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

Measure Information Form

Measure Set: Stroke (STK)

Set Measure ID: STK-10

Performance Measure Name: Assessed for Rehabilitation

Description: Ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services.

Rationale: Each year about 795,000 people experience a new or recurrent stroke, which is the fourth leading cause of death in the United States. Of all strokes, 87% are ischemic, 10% intracerebral hemorrhage (ICH), and 3% subarachnoid hemorrhage (SAH). Prevalence (median 3.0%) increases with age for both males and females. Stroke is a leading cause of serious, long-term disability in the United States, with about 9.0 million stroke survivors alive today, (Palaniappan, L., et al., 2026). More than 50% of survivors 65 years and older experience impaired mobility after a stroke. Between 2019 and 2020 the economic burden of stroke in the U.S. exceeded $56 billion, including the cost of health care services, medicines to treat stroke, and missed days of work, (CDC, 2024).

Approximately two thirds of stroke survivors require rehabilitation (Winstein, C., et al., 2016); however, many patients never receive these services. High priorities include early mobilization and resumption of self-care activities as soon as possible after stroke. A considerable body of evidence indicates better clinical outcomes when patients with stroke are treated in a setting that provides coordinated, interdisciplinary stroke-related evaluation and services. Evaluation of a stroke survivor’s rehabilitation needs is best performed by a team that can include a physician with expertise in rehabilitation, nurses, physical therapists, occupational therapists, speech/language therapists, psychologists, and orthotists, (Ibid., 2016)). Assessment using a comprehensive, standardized tool, such as the Barthel Index or the Functional Independence Measure (FIM), is recommended. A post-acute care assessment is also beneficial when determining long-term functional outcomes, (Ibid., 2016). Effective rehabilitation interventions initiated early following stroke can enhance the recovery process and minimize functional disability. The primary goal of rehabilitation is to prevent complications, minimize impairments, and maximize function.

In patients with acute ischemic stroke (AIS), a formal, individualized, interdisciplinary assessment of the patient’s rehabilitation needs should be completed during the inpatient hospitalization, (Prabhakaran, S., et al., 2026). Early assessment and implementation of mild activity, such as range of motion (ROM), within 24-48 hours is recommended for patients with moderate ICH, but aggressive mobilization should be avoided and could worsen 14-day mortality, (Greenberg, S., et al., 2022). Validated scoring tools or patient-reported outcome measures can screen for physical, cognitive, behavioral, and quality of life (QOL) deficits prior to discharge, (Hoh, B., et al., 2023).

Type Of Measure: Process

Improvement Noted As: Increase in the rate

Risk Adjustment: No.

Data Collection Approach: Retrospective data sources for required data elements include administrative data and medical records. 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:

• Centers for Disease Control and Prevention. (2024, October 24). Stroke facts. https://www.cdc.gov/stroke/data-research/facts-stats/index.html
• Greenberg, S. M., Ziai, W. C., Cordonnier, C., Dowlatshahi, D., Francis, B., Goldstein, J. N., Hemphill, J. C., III, Johnson, R., Keigher, K. M., Mack, W. J., Mocco, J., Newton, E. J., Ruff, I. M., Sansing, L. H., Schulman, S., Selim, M. H., Sheth, K. N., Sprigg, N., & Sunnerhagen, K. S. (2022). 2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: A guideline from the American Heart Association/American Stroke Association. Stroke, 53 (7), e325–e326.
• Hoh, B. L., Ko, N. U., Amin-Hanjani, S., Chou, S. H.-Y., Cruz-Flores, S., Dangayach, N. S., Derdeyn, C. P., Du, R., Hänggi, D., Hetts, S. W., Ifejika, N. L., Johnson, R., Keigher, K. M., Leslie-Mazwi, T. M., Lucke-Wold, B., Rabinstein, A. A., Robicsek, S. A., Stapleton, C. J., Suarez, J. I., … Welch, B. G. (2023). 2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage: A guideline from the American Heart Association/American Stroke Association. Stroke, 54, e321. https://doi.org/10.1161/STR.000000000000043.
• 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.
• Prabhakaran, S., Gonzalez, N. R., Zachrison, K. S., Adeoye, O., Alexandrov, A. W., Ansari, S. A., Chapman, S., Czap, A. L., Dumitrascu, O. M., Ishida, K., Jadhav, A. P., Johnson, B., Johnston, K. C., Khatri, P., Kimberly, W. T., Lee, V. H., Leslie-Mazwi, T. M., Mac Grory, B., Madsen, T. E., Menon, B., Mistry, E. A., Park, S., Parker, S., Pérez de la Ossa, N., Reeves, M., Saiz, T., Scott, P. A., Schwartzberg, D., Sheth, S. A., Sporns, P. B., Times, S., Tjoumakaris, S., Wolfe, S. Q., & Yaghi, S.; Peer Review Committee Collaborators. (2026). 2026 guideline for the early management of patients with acute ischemic stroke: A guideline from the American Heart Association/American Stroke Association. Stroke. Advance online publication. https://doi.org/10.1161/STR.0000000000000513.
• U.S. Department of Veterans Affairs & U.S. Department of Defense. (2024). VA/DoD clinical practice guideline for the management of stroke rehabilitation.
• Winstein, C. J., Stein, J., Arena, R., Bates, B., Cherney, L. R., Cramer, S. C., Deruyter, F., et al. (2016). Guidelines for adult stroke rehabilitation and recovery: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 47 (6). https://doi.org/10.1161/STR.0000000000000098