URSA-PHF-028: SNF LOS in Midnights per 1000 Member-Years

Measure Description

Among active membership periods, the rate of SNF stay length of stay in elapsed midnights per 1000 member-years.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Interval
• Component Class: Long-Form
• Denominator Case Field: Patient ID
• Target Direction: Down

Denominator Description

The elapsed patient-months among active membership periods during which the patient was alive and had medical claims data coverage, expressed in units of 1000s of patient-years.

Numerator Description

The number of midnights elapsed between admission and discharge of a SNF stay falling within the denominator period; NB: a single admission straddling multiple reporting periods will contribute (partial, prorated) LOS to each of those reporting periods.

Published Fields

• Data Model Keys

  • Patient ID
  • Primary Payor ID
  • Primary Plan ID

• Patient Fields

  • Patient Last Name
  • Patient Date of Birth
  • Patient Age Integer
  • Patient Age Category Tier 1
  • Patient Age Category Tier 2
  • Patient Sex Category
  • Is Patient Sex Female
  • Is Patient Sex Male
  • Count Hospital Inpatient Admissions in Last 12 Months
  • Count ED Visits Without Inpatient Admissions in Last 12 Months
  • PCP Attribution Category
  • Primary Care Engagement Category
  • Count Primary Care Visits in Last 36 Months
  • Specialty Care Engagement Category
  • Count Specialty Care Office Visits in Last 36 Months
  • Primary or Specialty Care Engagement Category
  • Count Clinician Office Visits in Last 3 Years

• Date Fields

  • Current Continuous Primary Payor Membership Episode Start Date
  • Current Continuous Primary Payor Membership Episode End Date
  • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Segmented Period Start Date
  • Segmented Period End Date

• Provider Fields

  • Primary Plan Attributee Provider Description
  • Empirical Attributee Primary Care Individual Provider Description

• Location Fields

  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • UW HIP ADI Quintile Category
  • CDC SVI Overall Quintile Category
  • CDC SVI Socioeconomic Quintile Category
  • CDC SVI Household / Disability Quintile Category
  • CDC SVI Minority / Language Quintile Category
  • CDC SVI Housing / Transportation Quintile Category

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description

• Diagnosis Fields

  • CCW Count Category
  • Count CCW Conditions
  • CCW Systems Category
  • Count CCW Systems
  • Is CCW System Behavioral Health
  • Is CCW System Cardiovascular
  • Is CCW System Congenital
  • Is CCW System Endocrine/Metabolic
  • Is CCW System Genitourinary
  • Is CCW System Hematologic
  • Is CCW System Musculoskeletal
  • Is CCW System Neurological
  • Is CCW System Oncologic
  • Is CCW System Ophthalmologic
  • Is CCW System Pulmonary
  • Is CCW System Other

• Numerator Fields

  • Segmented Admit Date
  • Segmented Discharge Date
  • Encounter ID
  • Facility Provider ID
  • Attending Provider ID
  • Encounter Start Date
  • Encounter End Date
  • Encounter LOS in Elapsed Midnights
  • Encounter LOS in Distinct Calendar Days
  • Is LOS in Days > 100
  • Is Discharge Status Home or Home with Home Health
  • Is Routine Discharge Home
  • Is Discharged Home with Home Health
  • Principal Discharge Diagnosis ICD-10-CM Code
  • Principal Discharge Diagnosis ICD-10-CM Description
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
  • MS-DRG Code
  • MS-DRG Description
  • Facility Provider Description
  • Attending Provider Description
  • CMS Admit Source Code
  • CMS Admit Source Description
  • CMS Admit Type Code
  • CMS Admission Type Description
  • CMS Place of Service Code
  • CMS Place of Service Description
  • CMS Patient Discharge Status Code
  • CMS Patient Discharge Status Description
  • Total Plan Paid Amount from All Plans
  • Primary Plan Paid Amount
  • Primary Plan Allowed Amount
  • Patient Paid Amount

• [No Field Group]

  • Ursa Serial ID

• Measure Fields

  • Denominator
  • Numerator