Potentially Preventable Within Stay Readmission Measure for Inpatient Rehabilitation Facility Quality Reporting Program
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Risk-standardised rate of unplanned, potentially preventable readmissions for patients who receive services in inpatient rehabilitation facilities
Numerator
The risk-adjusted estimate of the number of potentially preventable readmissions that occurred during the IRF stay.
Denominator
The risk-adjusted expected number of potentially preventable readmissions.
Exclusions
- Patients less than 18 years old. 2. Patients who were not continuously enrolled in Part A fee-for-service Medicare for the 12 months prior to the IRF admission date and during the index IRF stay. 3. Patients who did not have a short-term acute-care stay within 1 day prior to an IRF admission date. 4. Patients discharged against medical advice (AMA). 5. Patients for whom the prior short-term acute-care stay was for nonsurgical treatment of cancer. 6. Patients who were transferred to a federal hospital from the PAC facility. 7. Patients who received care from a provider located outside of the United States, Puerto Rico, or a U.S. territory. 8. IRF stays with data that are problematic (e.g., anomalous records for hospital stays that overlap wholly or in part, or are otherwise erroneous or contradictory).
Use of Risk Adjustment
Risk Adjustments
Demographic and eligibility characteristics; principal diagnoses; types of surgery or procedure from the prior short-term stay; comorbidities; length of stay and ICU/CCU utilisation from the immediately prior short-term stay; and number of admissions in the year preceding the PAC admission.
Stratifications
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Medicare claims data submitted for Medicare Fee-For-Service (FFS) patients
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
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)
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Technical Specifications
cmit.cms.gov/cmit/#/MeasureView?variantId=2048§ionNumber=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