GMCSAU2024FHIR
type: Measure
node role: treeRoot
id:
  v: GMCSAU2024FHIR
meta:
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    l: computable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm
    l: publishable-measure-cqfm
  profile:
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    l: executable-measure-cqfm
text:
  status:
    v: extensions
  div:
    v: Title: GMCSAU2024 Id: GMCSAU2024FHIR Download cql: GMCSAU2024FHIR.cql Version: 0.1.000 Url: GMCSAU2024 short-name identifier: GMCSAU2024FHIR version-independent identifier: urn:uuid:eed68e80-b466-4369-be87-166ada45f7c5 version-specific identifier: urn:uuid:d234bfa0-a3a4-4cb4-86a0-3d8ca137c4ed Effective Period: 2021-01-01 ..2021-12-31 Status: active Experimental: true Date: 2023-09-06 20:02:04+0000 Approval Date: 2023-09-06 Last Review Date: 2023-09-06 Name: GMCSAU2024FHIR Publisher: Academy of Nutrition and Dietetics Author: Academy of Nutrition and Dietetics: www.eatrightpro.org Description: This measure assesses the percentage of hospitalizations of adults aged 65 years and older at the start of the inpatient encounter during the measurement period, with a length of stay equal to or greater than 24 hours, who received optimal malnutrition care where care performed was appropriate to the patient's level of malnutrition risk and severity. Malnutrition care best practices recommend that for each hospitalization, adult inpatients are (1) screened for malnutrition risk or for a hospital dietitian referral order to be placed, (2) assessed by a registered dietitian (RD) or registered dietitian nutritionist (RDN) to confirm findings of malnutrition risk, and if identified with a "moderate" or "severe" malnutrition status in the current performed malnutrition assessment , (3) receive a current "moderate" or "severe" malnutrition diagnosis by a physician or eligible provider as defined by CMS, and (4) have a current nutrition care plan performed by an RD/RDN. Purpose: UNKNOWN Copyright: (C) Academy of Nutrition and Dietetics 2023 Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. ICD-10 copyright 2022 World Health Organization. This material contains SNOMED Clinical Terms (R) …
contained: Library
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        v: GMCSAU2024FHIR
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        v: Qualifying Encounter
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        v: statement
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        v: define "Qualifying Encounter": [Encounter: "Encounter Inpatient"] EncounterInpatient where EncounterInpatient.period ends during day of "Measurement Period" and AgeInYearsAt(date from start of EncounterInpatient.period) >= 65 and ( duration in hours of EncounterInpatient.period >= 24 ) and EncounterInpatient.status = 'finished'
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      value: String
        v: Measure Population
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      value: String
        v: 2
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      l: cqfm-logicDefinition
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      v: depends-on
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    use:
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    min:
      v: 0
    max:
      v: 1
    type:
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      v: out
    min:
      v: 0
    max:
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  data requirement:
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    code:
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system:
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v: 0.1.000

v: GMCSAU2024FHIR

v: GMCSAU2024

v: active

v: true

v: 2023-09-06T20:02:04+00:00

v: Academy of Nutrition and Dietetics

telecom:
  system:
    v: url
  value:
    v: www.eatrightpro.org

v: This measure assesses the percentage of hospitalizations of adults aged 65 years and older at the start of the inpatient encounter during the measurement period, with a length of stay equal to or greater than 24 hours, who received optimal malnutrition care where care performed was appropriate to the patient's level of malnutrition risk and severity. Malnutrition care best practices recommend that for each hospitalization, adult inpatients are (1) screened for malnutrition risk or for a hospital dietitian referral order to be placed, (2) assessed by a registered dietitian (RD) or registered dietitian nutritionist (RDN) to confirm findings of malnutrition risk, and if identified with a "moderate" or "severe" malnutrition status in the current performed malnutrition assessment , (3) receive a current "moderate" or "severe" malnutrition diagnosis by a physician or eligible provider as defined by CMS, and (4) have a current nutrition care plan performed by an RD/RDN.

v: UNKNOWN

v: This measure is constructed of four clinically eligible components that are aggregated as an arithmetic average of eligible hospitalizations and expressed as a percentage. The four populations used to calculate the four components may differ and the measure observations for the four components do not need to be performed sequentially. The initial population are hospitalizations during the measurement period for patients aged 65 years and greater with a length of stay of 24 hours and greater. Component Measure 1: Inpatient hospitalizations for patients with a current "Malnutrition Risk Screening" performed by an eligible healthcare clinician (professional). Component Measure 2: Inpatient hospitalizations for patients with a current "Nutrition Assessment" performed by an RD/RDN, after a "Malnutrition Screening At Risk Result" during the current hospitalization or a "Hospital Dietitian Referral" order from a physician or eligible clinician during the current hospitalization. For Component Measure 1 and Component Measure 2, only report LOINC code '84291-4 Nutrition and dietetics Risk assessment and screening note' when the RD/RDN performs both the "Malnutrition Risk Screening" and "Nutrition Assessment". Component Measure 3: Inpatient hospitalizations for patients with a current documented "Malnutrition Diagnosis" as a result of a current "Nutrition Assessment Status Moderately Malnourished" OR current "Nutrition Assessment Status Severely Malnourished". Component Measure 4: Inpatient hospitalizations for patients with a current "Nutrition Care Plan" performed as a result of a current "Nutrition Assessment Status Moderately Malnourished" OR current “Nutrition Assessment Status Severely Malnourished”. "Population 5 Measure Observation TotalMalnutritionComponentsScore" Calculations -For each hospitalization, Population Criteria 5 represents the subtotal of Measure Observations performed for Population Criteria 1, 2, 3, and 4. -For the reporting facility, the Population Cr…

v: (C) Academy of Nutrition and Dietetics 2023 Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. ICD-10 copyright 2022 World Health Organization. This material contains SNOMED Clinical Terms (R) (SNOMED CT [R]) copyright 2004-2022. International Health Terminology Standards Development Organization. All Rights Reserved.

v: 2023-09-06

v: 2023-09-06

start:
  v: 2021-01-01
end:
  v: 2021-12-31

name:
  v: Academy of Nutrition and Dietetics
telecom:
  system:
    v: url
  value:
    v: www.eatrightpro.org

v: This measure and the specifications are subject to further revisions. This performance measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, copyright is indicated by (C) or [C], registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

v: The components of this measure are supported by clinical guidance that recommends the following : (1) malnutrition screening for patients admitted into the acute inpatient care setting; (2) nutrition assessment for patients identified at risk for malnutrition or with a hospital dietitian referral order to form the basis for appropriate nutrition interventions; (3) appropriate recognition, diagnosis, and documentation of the nutrition status of a patient in order to (4) address their condition with an appropriate plan of care and communicate patient needs to other care providers. The process for risk identification, assessment, diagnosis, and treatment of malnutrition necessitates a multi-disciplinary care team that begins with the identification of an initial risk population for a more thorough assessment by the RD/RDN. The RD/RDN, in turn, provides the necessary treatment recommendations to address nutritional status utilizing a nutrition diagnosis and care plan, along with the clinical indicators that inform a medical diagnosis of malnutrition completed by a physician or eligible provider as defined by CMS. The four measure observations individually will only provide a fraction of the necessary information on quality of care for patients at risk for or with malnutrition. For example, knowing which patients have been assessed out of those who were initially identified as at risk, but not knowing if the appropriate proportion of patients were screened upon admission, would be an insufficient assessment of quality of care. Implementation of this measure supports timely malnutrition risk screening and hand off to RDNs for appropriate nutrition assessment for identified patients during the current hospitalization. For patients identified with a moderate or severe malnutrition by the nutrition assessment, best practice also recommends a medical diagnosis by a physician or other eligible clinician and the execution of the nutrition care plan by an RD/RDN. Evidence demons…

v: American Society for Parenteral and Enteral Nutrition (ASPEN) clinical guidelines on nutrition screening, assessment, and intervention in adults, Screening for nutrition risk is suggested for hospitalized patients. (ASPEN, 2011). This guideline places nutrition assessment and screening in the context of intervention as part of nutrition care. Screening those individuals at risk for malnutrition is the first step in nutrition care as risk for malnutrition, identified by nutrition screening, is associated with longer length of hospital stay, complications, and mortality. Malnutrition screening is also a predictor of mortality risk. Malnourished patients, identified by nutrition assessment tools, have more complications and longer hospitalizations than do patients with optimal nutrition status. Such patients, identified by nutrition assessment tools, have more infectious and noninfectious complications, longer hospital length of stay, and greater mortality. Nutrition intervention is recommended for patients identified by assessment as at risk for malnutrition or malnourished. Nutrition intervention with associated monitoring and evaluation plants in patients identified as at risk for malnutrition or malnourished improves clinical outcomes. Nutrition interventions and their associated monitoring and evaluation plans in malnourished patients are associated with improved nutrition status, nutrient intake, physical function, and quality of life. Hospital readmissions, inpatient length of stay, and complications were reduced with increased nutrition support interventions.

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      code:
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extension:
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  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: measure-observation
      display:
        v: Measure Observation
  description:
    v: Care Plan
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Measure Observation 4

id:
  v: 64ef45c156d636294b157b03
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
    l: cqfm-scoring
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-scoring
        l: measure-scoring
      code:
        v: continuous-variable
      display:
        v: Continuous Variable
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
    l: cqfm-populationBasis
  value: Code
    v: Encounter
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type
    l: cqfm-type
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-type
        l: measure-type
      code:
        v: process
      display:
        v: Process
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: initial-population
      display:
        v: Initial Population
  description:
    v: Initial
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Initial Population
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: measure-population
      display:
        v: Measure Population
  description:
    v: Measure
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Measure Population
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: measure-population-exclusion
      display:
        v: Measure Population Exclusion
  criteria:
    language:
      v: text/cql-identifier
population:
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod
      l: cqfm-aggregateMethod
    value: String
      v: Sum
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
      l: cqfm-criteriaReference
    value: String
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: measure-observation
      display:
        v: Measure Observation
  description:
    v: Total Score
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Measure Observation TotalMalnutritionComponentsScore

id:
  v: 64ef45d356d636294b157b04
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
    l: cqfm-scoring
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-scoring
        l: measure-scoring
      code:
        v: continuous-variable
      display:
        v: Continuous Variable
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
    l: cqfm-populationBasis
  value: Code
    v: Encounter
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type
    l: cqfm-type
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-type
        l: measure-type
      code:
        v: process
      display:
        v: Process
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: initial-population
      display:
        v: Initial Population
  description:
    v: Initial
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Initial Population
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: measure-population
      display:
        v: Measure Population
  description:
    v: Measure
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Measure Population
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: measure-population-exclusion
      display:
        v: Measure Population Exclusion
  criteria:
    language:
      v: text/cql-identifier
population:
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod
      l: cqfm-aggregateMethod
    value: String
      v: Average
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
      l: cqfm-criteriaReference
    value: String
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: measure-observation
      display:
        v: Measure Observation
  description:
    v: GMCS Percentage
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Measure Observation TotalMalnutritionCompositeScore as Percentage
stratifier:
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo
      l: cqfm-appliesTo
    value: CodeableConcept
  criteria:
    language:
      v: text/cql-identifier
stratifier:
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo
      l: cqfm-appliesTo
    value: CodeableConcept
  criteria:
    language:
      v: text/cql-identifier

v: initial-population

v: Initial Population

v: initial-population

v: Initial Population