eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Active as of 2026-03-13 |
<Measure xmlns="http://hl7.org/fhir">
<id value="CMS1017HHFIFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Hospital Harm – Falls with Major InjuryFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">CMS1017HHFIFHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.0.026</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-CMS1017HHFIFHIR.html">Hospital Harm – Falls with Major InjuryFHIR</a></td>
</tr>
<tr>
<th scope="row">
<b>
Short Name Identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS1017FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
Version Independent Identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:6425d5e9-a54b-40e0-a07d-e6e17137871c</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
Version Specific Identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:0a959a37-4759-47b6-a71f-62823f9e4dee</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
Endorser (CMS Consensus Based Entity) Identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>4120e</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
Publisher (CMS) Identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>1017FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2026-01-01..2026-12-31</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">Centers for Medicare & Medicaid Services (CMS)</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<td style="padding-left: 4px;">Mathematica</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>This ratio measure assesses the number of inpatient hospitalizations where at least one fall with a major or moderate injury occurs among the total qualifying inpatient hospital days for patients aged 18 years and older</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. Mathematica disclaims all liability for use or accuracy of any third-party codes contained in the specifications.</p>
<p>LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><p>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.</p>
<p>THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND.</p>
<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<td style="padding-left: 4px;"><div><p>Inpatient falls are among the most common incidents reported in hospitals and can increase length of stay and patient costs. Due to the potential for serious harm associated with patient falls, “patient death or serious injury associated with a fall while being cared for in a health care setting” is considered a Serious Reportable Event by the National Quality Forum (NQF).</p>
<p>Falls (including unplanned or unintended descents to the floor) can result in patient injury ranging from minor abrasion or bruising to death as a result of injuries sustained from a fall. While major injuries (e.g., fractures, closed head injuries, internal bleeding) (Mintz, 2022) have the biggest impact on patient outcomes, 2008-2021 data findings from The 2022 Network of Patient Safety Databases (NPSD) demonstrated that 41.8 % of falls resulted in moderate injuries such as skin tear, avulsion, hematoma, significant bruising, dislocations and lacerations requiring suturing. Moderate injury is, as defined by NDNQI, that resulted in suturing, application of steri-strips or skin glue, splinting, or muscle/joint strain (Press GaneyI, 2020). NPSD findings also demonstrated that mild to moderate level of harm represent 24.2.%, 0.4% - severe harm, and 0.1% - death (levels of harm definitions developed by WHO, 2009).</p>
<p>By focusing on falls with major and moderate injuries, the goal of this hospital harm eCQM is to raise awareness of fall rates and, ultimately, to improve patient safety by preventing falls with injury in all hospital patients. The purpose of measuring the rate of falls with major and moderate injury events is to improve hospitals’ practices for monitoring patients at high risk for falls with injury and, in so doing, to reduce the frequency of patient falls with injury.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>Certain protocols and prevention measures to reduce patient falls with injury include using fall risk assessment tools to gauge individual patient risk, implementing fall prevention protocols directed at individual patient risk factors, and implementing environmental rounds to assess and correct environmental fall hazards. Recommended clinical guidelines and practices to reduce falls and injuries from falls in hospitals support many prevention activities including implementing multifactorial interventions and tailoring interventions to individual patient's conditions and needs. The intent and desired outcome for this eCQM is to work with existing and recommended falls prevention processes to track falls with injury, and aim to reduce rates of inpatient falls resulting in major injury.</p>
<p>Recommended falls prevention guidelines are:</p>
<ul>
<li>Optimal Perioperative Management of the Geriatric Patient: Best Practices Guideline (ACS NSQIP/AGS, 2016)</li>
<li>Falls in older people: assessing risk and prevention (NICE, 2013)</li>
<li>Preventing falls and reducing injury from falls (4th edition) (RNAO, 2017)</li>
<li>Fall prevention in hospitals and nursing homes: Clinical practice guideline (Schoberer et al., 2022)</li>
<li>World guidelines for falls prevention and management for older adults: a global initiative, ('Montero-Odasso et al., 2022)</li>
</ul>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<td style="padding-left: 4px;">Hospital days are measured in 24-hour periods starting from the time of arrival at the hospital (including time in the Emergency Department and or Observation). The number of days will be counted as whole numbers; any fractional periods are dropped. For example, an eligible encounter with a length of stay of 75 hours will be measured as 3 days (72 hours).
This measure includes two measure observations used to calculate the ratio of the number of encounters with a fall over the total number of eligible hospital days. The ratio is reported as the rate of inpatient hospitalizations with falls with moderate or major injury per 1000 patient days.
To express the rate of inpatient hospitalizations with falls with moderate or major injury per 1,000 patient days, the following calculation is applied post-production during implementation: (Total number of encounters with falls with moderate or major injury / Total number of eligible hospital days) x 1000 = rate.
Example: 1 eligible encounter with a patient fall with moderate or major injury over 120 eligible days (1/120) x 1000 = 8.33.
In ratio measures, both the Denominator and Numerator populations flow separately from the same Initial Population. Therefore, the same exclusion criteria must be applied to both the Denominator and Numerator to prevent excluded cases from being considered.
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure: CMS1017v2. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>6759fcdf46b6174510cfeffa</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<td>Inpatient hospitalizations for patients aged 18 years and older with a length of stay less than or equal to 120 days that ends during the measurement period</td>
</tr>
<tr>
<td>Denominator:</td>
<td>Equals initial population</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<td>Inpatient hospitalizations where the patient has a fall diagnosis present on admission.</td>
</tr>
<tr>
<td>Numerator:</td>
<td>Inpatient hospitalizations where the patient has a fall that results in moderate or major injury or death.
The diagnosis of a fall and of a moderate or major injury must not be present on admission.</td>
</tr>
<tr>
<td>Numerator Exclusion:</td>
<td>Inpatient hospitalizations where the patient has a fall diagnosis present on admission</td>
</tr>
<tr>
<td>Measure Observation:</td>
<td>Denominator Observation, associated with the Denominator: The total number of eligible days across all encounters which match the initial population/denominator criteria. </td>
</tr>
<tr>
<td>Measure Observation:</td>
<td>Numerator Observation, associated with the Numerator: The total number of inpatient hospitalizations where a fall with major or moderate injury occurred, across all eligible encounters.</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-CMS1017HHFIFHIR.html">CMS1017HHFIFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Terminology and Other Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><code>Library/CQMCommon|2.2.000</code></li>
<li><code>Library/FHIRHelpers|4.4.000</code></li>
<li><code>Library/QICoreCommon|2.1.000</code></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion">Emergency Department Visit</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1147.171/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1147.198/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.198</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1147.174/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.174</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1248.205/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.205</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1147.197/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.197</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>Numerator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Numerator Exclusions</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator Exclusions</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Resource Type</b></th>
<th><b>Resource Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
diagnosis
</td>
<td>
Observation Services
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
diagnosis
</td>
<td>
Emergency Department Visit
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion">Emergency Department Visit</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
diagnosis
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
diagnosis
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
id
id.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>AdverseEvent(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-adverseevent.html">QICoreAdverseEvent</a>)</td>
<td>
event
date
date.value
recordedDate
recordedDate.value
</td>
<td>
Inpatient Falls
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1147.171/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 6759fcdf46b6174510cfeffa </td>
<td colspan="3" style="padding-left: 4px;">
<b>Group scoring:</b>
<span> ratio </span>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Outcome </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rate Aggregation: </b></th>
<td colspan="3" style="padding-left: 4px;">None</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>decrease </span>
</p>
</td>
</tr>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
"Qualifying Encounter"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusions":
"Encounter with a Fall Present on Admission"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
"Encounter where a Fall and Major Injury Occurred"
union "Encounter where a Fall and Moderate Injury Occurred"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator Exclusion</td>
<td>
<pre><code class="language-cql">define "Numerator Exclusions":
"Encounter with a Fall Present on Admission"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Measure Observation</td>
<td>
<pre><code class="language-cql">define function "Denominator Observation"(QualifyingEncounter Encounter):
duration in days of CQMCommon.HospitalizationWithObservation ( QualifyingEncounter )</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Measure Observation</td>
<td>
<pre><code class="language-cql">define function "Numerator Observation"(QualifyingEncounter Encounter):
Count("Numerator" FallsEncounter
where FallsEncounter.period ends during CQMCommon.HospitalizationWithObservation(QualifyingEncounter)
)</code></pre>
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>Inpatient Encounter</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Inpatient Encounter":
[Encounter: "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and EncounterInpatient.period ends during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Qualifying Encounter</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Qualifying Encounter":
CQMCommon."Inpatient Encounter" InpatientEncounter
//where InpatientEncounter.hospitalizationLengthOfStay() <= 120
where InpatientEncounter.hospitalizationWithObservation ( ).lengthInDays ( ) <= 120
and AgeInYearsAt(date from start of InpatientEncounter.period) >= 18</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Encounter with a Fall Not Present on Admission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with a Fall Not Present on Admission":
"Qualifying Encounter" InpatientEncounter
where exists ( InpatientEncounter.diagnosis Dx
where CQMCommon."GetCondition" ( Dx.condition ).code in "Inpatient Falls"
//and Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
and ( Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
or Dx.diagnosisPresentOnAdmission is null
) //new addition
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Encounter with a Fall Event</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with a Fall Event":
"Qualifying Encounter" InpatientEncounter
with [AdverseEvent: event in "Inpatient Falls"] FallsDocumentation
such that Coalesce(FallsDocumentation.date, FallsDocumentation.recordedDate) during CQMCommon."HospitalizationWithObservation" ( InpatientEncounter )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Encounter where a Fall Occurred</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter where a Fall Occurred":
"Encounter with a Fall Not Present on Admission"
union "Encounter with a Fall Event"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Encounter where a Fall and Major Injury Occurred</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter where a Fall and Major Injury Occurred":
"Encounter where a Fall Occurred" FallOccurred
where exists ( FallOccurred.diagnosis Dx
where CQMCommon."GetCondition" ( Dx.condition ).code in "Major Injuries"
and ( Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
or Dx.diagnosisPresentOnAdmission is null
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Encounter where a Fall and Moderate Injury Occurred</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter where a Fall and Moderate Injury Occurred":
"Encounter where a Fall Occurred" FallOccurred
where exists ( FallOccurred.diagnosis Dx
where CQMCommon."GetCondition" ( Dx.condition ).code in "Moderate Injuries"
and ( Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
or Dx.diagnosisPresentOnAdmission is null
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
"Encounter where a Fall and Major Injury Occurred"
union "Encounter where a Fall and Moderate Injury Occurred"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
"Qualifying Encounter"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Encounter with a Fall Present on Admission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with a Fall Present on Admission":
"Qualifying Encounter" InpatientEncounter
where exists ( InpatientEncounter.diagnosis Dx
where Dx.condition.getCondition ( ).code in "Inpatient Falls"
and Dx.diagnosisPresentOnAdmission in "Present on Admission or Clinically Undetermined"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Numerator Exclusions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator Exclusions":
"Encounter with a Fall Present on Admission"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Denominator Exclusions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
"Encounter with a Fall Present on Admission"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToInterval</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>lengthInDays</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Calculates the difference in calendar days between the start and end of the given interval.
*/
define fluent function lengthInDays(Value Interval<DateTime> ):
difference in days between start of Value and end of Value</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>hospitalizationWithObservation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
*/
define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>GetCondition</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the Condition resource for the given reference
@deprecated: This function is deprecated. Use the fluent function `getCondition()` instead
*/
define function "GetCondition"(reference Reference):
singleton from ([Condition] C where C.id = reference.reference.getId())</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>getId</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
Last(Split(uri, '/'))</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToString</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>HospitalizationWithObservation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
@deprecated: This function is deprecated. Use the fluent function `hospitalizationWithObservation()` instead.
*/
define function "HospitalizationWithObservation"(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Denominator Observation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define function "Denominator Observation"(QualifyingEncounter Encounter):
duration in days of CQMCommon.HospitalizationWithObservation ( QualifyingEncounter )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>getCondition</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the Condition resource for the given reference
*/
define fluent function getCondition(reference Reference):
singleton from ([Condition] C where C.id = reference.reference.getId())</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CMS1017HHFIFHIR</td>
<td>Numerator Observation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define function "Numerator Observation"(QualifyingEncounter Encounter):
Count("Numerator" FallsEncounter
where FallsEncounter.period ends during CQMCommon.HospitalizationWithObservation(QualifyingEncounter)
)</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="Inpatient Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Inpatient Encounter":
[Encounter: "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and EncounterInpatient.period ends during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Qualifying Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Qualifying Encounter":
CQMCommon."Inpatient Encounter" InpatientEncounter
//where InpatientEncounter.hospitalizationLengthOfStay() <= 120
where InpatientEncounter.hospitalizationWithObservation ( ).lengthInDays ( ) <= 120
and AgeInYearsAt(date from start of InpatientEncounter.period) >= 18"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with a Fall Not Present on Admission"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with a Fall Not Present on Admission":
"Qualifying Encounter" InpatientEncounter
where exists ( InpatientEncounter.diagnosis Dx
where CQMCommon."GetCondition" ( Dx.condition ).code in "Inpatient Falls"
//and Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
and ( Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
or Dx.diagnosisPresentOnAdmission is null
) //new addition
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Encounter with a Fall Event"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with a Fall Event":
"Qualifying Encounter" InpatientEncounter
with [AdverseEvent: event in "Inpatient Falls"] FallsDocumentation
such that Coalesce(FallsDocumentation.date, FallsDocumentation.recordedDate) during CQMCommon."HospitalizationWithObservation" ( InpatientEncounter )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Encounter where a Fall Occurred"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter where a Fall Occurred":
"Encounter with a Fall Not Present on Admission"
union "Encounter with a Fall Event""/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter where a Fall and Major Injury Occurred"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter where a Fall and Major Injury Occurred":
"Encounter where a Fall Occurred" FallOccurred
where exists ( FallOccurred.diagnosis Dx
where CQMCommon."GetCondition" ( Dx.condition ).code in "Major Injuries"
and ( Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
or Dx.diagnosisPresentOnAdmission is null
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter where a Fall and Moderate Injury Occurred"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter where a Fall and Moderate Injury Occurred":
"Encounter where a Fall Occurred" FallOccurred
where exists ( FallOccurred.diagnosis Dx
where CQMCommon."GetCondition" ( Dx.condition ).code in "Moderate Injuries"
and ( Dx.diagnosisPresentOnAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
or Dx.diagnosisPresentOnAdmission is null
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Encounter where a Fall and Major Injury Occurred"
union "Encounter where a Fall and Moderate Injury Occurred""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
"Qualifying Encounter""/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Encounter with a Fall Present on Admission"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with a Fall Present on Admission":
"Qualifying Encounter" InpatientEncounter
where exists ( InpatientEncounter.diagnosis Dx
where Dx.condition.getCondition ( ).code in "Inpatient Falls"
and Dx.diagnosisPresentOnAdmission in "Present on Admission or Clinically Undetermined"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator Exclusions":
"Encounter with a Fall Present on Admission""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusions":
"Encounter with a Fall Present on Admission""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="lengthInDays"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Calculates the difference in calendar days between the start and end of the given interval.
*/
define fluent function lengthInDays(Value Interval<DateTime> ):
difference in days between start of Value and end of Value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="hospitalizationWithObservation"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
*/
define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="GetCondition"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Condition resource for the given reference
@deprecated: This function is deprecated. Use the fluent function `getCondition()` instead
*/
define function "GetCondition"(reference Reference):
singleton from ([Condition] C where C.id = reference.reference.getId())"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="getId"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
Last(Split(uri, '/'))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="HospitalizationWithObservation"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
@deprecated: This function is deprecated. Use the fluent function `hospitalizationWithObservation()` instead.
*/
define function "HospitalizationWithObservation"(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Observation"/>
</extension>
<extension url="statement">
<valueString
value="define function "Denominator Observation"(QualifyingEncounter Encounter):
duration in days of CQMCommon.HospitalizationWithObservation ( QualifyingEncounter )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="getCondition"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Condition resource for the given reference
*/
define fluent function getCondition(reference Reference):
singleton from ([Condition] C where C.id = reference.reference.getId())"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1017HHFIFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator Observation"/>
</extension>
<extension url="statement">
<valueString
value="define function "Numerator Observation"(QualifyingEncounter Encounter):
Count("Numerator" FallsEncounter
where FallsEncounter.period ends during CQMCommon.HospitalizationWithObservation(QualifyingEncounter)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library CQMCommon"/>
<resource value="Library/CQMCommon|2.2.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="Library/QICoreCommon|2.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Encounter Inpatient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Observation Services"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Emergency Department Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Inpatient Falls"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Not Present On Admission or Documentation Insufficient to Determine"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.198"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Major Injuries"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.174"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Moderate Injuries"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.205"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Present on Admission or Clinically Undetermined"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.197"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Numerator Exclusions"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator Exclusions"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<mustSupport value="diagnosis"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<mustSupport value="diagnosis"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
<dateFilter>
<path value="period"/>
<valuePeriod>
<extension url="http://hl7.org/fhir/uv/crmi-analysisException">
<valueString
value="Error attempting to determine filter value: toFhirValue not implemented for Subtract"/>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<mustSupport value="diagnosis"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
<dateFilter>
<path value="period"/>
<valuePeriod>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<language value="text/cql-identifier"/>
<expression value="Measurement Period"/>
</valueExpression>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<mustSupport value="diagnosis"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
<codeFilter>
<path value="diagnosis.condition.code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171"/>
</codeFilter>
<dateFilter>
<path value="period"/>
<valuePeriod>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<language value="text/cql-identifier"/>
<expression value="Measurement Period"/>
</valueExpression>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
</dataRequirement>
<dataRequirement>
<type value="AdverseEvent"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-adverseevent"/>
<mustSupport value="event"/>
<mustSupport value="date"/>
<mustSupport value="date.value"/>
<mustSupport value="recordedDate"/>
<mustSupport value="recordedDate.value"/>
<codeFilter>
<path value="event"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="https://madie.cms.gov/Measure/CMS1017HHFIFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
<display value="Short Name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS1017FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
<display value="Version Independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:6425d5e9-a54b-40e0-a07d-e6e17137871c"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
<display value="Version Specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:0a959a37-4759-47b6-a71f-62823f9e4dee"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="endorser"/>
<display value="Endorser"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cbeId"/>
<value value="4120e"/>
<assigner>
<display value="CMS Consensus Based Entity"/>
</assigner>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
<display value="Publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="1017FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.0.026"/>
<name value="CMS1017HHFIFHIR"/>
<title value="Hospital Harm – Falls with Major InjuryFHIR"/>
<status value="active"/>
<experimental value="false"/>
<date value="2026-03-13T01:50:39+00:00"/>
<publisher value="Centers for Medicare & Medicaid Services (CMS)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.cms.gov/"/>
</telecom>
</contact>
<description
value="This ratio measure assesses the number of inpatient hospitalizations where at least one fall with a major or moderate injury occurs among the total qualifying inpatient hospital days for patients aged 18 years and older"/>
<purpose value="UNKNOWN"/>
<usage
value="Hospital days are measured in 24-hour periods starting from the time of arrival at the hospital (including time in the Emergency Department and or Observation). The number of days will be counted as whole numbers; any fractional periods are dropped. For example, an eligible encounter with a length of stay of 75 hours will be measured as 3 days (72 hours).
This measure includes two measure observations used to calculate the ratio of the number of encounters with a fall over the total number of eligible hospital days. The ratio is reported as the rate of inpatient hospitalizations with falls with moderate or major injury per 1000 patient days.
To express the rate of inpatient hospitalizations with falls with moderate or major injury per 1,000 patient days, the following calculation is applied post-production during implementation: (Total number of encounters with falls with moderate or major injury / Total number of eligible hospital days) x 1000 = rate.
Example: 1 eligible encounter with a patient fall with moderate or major injury over 120 eligible days (1/120) x 1000 = 8.33.
In ratio measures, both the Denominator and Numerator populations flow separately from the same Initial Population. Therefore, the same exclusion criteria must be applied to both the Denominator and Numerator to prevent excluded cases from being considered.
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure: CMS1017v2. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html)."/>
<copyright
value="Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. Mathematica disclaims all liability for use or accuracy of any third-party codes contained in the specifications.
LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved."/>
<effectivePeriod>
<start value="2026-01-01"/>
<end value="2026-12-31"/>
</effectivePeriod>
<author>
<name value="Mathematica"/>
<telecom>
<system value="url"/>
<value value="https://www.mathematica.org/"/>
</telecom>
</author>
<library value="https://madie.cms.gov/Library/CMS1017HHFIFHIR"/>
<disclaimer
value="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 MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
<rationale
value="Inpatient falls are among the most common incidents reported in hospitals and can increase length of stay and patient costs. Due to the potential for serious harm associated with patient falls, “patient death or serious injury associated with a fall while being cared for in a health care setting” is considered a Serious Reportable Event by the National Quality Forum (NQF).
Falls (including unplanned or unintended descents to the floor) can result in patient injury ranging from minor abrasion or bruising to death as a result of injuries sustained from a fall. While major injuries (e.g., fractures, closed head injuries, internal bleeding) (Mintz, 2022) have the biggest impact on patient outcomes, 2008-2021 data findings from The 2022 Network of Patient Safety Databases (NPSD) demonstrated that 41.8 % of falls resulted in moderate injuries such as skin tear, avulsion, hematoma, significant bruising, dislocations and lacerations requiring suturing. Moderate injury is, as defined by NDNQI, that resulted in suturing, application of steri-strips or skin glue, splinting, or muscle/joint strain (Press GaneyI, 2020). NPSD findings also demonstrated that mild to moderate level of harm represent 24.2.%, 0.4% - severe harm, and 0.1% - death (levels of harm definitions developed by WHO, 2009).
By focusing on falls with major and moderate injuries, the goal of this hospital harm eCQM is to raise awareness of fall rates and, ultimately, to improve patient safety by preventing falls with injury in all hospital patients. The purpose of measuring the rate of falls with major and moderate injury events is to improve hospitals’ practices for monitoring patients at high risk for falls with injury and, in so doing, to reduce the frequency of patient falls with injury."/>
<clinicalRecommendationStatement
value="Certain protocols and prevention measures to reduce patient falls with injury include using fall risk assessment tools to gauge individual patient risk, implementing fall prevention protocols directed at individual patient risk factors, and implementing environmental rounds to assess and correct environmental fall hazards. Recommended clinical guidelines and practices to reduce falls and injuries from falls in hospitals support many prevention activities including implementing multifactorial interventions and tailoring interventions to individual patient's conditions and needs. The intent and desired outcome for this eCQM is to work with existing and recommended falls prevention processes to track falls with injury, and aim to reduce rates of inpatient falls resulting in major injury.
Recommended falls prevention guidelines are:
- Optimal Perioperative Management of the Geriatric Patient: Best Practices Guideline (ACS NSQIP/AGS, 2016)
- Falls in older people: assessing risk and prevention (NICE, 2013)
- Preventing falls and reducing injury from falls (4th edition) (RNAO, 2017)
- Fall prevention in hospitals and nursing homes: Clinical practice guideline (Schoberer et al., 2022)
- World guidelines for falls prevention and management for older adults: a global initiative, ('Montero-Odasso et al., 2022)"/>
<guidance
value="Hospital days are measured in 24-hour periods starting from the time of arrival at the hospital (including time in the Emergency Department and or Observation). The number of days will be counted as whole numbers; any fractional periods are dropped. For example, an eligible encounter with a length of stay of 75 hours will be measured as 3 days (72 hours).
This measure includes two measure observations used to calculate the ratio of the number of encounters with a fall over the total number of eligible hospital days. The ratio is reported as the rate of inpatient hospitalizations with falls with moderate or major injury per 1000 patient days.
To express the rate of inpatient hospitalizations with falls with moderate or major injury per 1,000 patient days, the following calculation is applied post-production during implementation: (Total number of encounters with falls with moderate or major injury / Total number of eligible hospital days) x 1000 = rate.
Example: 1 eligible encounter with a patient fall with moderate or major injury over 120 eligible days (1/120) x 1000 = 8.33.
In ratio measures, both the Denominator and Numerator populations flow separately from the same Initial Population. Therefore, the same exclusion criteria must be applied to both the Denominator and Numerator to prevent excluded cases from being considered.
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure: CMS1017v2. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html)."/>
<group id="6759fcdf46b6174510cfeffa">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="ratio"/>
<display value="Ratio"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="outcome"/>
<display value="Outcome"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueCode value="None"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="decrease"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="14936FB5-C2D9-48F0-8274-203DCB3DF9F2">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients aged 18 years and older with a length of stay less than or equal to 120 days that ends during the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="F26B3AA5-0671-49F8-915E-922A13103B2C">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals initial population"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="6FED28F1-9BAB-4AEB-97B4-C5EE6EFA38D7">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="Inpatient hospitalizations where the patient has a fall diagnosis present on admission."/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="165C995B-9F84-4C7B-B11C-B02069187209">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Inpatient hospitalizations where the patient has a fall that results in moderate or major injury or death.
The diagnosis of a fall and of a moderate or major injury must not be present on admission."/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="f6233de0-9356-4819-b2f6-10a23de9485d">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator-exclusion"/>
<display value="Numerator Exclusion"/>
</coding>
</code>
<description
value="Inpatient hospitalizations where the patient has a fall diagnosis present on admission"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator Exclusions"/>
</criteria>
</population>
<population id="0c0080bd-3e3d-439c-9957-003e0e9b7f0d">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
<valueString value="Sum"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
<valueString value="F26B3AA5-0671-49F8-915E-922A13103B2C"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-observation"/>
<display value="Measure Observation"/>
</coding>
</code>
<description
value="Denominator Observation, associated with the Denominator: The total number of eligible days across all encounters which match the initial population/denominator criteria. "/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Observation"/>
</criteria>
</population>
<population id="00549484-9c64-4a17-a26d-a846152dd36b">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
<valueString value="Count"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
<valueString value="165C995B-9F84-4C7B-B11C-B02069187209"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-observation"/>
<display value="Measure Observation"/>
</coding>
</code>
<description
value="Numerator Observation, associated with the Numerator: The total number of inpatient hospitalizations where a fall with major or moderate injury occurred, across all eligible encounters."/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator Observation"/>
</criteria>
</population>
</group>
</Measure>
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2026-03-13
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