Estimates days spent in acute care within 30 days of discharge from an inpatient hospitalisation for heart failure (i.e. emergency department visits, observation stays, and unplanned readmissions).

A count of the number of days the patient spends in acute care within 30 days of discharge from an eligible index heart failure hospitalisation (i.e. days spent in an emergency department, admitted to an observation unit, or admitted as an unplanned readmission for any cause to a short-term acute care hospital). Each Emergency Department treat-and-release visit = 0.5 days. Observation stays are rounded up to the nearest half-day. Each readmission day is counted as one full day (1 day). Counts all eligible outcomes occurring in the 30-day period, even if they are repeat occurrences.

Admissions for patients that meet all of the following inclusion criteria: 1. Discharged from the hospital with a principal discharge diagnosis of HF 2. Aged 65 or over 3. Discharged alive 4. Not transferred to another acute care facility.

Index admissions for patients: With a procedure code for left ventricular assist device implantation or heart transplantation either during the index admission or in the 12 months prior to the index admission; HF admissions within 30 days of discharge from a prior HF index admission; or Discharged against medical advice. With a principal diagnosis code of COVID-19 or with a secondary diagnosis code of COVID-19 coded as present on admission on the index admission claim.

Age (years above 65); Male; history of coronary artery bypass graft (CABG) surgery; comorbidities (Condition Categories) to adjust for case-mix differences among hospitals based on the clinical status of the patient at the time of the index admission.

Medicare administrative claims and enrolment information.

The Centers for Medicare & Medicaid Services annually reports this measure for patients who are 65 years or older and are either Medicare fee-for-service beneficiaries hospitalised in non-federal short-term acute care hospitals and critical access hospitals or VA beneficiaries hospitalised in VA facilities. Hospital Inpatient Quality Reporting Program (CMS and Providers) CMS Provider Compare and CMS Care Compare - Hospitals (Publicly reported) Contributes to Overall Hospital Star Quality Rating.

Wadhera RK, Joynt Maddox KE, Desai NR, Landon BE, Md MV, Gilstrap LG, Shen C, Yeh RW. Evaluation of Hospital Performance Using the Excess Days in Acute Care Measure in the Hospital Readmissions Reduction Program. Ann Intern Med. 2021 Jan;174(1):86-92. doi: 10.7326/M20-3486. Epub 2020 Oct 13. PMID: 33045180; PMCID: PMC8165741. cmit.cms.gov/cmit/#/MeasureView/?variantId=1873&sectionNumber=1 data.cms.gov/provider-data/topics/hospitals/measures-and-current-data-collection-periods data.cms.gov/provider-data/topics/hospitals/overall-hospital-quality-star-rating

www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/measure-methodology