRF-Quality-Reporting/Downloads/Measure-Specifications-for-FY17-IRF-QRP-Final-Rule.pdf