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Thirty-day all-cause unplanned readmission following psychiatric hospitalization in an inpatient psychiatric facility (IPF)

CBE ID
2860
1.4 Project
All-Cause Admissions and Readmissions
Endorsement Status
Endorsed
1.1 New or Maintenance
Maintenance
Previous Endorsement Cycle
Spring 2021
Is Under Review
No
Next Maintenance Cycle
Spring 2025
1.3 Measure Description

This facility-level measure estimates an all-cause, unplanned, 30-day, risk-standardized readmission rate for adult Medicare fee-for-service (FFS) patients with a principal discharge diagnosis of a psychiatric disorder or dementia/Alzheimer’s disease.

The performance period for the measure is 24 months.

    • 1.14 Numerator

      The measure estimates the incidence of unplanned, all-cause readmissions to IPFs or short-stay acute care hospitals following discharge from an eligible IPF index admission. A readmission is defined as any admission that occurs within 3-30 days after the discharge date from an eligible index admission to an IPF, except those considered planned.

    • 1.15 Denominator

      The target population for this measure is Medicare FFS beneficiaries discharged from an IPF with a principal diagnosis of a psychiatric disorder. A readmission within 30 days is eligible as an index admission, if it meets all other eligibility criteria.

    • Exclusions

      The measure excludes admissions for patients:
      - Discharged against medical advice (AMA)
      - With unreliable demographic and vital status data defined as the following:
      o Age greater than 115 years
      o Missing gender
      o Discharge status of “dead” but with subsequent admissions
      o Death date prior to admission date
      o Death date within the admission and discharge dates but the discharge status was not “dead”
      - With readmissions on the day of discharge or day following discharge because those readmissions are likely transfers to another inpatient facility. The hospital that discharges the patient to home or a non-acute care setting is accountable for subsequent readmissions.
      - With readmissions two days following discharge because readmissions to the same IPF within two days of discharge are combined into the same claim as the index admission and do not appear as readmissions due to the interrupted stay billing policy. Therefore, complete data on readmissions within two days of discharge are not available.

    • Most Recent Endorsement Activity
      Endorsed All-Cause Admissions and Readmissions Spring 2021
      Initial Endorsement
      Last Updated
    • Steward
      Centers for Medicare & Medicaid Services
      Steward Organization POC Email
      [email protected]
      Steward Organization Copyright

      Not applicable