CMS ID

The unique facility identifier assigned by CMS

Organization NPI

The 10-digit National Provider Identifier (NPI) assigned to an organization for billing and administrative transactions.

Time Period

The span of YRMOs that claims occur

Facility Type

A classification describing the type of healthcare facility (SNF or HH)

Facility Name

Name of the healthcare facility.

City

The city where the facility is physically located.

Zip Code

The U.S. Postal Service ZIP Code associated with the facilitys physical address.

County

The county in which the facility is located.

Region

A higher-level geographic grouping used for reporting or analysis

State

The U.S. state or territory where the facility is located.

Network Indicator

A flag indicating whether the facility is in-network or out-of-network

Member Count

Total number of members with one or more rehospitalized that was potentially preventable withinadmissions during the current time period

Average Risk Score (V28)

Average HCC risk score of members with one or more rehospitalized that was potentially preventable withinadmissions during the current time period

Quality Rating

CMS Quality Star Rating (if applicable) during the current year

CAHPS Rating

CMS CAHPS Summary Star Rating (if applicable) during the current year

HH Timeliness of Care

CMS Home Health Timeliness of Care Rating (if applicable) during the current year

Pct Rehosp 30 Days

Percent of admissions where the member was rehospitalized within 30 days post hospital discharge during the current time period

Post discharge from Hospital Inpatient, admitted to a SNF/HH and readmitted to any Inpatient Acute Care Facility with in 30 Days (denominator all Medicare FFS with a SNF/HH Stay during the time period below; numerator are the Medicare FFS that are readmitted to an Inpatient Acute Care Facility during the same time frame)

Pct Prev Rehosp 30 Days

Percent of admissions where the member was rehospitalized that was potentially preventable within 30 days post hospital discharge during the current time period

Post discharge from Hospital Inpatient, admitted to a SNF/HH and ptoentially preventable readmitted to any Inpatient Acute Care Facility with in 30 Days (denominator all Medicare FFS with a SNF/HH stay during the time period below; numerator are the Medicare FFS that are potentially preventably readmitted to an Inpatient Acute Care Facility during the same time frame)

Pct Readmission to PAC 30 Days

Percent of admissions where the member was readmitted to a Post-Acute Care Facility within 30 days post hospital discharge during the current time period

Post discharge from Hospital Inpatient, admitted to a SNF/HH and readmitted to any Inpatient Acute Care Facility with in 30 Days (denominator all Medicare FFS with a SNF/HH Stay during the time period below; numerator are the Medicare FFS that are readmitted to an Inpatient Acute Care Facility during the same time frame)

Pct ED Visit 30 Days

Percent of admissions where the member had an outpatient emergency department visit within 30 days post hospital discharge during the current time period

Post discharge from Hospital Inpatient, admitted to a SNF/HH (currently being serviced by SNF/HH) and member had an outpatient emergency department visit during the first 30 days; (denominator all Medicare FFS with a SNF/HH visit during the time period; numerator are the Medicare FFS that has a outpatient emergency department visit during the same time frame). (does not include those who had visits in the first 7 days)

Pct Avoid ED Visit 30 days

Percent of admissions where the member had an outpatient emergency department visit that was potentially avoidable within 30 days post hospital discharge during the current time period

Post discharge from Hospital Inpatient, admitted to a SNF/HH (currently being serviced by SNF/HH) and member had an AVOIDABLE outpatient emergency department visit during the first 30 days; (denominator all Medicare FFS with a SNF/HH visit during the time period; numerator are the Medicare FFS that has a AVOIDABLE outpatient emergency department visit during the same time frame). Calculated using the NYU Wagner Methodology.

ALOS (Medicare Only)

Average length of stay for Medicare only admissions during the current time period

Average number of Medicare covered days between admit date and discharge date for all claims

Mortality Rate 30-Day During Stay

The percentage of patients who died within 30 days of admission while still admitted to the facility.

Number of patients who died within 30 days of admission while still admitted to the facility / Total number of admissions lasting 30 or less days

Mortality Rate 30-Day After Stay

The percentage of patients who died within 30 days following discharge from the facility.

Number of patients who died within 30 days following discharge from the facility / Total number of admissions lasting 30 or less days

Admissions

Total number of admissions during the current time period

Days (Medicare Covered)

Total number of days during the current time period

Rehosp 30 Days

Total number of admissions where the member was rehospitalized within 30 days post hospital discharge during the current time period

Prev Rehosp 30 Days

Total number of admissions where the member was rehospitalized that was potentially preventable within 30 days post hospital discharge during the current time period

EDVisits 30 Days

Total number of admissions where the member had an outpatient emergency department visit within 30 days post hospital discharge during the current time period

Post discharge from Hospital Inpatient, admitted to a SNF/HH and member had an outpatient emergency department visit during the first 30 days; numerator are the Medicare FFS that have out patient emergency department visits during the first 30 days.

Avoid EDVisits 30 Days

Total number of admissions where the member had an outpatient emergency department that was potentially avoidable visit within 30 days post hospital discharge during the current time period

Post discharge from Hospital Inpatient, admitted to a SNF/HH and member had a potentially avoidable outpatient emergency department visit during the first 30 days; numerator are the Medicare FFS that have out patient emergency department visits during the first 30 days.

Average Risk Score (V28) - Benchmark

Average risk score for facilities with more than 20 members for the given state and facility type in the current time period

Member months weighted average of 'Average Risk Score (V28)' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Pct Rehosp 30 Days - Benchmark

The risk adjusted benchmark for measure 'Pct Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Pct Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Pct Prev Rehosp 30 Days - Benchmark

The risk adjusted benchmark for measure 'Pct Prev Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Pct Prev Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Pct Readmission to PAC 30 Days - Benchmark

The risk adjusted benchmark for measure 'Pct Readmission to PAC 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Pct Readmission to PAC 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Pct ED Visit 30 Days - Benchmark

The risk adjusted benchmark for measure 'Pct ED Visit 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Pct ED Visit 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Pct Avoid ED Visit 30 Days - Benchmark

The risk adjusted benchmark for measure 'Pct Avoid ED Visit 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Pct Avoid ED Visit 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

ALOS (Medicare Only) - Benchmark

The risk adjusted benchmark for measure 'ALOS (Medicare Only)' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'ALOS (Medicare Only)' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Mortality Rate 30-Day During Stay - Benchmark

The risk adjusted benchmark for measure 'Mortality Rate 30-Day During Stay' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Mortality Rate 30-Day During Stay' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Mortality Rate 30-Day After Stay - Benchmark

The risk adjusted benchmark for measure 'Mortality Rate 30-Day After Stay' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Mortality Rate 30-Day After Stay' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Admissions - Benchmark

The risk adjusted benchmark for measure 'Admissions' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Admissions' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Days (Medicare Covered) - Benchmark

The risk adjusted benchmark for measure 'Days (Medicare Covered)' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Days (Medicare Covered)' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Rehosp 30 Days - Benchmark

The risk adjusted benchmark for measure 'Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Prev Rehosp 30 Days - Benchmark

The risk adjusted benchmark for measure 'Prev Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Prev Rehosp 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

EDVisits 30 Days - Benchmark

The risk adjusted benchmark for measure 'EDVisits 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'EDVisits 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'

Avoid EDVisits 30 Days - Benchmark

The risk adjusted benchmark for measure 'Avoid EDVisits 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period

Member months weighted average of 'Avoid EDVisits 30 Days' amongst facilities with more than 20 members of the same facility type in the same state for the current time period * 'Average Risk Score (v28)' / 'Average Risk Score (v28) - Benchmark'