Transfer of Health Information to the Patient Post-Acute Care

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Inpatient Rehabilitation Facility Quality Reporting Program
Type of Quality Indicator
Process
IOM Quality Dimension
Timeliness
Domain
Communication

Defining Attributes

Definition

The percentage of inpatient rehabilitation facility (IRF) patient stays with an IRF-PAI discharge assessment indicating that a current reconciled medication list was provided to the patient, family and/or caregiver at the time of discharge/transfer. Process-based measure that assesses whether or not a current reconciled medication list was provided to the patient, family, or caregiver when the patient was discharged from a Post-acute Care setting to a home setting.

Numerator

The number of IRF patient stays with an IRF-PAI discharge assessment indicating that a current reconciled medication list was provided to the patient, family and/or caregiver at the time of discharge/transfer.

Denominator

The total number of IRF Medicare Part A and Medicare Advantage (Part C) patient stays ending in discharge to the following settings only: private home/apartment, board and care home, assisted living, group home, or transitional living.

Exclusions

Patients who died and patients discharged home under the care of an organised home health service or hospice are not included in this measure.

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

None

Data Attributes

Type of Data Collection
Standardised clinical data
Data Collection Methods

Data collected using Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) and submitted to the Centers for Medicare & Medicaid Services (CMS) via the Internet Quality Improvement and Evaluation System (iQIES).

Frequency of Data Collection
IRP-PAI is completed for each Medicare Part A fee-for-service and Medicare Part C patient discharged from an IRF
Frequency of Data Collection in Days
365
Reporting Methods

Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (CMS, and providers) Will be reported on CMS Care Compare - Inpatient rehabilitation facilities.

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025