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Centers for Medicare & Medicaid Services

Non-Emergent Coronary Artery Bypass Graft (CABG) Measure

  • The Non-Emergent CABG episode-based cost measure evaluates a clinician’s risk-adjusted cost to Medicare for patients who undergo a CABG procedure during the performance period. The measure score is the clinician’s risk-adjusted cost for the episode group averaged across all episodes attributed to the clinician. This procedural measure includes costs of services that are clinically related to the attributed clinician’s role in managing care during each episode from 30 days prior to the clinical event that opens, or “triggers,” the episode through 90 days after the trigger.

    CBE ID
    3625

Nurse staffing hours - 4 parts

  • Percentage of daily work in hours by the entire group of nurses or nursing assistants spent tending to residents

    CBE ID
    0190

PACE Participant Fall Rate

  • The quarterly incidence rate of falls amongst PACE participants per 1,000 participant days.

    CBE ID
    3001

PACE-Acquired Pressure Ulcer/Injury Prevalence Rate

  • Prevalence of PACE-acquired pressure ulcers/injuries (Stages 3, 4, unstageable, and deep tissue injury) among PACE participants in a quarter, expressed as persons with 1 or more pressure ulcers/injuries divided by the number of participants on the PACE organization’s census who resided in a home setting (home or assisted living facility)for at least one day during the quarter.

    CBE ID
    3000

Pain Assessment and Follow-Up

  • Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present

    CBE ID
    0420

Pain Assessment Conducted

  • Percentage of home health episodes of care in which the patient was assessed for pain, using a standardized pain assessment tool, at start/resumption of care.

    CBE ID
    0523

Participation by a physician or other clinician in systematic clinical database registry that includes consensus endorsed quality measures

  • Participation in a systematic qualified clinical database registry involves:
    a. Physician or other clinician submits standardized data elements to registry
    b. Data elements are applicable to consensus endorsed quality measures
    c. Registry measures shall include at least two (2) representative NQF consensus endorsed measures for registry's clinical topic(s) and report on all patients eligible for the selected measures.
    d. Registry provides calculated measures results, benchmarking, and quality improvement information to individual physicians and clinicians.

    CBE ID
    0493