AppendixETJC - Manual - Performance Measurement Network

Specifications Manual for Joint Commission National Quality Measures (v2012B)

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Appendix ETJC
Version 2012B

Appendix E - Miscellaneous Tables

Table of Contents

Appendix E - Miscellaneous Tables
Table 2.5 Discharge Status
Table 2.6 Qualifiers and Modifiers Table
Table 2.7 Allowable Measure Set Combinations
Related Topics

Table 2.5 Discharge Status

Note: This chart provides supportive clarification of the Allowable Values listed in the data element _Discharge Status_.

Discharge Status	Discharge Disposition
01	Adult Foster Care Another acute care facility for an outpatient procedure Board and care Foster care facility Group home Home with home oxygen Home with Hospice referral only (has not accepted hospice care by a hospice organization) Home with oxygen that is not provided through home health plan of care Home with walker Home with IV’s or home with IV services under a home health agency Home with outpatient therapy (OT/PT) not provided by a home health service organization Home with PICC line for home IV therapy or home with PICC line under an Infusion Company Home with services of DME supplier Homeless shelter Personal care home Residential care Partial hospitalization - A nonresidential treatment modality which includes psychiatric, psychological, social and vocational elements under medical supervision. It is designed for patients with moderate to severe mental or emotional disorders. Partial hospitalization patients require less than 24-hour care, but more intensive and comprehensive services than are offered in outpatient treatment programs. Partial hospitalization is provided on a planned and regularly scheduled basis for a minimum of 3 hours, but less than 24 hours in any 1day. Physician’s office
02	Short term general hospital Tertiary care
03	Skilled nursing facility (SNF) Skilled nursing facility with hospice referral only (has not accepted hospice care by a hospice organization) SNF rehabilitation unit (a unit within the SNF) Sub-Acute Care Transitional Care Unit (TCU)
04	Assisted Living Facility ECF (Extended Care Facility) ICF (Intermediate Care Facility) Nursing Home Nursing facility for non-skilled/custodial/residential level of care Nursing facility with hospice referral only (has not accepted hospice care by a hospice organization)
05	Children’s hospital Designated cancer centers
06	Home under care of organized home health services with oxygen Foster care facility with home care Home under care of organized home health service organization Home with home health agency with DME Home with therapy services (PT/OT) provided by home health service organization Home with written plan of care for home care services – whether home attendant, nursing aides, certified attendants, etc.
07	Left against medical advice or discontinued care
20	Expired
21	Jail Prison Other Detention Facilities
30	Leave of absence days Interim bills
43	Federal health care facility (VA, DOD) Department of Defense hospital (DOD) Veteran's Administration hospital (VA) Veteran's Administration nursing facility Psych unit within VA hospital Transfer to VA hospital
50	Discharged to home or an alternative setting that is the patient’s “home,” such as a nursing facility, and will receive in-home hospice services
51	Discharged from acute care hospital but remains at the same hospital under hospice care General Inpatient Hospice care General Inpatient Respite Hospice care SNF with hospice care Residential with hospice care Non-skilled level of care outside the hospice benefit for conditions unrelated to the terminal illness
61	Discharged from an acute hospital to a Critical Access Hospital swing bed SNF level of care within hospital’s approved swing bed arrangement Swing bed
62	Inpatient rehabilitation facility including rehabilitation distinct part units of a hospital
63	Long-term care hospital (long-term care facilities provide acute inpatient care with an average length of stay greater than 25 days) LTCH
64	Nursing facility certified under Medicaid but not certified under Medicare
65	Psychiatric hospital or psychiatric distinct part unit of hospital
66	Discharged/transferred to a Critical Access Hospital
70	Another type of health care institution not defined elsewhere in the code list Chemical dependency treatment facility that is not part of a hospital (if the chemical dependency treatment facility is not a psychiatric hospital or psychiatric distinct part/unit of a hospital

Table 2.6 Qualifiers and Modifiers Table

Note: These guideleines apply only to those data elements that refer to them in their Guidelines for Abstraction Exclusion list(s)

Qualifiers

Modifiers

Qualifiers are words used as adjectives to indicate some uncertainty about whether or not a condition really exists.

Quantitative modifiers are adjectives that quantitatively describe a condition

The following qualifiers should be abstracted as negative findings, unless otherwise specified - Consider this list all-inclusive:

And/or (+/-; e.g., "ST abnormalities consistent with ischemia and/or injury"), except when comparing only inclusions (e.g., "ST segment elevation and/or STEMI")
Cannot exclude
Cannot rule out
Could be
Could have been
May be
May have
May have had
May indicate
Or, except when comparing only inclusions
Possible
Questionable (?)
Risk of
Rule out (r'd/o, r/o'd)
Suggestive of
Suspect
Suspicious
Vs., except when comparing only inclusions
Example: If the in-hospital echocardiogram report documents "questionable LVSD", this should be abstracted as a negative finding.

The following quantitative modifiers should be abstracted as negative findings, unless otherwise specified - Consider this list all-inclusive:

Borderline
Insignificant
Scant
Slight
Sub-clinical
Subtle
Trace
Trivial

Table 2.7 Allowable Measure Set Combinations

			PC¹	HBIPS¹
			Newborns - 0 to <=2 days Mother - 8 to <65 years	>= 1 year
Principal Procedure or Principal/Other Diagnosis			P/O Dx	Psychicatric Care Setting = "y"
AMI	>= 18 years	P Dx	Yes for mothers age 18 or greater	>= 18
HF	>= 18 years	P Dx	Yes for mothers age 18 or greater	>= 18
PN	>= 18 years	P Dx	Yes for mothers age 18 or greater	>= 18
STK¹	>= 18 years	P Dx	Yes for mothers age 18 or greater	>= 18
CAC¹	2 to < 18 years	P Dx	Yes for mothers under age 18	2 to < 18
VTE¹	>= 18 years	P/O Dx	Yes for mothers age 18 or greater	>= 18
PC¹	Newborns: 0 to <=2 days Mother: 8 to <65 years	P/O Dx	N/A	Yes for Mothers
SCIP	No age limitation	P/O Px	Yes	>= 1
HBIPS¹	>=1 year	Psychiatric Care Setting = "Y"	Yes for mothers	N/A
ED	No age limitation	Lenght of Stay < 120 days	Yes	>= 1
IMM	>= 6 Mo old	Lenght of Stay < 120 days	Yes for Mothers	Patients age 1 year and older
SUB	>= 18 years	Lenght of Stay < 120 days	Mothers age 18 years and older	Patients age 18 years and older
TOB	>= 18 years	Lenght of Stay < 120 days	Mothers age 18 years and older	Patients age 18 years and older

Can Combine
Cannot combine²

^{1 These measure sets are Joint Commission Only. The measure set combinations containing these sets are only applicable for the transmission of data to The Joint Commission. The Measure Set combination for aligned measures is maintained in the NHQM Specifications Manual.}
^{2 "Cannot Combine" is a placeholder at this time, as the populations for the HBIPS and PC measure sets can currently be combined with all other measure sets.}

Appendix E - Miscellaneous Tables

Table 2.5 Discharge Status

Table 2.6 Qualifiers and Modifiers Table

Table 2.7 Allowable Measure Set Combinations

Related Topics