Percentage of patients who are at or above an expected ability to move around at discharge

The numerator is the number of patients in an IRF with a discharge mobility score that is equal to or higher than the calculated expected discharge mobility score.* *Functional assessment items included in this measure on the assessment are GG0170A3, GG0170B3, GG0170C3, GG0170D3, GG0170E3, GG0170F3, GG0170G3, GG0170I3, GG0170J3, GG0170K3, GG0170L3, GG0170M3, GG0170N3, GG0170O3, GG0170P3, GG0170R3, and GG0170S3.

The total number of IRF stays with a discharge date in the measure target period, which do not meet the exclusion criteria

An IRF stay is excluded if: Patient had an incomplete stay: • Discharge destination (Item 44D = [02, 63, 65, 66]): Discharge to acute care that results in the patient's absence from the IRF for longer than 3 calendar days; or • Died while in IRF (Item 44C = [0]); or • Discharged against medical advice (Item 41 = [1]); or • Length of stay is less than 3 days; i.e., Item 40 (Discharge Date) – Item 12 (Admission Date) is less than 3 days. Patient has any of the following medical conditions:* • Coma, persistent vegetative state, complete tetraplegia, locked-in syndrome, severe anoxic brain damage, cerebral oedema, or compression of brain. Patient is younger than age 18: • Truncate (Item 12 (Admission Date) – Item 6 (BirthDate)). Patient is discharged to hospice: • Item 44D (Discharge destination/Living setting) = [50,51]. *The medical conditions are identified by: Impairment Group 0004.1221 or 0004.1222 or 0004.2221 or 0004.2222 on Item 21A; or specific ICD-10-CM codes on Item 22 or Item 24 (see Appendix A, Table A-3).

Data for each covariate are derived from the admission data included in the target IRF stays. 1. Age group 2. Admission mobility score – continuous 3. Admission mobility score – squared 4. Primary diagnosis group 5. Interaction between admission mobility and primary diagnosis group 6. Prior acute or IRF primary diagnosis – surgical 7. Prior functioning: indoor ambulation 8. Prior functioning: stair negotiation 9. Prior functioning: cognition 10. Prior mobility device/ aids 11. Stage 2 pressure ulcer 12. Stage 3, 4, or unstageable pressure ulcer/injury 13. Cognitive function 14. Communication impairment 15. Bladder incontinence 16. Bowel incontinence 17. Nutritional approaches 18. History of falls 19. Low BMI 20. Comorbidities See covariate details in Appendix A, Table A-4 and Table A-5 and the associated Risk Adjustment Appendix File

Effective on October 1, 2022, the IRF-PAI Version 4.0 is used to collect and submit assessment data for the IRF QRP

Internet Quality Improvement and Evaluation System (iQIES)

Centers for Medicare & Medicaid Services (CMS), United States. Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP) Measures Information. Accessed August 3, 2023. Available from: www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/irf-quality-reporting/irf-quality-reporting-program-measures-information-.

Centers for Medicare & Medicaid Services (CMS), United States. Inpatient Rehabilitation Facility Quality Reporting Program Measure Calculations and Reporting User’s Manual. Accessed August 3, 2023. Available from: www.cms.gov/files/document/irf-quality-measure-calculations-and-reporting-users-manual-v40.pdf.

Centers for Medicare & Medicaid Services (CMS), United States. Inpatient rehabilitation facilities - The Measures. Accessed August 3, 2023. Available from: data.cms.gov/provider-data/topics/inpatient-rehabilitation-facilities/measures.

Inpatient Rehabilitation Facility - Quality Reporting Program: www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/irf-quality-reporting/irf-quality-reporting-program-measures-information-

Technical specifications: www.cms.gov/files/document/irf-quality-measure-calculations-and-reporting-users-manual-v40.pdf

Measures: data.cms.gov/provider-data/topics/inpatient-rehabilitation-facilities/measures

Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) (Admission and Discharge, Section GG: functional Abilities and Goals (see numerator for codes))