CMS-10752 AHCAH Data Measures form

Submissions of 1135 Waiver Request Automated Process (CMS-10752)

AHCAH Data Measures form

Acute Hospital Care at Home

OMB: 0938-1384

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[AHCAH-34230 Created: Jul/24/2024 Updated: Jul/24/2024 Resolved: Jul/24/2024
Status:
Project:
Component/s:
Affects
Version/s:
Fix Version/s:

Measures Submitted
Acute Hospital Care at Home
None
None

Type:
Reporter:
Resolution:
Labels:
Remaining
Estimate:
Time Spent:
Original
Estimate:

AHCAH Measure - Tier 2

Issue Links:

Relates
relates to

None

Done
None
Not Specified

Priority:
Assignee:
Votes:

Medium
Unassigned
0

Not Specified
Not Specified

Hospital Name:
CCN:
140150
Measure From
Date:
Measure To
Date:
1a. How many
Fee For Service
(FFS) Medicare
patients were
discharged from
acute hospital
care at home in
the last 7 days?:
1b. How many
non-managed
care Medicaid
patients were
discharged from
acute hospital

CCN:

Approved

care at home in
the last 7 days?:
1c. How many
discharges
involved patients
who had both
FFS Medicare
and FFS
Medicaid (DualEligibles)?:
2a. Excluding
patients on
hospice and those
not on hospice
but whose death
was expected by
the care team and
the patient and
their
family/caregivers,
how many FFS
Medicare
patients died
during their
hospitalization in
the past 7 days?:
2b. Excluding
patients on
hospice and those
not on hospice
but whose death
was expected by
the care team and
the patient and
their
family/caregivers,
how many nonmanaged care
Medicaid
patients died
during their
hospitalization in
the past 7 days?:
2c. Excluding
patients on

hospice and those
not on hospice
but whose death
was expected,
how many
patients died
during their
hospitalization in
the past 7 days
who had both
FFS Medicare
and FFS
Medicaid (DualEligibles)?:
3a. How many
FFS Medicare
patients required
transfer back and
admission to the
traditional
inpatient hospital
setting from their
acute hospital
care at home in
the past 7 days?:
3b. How many
non-managed
care Medicaid
patients required
transfer back and
admission to the
traditional
inpatient hospital
setting from their
acute hospital
care at home in
the past 7 days?:
3c. How many
patient
discharges
involved a
transfer to the
traditional
inpatient hospital
setting from their

acute hospital
care at home in
the past 7 days
and had coverage
by both FFS
Medicare and
FFS Medicaid
(Dual-Eligibles)?:
4. Has your acute
hospital care at
home safety
committee
reviewed the
metrics being
reported in this
weekly report?:
POC Name:
POC Email:
Measures
Submitter Name:
Measures
Submitter Email:
.


File Typeapplication/pdf
File Title[#AHCAH-34230] University of Illinois Hospital and Clinics: Measures for 2024-07-15 - 2024-07-21
AuthorAdams, Danielle (CMS/CCSQ)
File Modified2024-08-09
File Created2024-08-07

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