Performance Measurement Network

Question: Inpatient Rehab Facility and SNF excluded from Stroke Education Measure

Can someone explain why patients discharged to inpatient rehab facilities and an SNF are excluded from the stroke education measure? These patients and families need to be educated prior to discharge and then reinforced while at the rehab facility. Not all patients who are discharged to a SNF are unable to learn or on comfort measures. Some of our patients do not qualify for inpatient rehab but go to a SNF, receive physical therapy and then return to their homes. They are still at risk for having another stroke. The measure written this ways does not assist our hospital in quality improvement because we want to know if these populations are educated. I would hope that this measure would be reviewed.


Concur with your clinical rationale. Absolutely continue to educate all stroke patients. However, only those patients discharged to home, home care, or law enforcement are now captured in the STK-8 denominator. This change only impacts data reported to The Joint Commission and NOT clinical practice.

This change was made due to the CMS alignment process required to include stroke in the national specifications manual as a new core measure set. The alignment process strives to adopt common abstraction guidelines for similar type measures. Other patient education core measures, such as HF-1: Discharge Instructions, share similar abstraction guidelines to ease the data collection burden for hospitals collecting data on multiple core measure sets.

Due to your patient population, we would suggest that you track stroke education for SNF and rehab patients separately from the data you report to Joint Commission each quarter for STK-8, and share these findings internally with your staff/colleagues to help improve the quality of education provided to all stroke patients.

Thank you for your comments.

Question Details
Focus area(s): Measure Algorithms – Technical (chart abstracted)
Related documents: STK, STK-08,

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