Potentially Preventable Within Stay Readmission Measure

Identifying Attributes

Care Settings
Rehabilitation Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP)
Type of Quality Indicator
Outcome
IOM Quality Dimension
Efficiency
Domain
Adverse Events

Defining Attributes

Definition

Potentially Preventable Within Stay Readmission Measure.

Numerator

The potentially preventable readmission (PPR) definition for the inpatient rehabilitation facility (IRF) within-stay measure was developed concurrently with the definition used in the post-discharge measures.

Denominator

The IRF within-stay measure includes all IRF discharges after the appropriate exclusions have been applied.

Exclusions

Denominator Exclusions: IRF Within Stay Measure Several of the exclusions listed for the IRF post-discharge measure apply to the IRF within-stay measure except for the following: Exclusion related to: patients/residents who died during the post-acute care (PAC) stay Exclusion related to patients/residents who were transferred at the end of a stay to another skilled nursing facility (SNF)/IRF/long-term care hospital (LTCH) or short-term acute care hospital Exclusion related to patients/residents who were not continuously enrolled in Part A FFS Medicare for the 12 months prior to the SNF/IRF/LTCH admission date, and at least 30 days after SNF/IRF/LTCH discharge date Exclusion related to patients/residents who did not have a short-term acute-care stay within 30 days prior to a SNF/IRF/LTCH admission date.

Use of Risk Adjustment
No
Risk Adjustments
Stratifications

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

All measures are based on administrative claims data.

Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods

Medicare Program Reporting.

Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source

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.

Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services (CMS), United States. Measure Specifications: Medicare Spending Per Beneficiary – Post-Acute Care Skilled Nursing Facility, Inpatient Rehabilitation Facility, and Long-Term Care Hospital Resource Use Measures. Accessed August 3, 2023. Available from: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/LTCH-Quality-Reporting/Downloads/20160720mspbpacltchirfsnfmeasure_specs.pdf.

Link to Measurement Tools
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