Specifications Manual for Joint Commission National Quality Measures (v2027A)
Posted: 8/7/2026

Release Notes:
Measure Information Form
Version 2027A

**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**

Measure Information Form

Measure Set: Stroke (STK)

Set Measure ID: STK-6

Performance Measure Name: Discharged on Statin Medication

Description: Ischemic stroke patients who are prescribed statin medication at hospital discharge.

Rationale: There is an extensive and consistent body of evidence supporting the use of statins for secondary prevention in patients with clinically evident atherosclerotic cardiovascular disease (ASCVD), which includes individuals with ischemic stroke due to large artery atherosclerosis, individuals with ischemic stroke due to intrinsic small vessel disease, and individuals with ischemic stroke not directly due to atherosclerosis but with clinically evident atherosclerotic disease in an uninvolved cerebral or noncerebral bed. Both women and men with clinical ASCVD are at increased risk for recurrent ASCVD and ASCVD death.

High-intensity statin therapy should be initiated or continued as first-line therapy in women and men less than or equal to 75 years of age who have clinical ASCVD, unless contraindicated. In patients with clinical ASCVD and a contraindication to high-intensity statin therapy, moderate-intensity therapy should be considered as an alternative if it can be tolerated. In individuals greater than 75 years of age, the potential for ASCVD risk reduction benefits, adverse effects, drug-drug interactions, and patient preferences should be considered, and statin therapy individualized based on these considerations (Stone, N., et al., 2013; Blumenthal, R., et al., 2026).

Previously, a goal of LDL-C <70 mg/dL has been recommended for secondary stroke prevention, (Martin, S., et al., 2025). However, most patients with clinical ASCVD, including those with ischemic stroke, are likely to be at very high risk and have other co-morbidities, such as, a history of hypertension, myocardial infarction, heart failure, or diabetes. A goal of LDL-C <55 mg/dL is now preferred for very high risk patients. In addition to high-intensity statin therapy, ezetimibe and/or a PCSK9 inhibitor may be needed to lower LDL-C and reduce the risk of future ASCVD events, (Blumenthal, R., et al., 2026).

Type Of Measure: Process

Improvement Noted As: Increase in the rate

Numerator Statement: Ischemic stroke patients prescribed statin medication at hospital discharge.
Included Populations: Not applicable

Excluded Populations: None

Data Elements:

Denominator Statement: Ischemic stroke patients
Included Populations: Discharges with an ICD-10-CM Principal Diagnosis Code for ischemic stroke as defined in Appendix A, Table 8.1

Excluded Populations:
  • Patients less than 18 years of age
  • Patients who have a Length of Stay greater than 120 days
  • Patients with Comfort Measures Only documented
  • Patients enrolled in clinical trials
  • Patients admitted for Elective Carotid Intervention
  • Patients discharged to another hospital
  • Patients who left against medical advice
  • Patients who expired
  • Patients discharged to home for hospice care
  • Patients discharged to a health care facility for hospice care
  • Patients with a Reason for Not Prescribing Statin Medication at Discharge

Data Elements:

Risk Adjustment: No.

Data Collection Approach: Retrospective data sources for required data elements include administrative data and medical record documents. Some hospitals may prefer to gather data concurrently by identifying patients in the population of interest. This approach provides opportunities for improvement at the point of care/service. However, complete documentation includes the principal or other ICD-10 diagnosis and procedure codes, which require retrospective data entry.

Data Accuracy: Variation may exist in the assignment of ICD-10 codes; therefore, coding practices may require evaluation to ensure consistency.

Measure Analysis Suggestions: None

Sampling: Yes. Please refer to the measure set specific sampling requirements and for additional information see the Population and Sampling Specifications section

Data Reported As: Aggregate rate generated from count data reported as a proportion.

Selected References:
  • Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., de Ferranti, S. D., Gianos, E., Gluckman, T. J., Gradney, K. F., Isiadinso, I., Lloyd-Jones, D. M., Marrs, J. C., Martin, S. S., McLain, K. H., Mehta, L. S., … Wilkins, J. T. (2026). 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of dyslipidemia: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 153 (17), e1154–e1276. https://doi.org/10.1161/CIR.0000000000001423.
  • Culver, A. L., Ockene, I. S., Balasubramanian, R., Olendzki, B. C., Sepavich, D. M., Wactawski-Wende, J., Manson, J. E., … (2012). Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative. Archives of Internal Medicine, 172 (2), 144–152.
  • Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., … (2018). 2018 guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2018.11.003.
  • Kleindorfer, D. O., Towfighi, A, Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., Kamel, H., Kernan, W. N., Kittner, S. J., Leira, E. C., Lennon, O., Meschia, J. F., Nguyen, T. N., Pollak, P. M., Santangeli, P., Sharrief, A. Z., Smith, S. C., Jr., Turan, T. N., & Williams, L. S. (2021). Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American Heart Association/American Stroke Association. Stroke, 52 (7), e364–e467.
  • Kostis, W. J., Cheng, J. Q., Dobrzynski, J. M., Cabrera, J., & Kostis, J. B. (2012). Meta-analysis of statin effects in women versus men. Journal of the American College of Cardiology, 59 (6), 572–582.
  • Martin, S. S., Aday, A. W., Allen, N. B., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., … Palaniappan, L. P. (2025). 2025 heart disease and stroke statistics: A report of US and global data from the American Heart Association. Circulation, 151, e333–e334.
  • Palaniappan, L. P., Allen, N. B., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Bansal, N., Currie, M. E., Earlie, R. S., Fan, W., Fetterman, J. L., Barone Gibbs, B., Heard, D. G., Hiremath, S., Hong, H., Hyacinth, H. I., Ibeh, C., Jiang, T., … Khan, S. S. (2026). 2026 heart disease and stroke statistics: A report of U.S. and global data from the American Heart Association. Circulation. Advance online publication. https://doi.org/10.1161/CIR.0000000000001412.
  • Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., et al., on behalf of the American Heart Association Stroke Council. (2018). 2018 guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 49, e10–e11, e26–e30.
  • Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., et al. (2019). Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke—A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 50 (12), e344–e418.
  • Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., McBride, P., Schwartz, J. S., Shero, S. T., Smith, S. C., Watson, K., & Wilson, P. W. F. (2013). Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease in adults: A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation, 11, 1–84.

Measure Algorithm:
Graphic depiction of the Measure Algorithm. Refer to the Algorithm Narrative for each detailed step. Graphic depiction of the Measure Algorithm. Refer to the Algorithm Narrative for each detailed step.

STK-6: Algorithm Narrative

STK-6: Discharged on Statin Medication

Numerator: Ischemic stroke patients prescribed statin medication at hospital discharge.
Denominator: Ischemic stroke patients.

1. Start processing. Run cases, which are included in the Stroke Initial Patient Population and pass the edits defined in the Clinical Data Processing Flow, through this measure.

2. Check ICD-10-CM Principal Diagnosis Code
  1. If none of the ICD-10-CM Principal Diagnosis codes are on Table 8.1, the case will proceed to a Measure Category Assignment of B and will not be in the Measure Population. Stop processing.
  2. If at least one of the ICD-10-CM Principal Diagnosis Codes is on Table 8.1, continue processing and proceed to check Discharge Disposition.

3. Check Discharge Disposition.
  1. If Discharge Disposition is missing, the case will proceed to a Measure Category Assignment of X and will be rejected. Stop processing.
  2. If Discharge Disposition equals 2, 3, 4, 6 or 7, the case will proceed to a Measure Category Assignment of B and will not be in the Measure Population. Stop processing.
  3. If Discharge Disposition equals 1, 5 or 8, continue processing and proceed to check Comfort Measures Only.

4. Check Comfort Measures Only.
  1. If Comfort Measures Only is missing, the case will proceed to a Measure Category Assignment of X and will be rejected. Stop processing.
  2. If Comfort Measures Only equals 1, 2 or 3, the case will proceed to a Measure Category Assignment of B and will not be in the Measure Population. Stop processing.
  3. If Comfort Measures Only equals 4, continue processing and proceed to check Clinical Trial.

5. Check Clinical Trial.
  1. If Clinical Trial is missing, the case will proceed to a Measure Category Assignment of X and will be rejected. Stop processing.
  2. If Clinical Trial equals Y, the case will proceed to a Measure Category Assignment of B and will not be in the Measure Population. Stop processing.
  3. If Clinical Trial equals N, continue processing and proceed to check Elective Carotid Intervention.

6. Check Elective Carotid Interventions.
  1. If Elective Carotid Intervention is missing, the case will proceed to a Measure Category Assignment of X and will be rejected. Stop processing.
  2. If Elective Carotid Intervention equals Y, the case will proceed to a Measure Category Assignment of B and will not be in the Measure Population. Stop processing.
  3. If Elective Carotid Intervention equals N, continue processing and proceed to check Statin Medication Prescribed at Discharge.

7. Check Statin Medication Prescribed at Discharge.
  1. If Statin Medication Prescribed at Discharge is missing, the case will proceed to a Measure Category Assignment of X and will be rejected. Stop processing.
  2. If Statin Medication Prescribed at Discharge equals Y, the case will proceed to a Measure Category Assignment of E and will be in the Numerator Population. Stop processing.
  3. If Statin Medication Prescribed at Discharge equals N, the case will proceed check Reason for Not Prescribing Statin Medication at Discharge.

8. Check Reason for Not Prescribing Statin Medication at Discharge.
  1. If Reason for Not Prescribing Statin Medication at Discharge is missing, the case will proceed to a Measure Category Assignment of X and will be rejected. Stop processing.
  2. If Reason for Not Prescribing Statin Medication at Discharge equals Y, the case will proceed to a Measure Category Assignment of B and will not be in the Measure Population. Stop processing.
  3. If Reason for Not Prescribing Statin Medication at Discharge equals N, the case will proceed to a Measure Category Assignment of D and will be in the Measure Population. Stop processing.

Measure Information Form STK-6
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Specifications Manual for Joint Commission National Quality Measures (v2027A)
Discharges 01-01-2027 (1Q27) through 06-30-2027 (2Q27)

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