    Readme File for March 2011 CMS Hospital-Acquired Conditions (HAC) Measures Posting
    
    Revised March 29, 2011 
    
    BACKGROUND
    
    
    The file in CMS_HAC.zip contains hospital-level results from eight hospital-acquired condition (HAC) measures calculated using administrative data for Medicare patients from the Centers for Medicare & Medicaid Services (CMS) for discharges between October 1, 2008 and June 30, 2010. 
    
    CMS adopted these measures for the Hospital Inpatient Quality Reporting Program as part of the 2011 Inpatient Rule. Hospitals were given the opportunity to preview these data prior to this posting. 
    
    More information on this posting, measure definitions, and methods can be found at the Hospitals-Inpatient / HAC measures page on the Quality Net website [http://www.qualitynet.org]. 
    
    
    FILE CONTENTS AND INSTRUCTIONS
    
    The zip file HAC Downloadable File APU 03_2011.zip contains one text file in .csv format: HAC_MEASURES_MAR2011_APU.csv
    
    
    The file contains one record per hospital, per measure, and includes the elements listed below.
    
    The file includes all Inpatient Prospective Payment System (IPPS) hospitals that were participating in the Inpatient Quality Reporting Program, and open as of February 4, 2011.
    
    The file does not include critical access or other non-IPPS hospitals. 
    
    "N/A" indicates that a hospital had 0 qualifying cases for the measure. 
    
    
    The file contents are as follows. There are eight rows per provider, one for each HAC measure.
    
    Column 1 - Provider ID  
      6-digit CMS Certification Number 
      
    Column 2 - Hospital name 
      Hospital name
      
    Column 3 - Hospital state  
      Hospital state (two-digit postal abbreviation)
    
    Column 4 - Measure
      Contains eight HAC measures: Foreign object retained after surgery, Air embolism, Blood incompatibility, Pressure ulcer stages III and IV, Falls and trauma, Vascular catheter-associated infection, Catheter-associated UTI, and Manifestations of poor glycemic control.  
      
    Column 5 - Number of eligible discharges (Denominator)
      Number of discharges at hospital meeting inclusion/exclusion criteria for measure during timeframe of interest**
      
    Column 6 - Number of HACs (Numerator)
      Number of HAC occurrences for the measure at hospital during timeframe of interest
    
    Column 7 - Rate (per 1,000 discharges)
      Hospitals HAC rate  =(Numerator/Denominator)*(1,000)
    
    Column 8 - National number of eligible discharges
      Number of eligible discharges at all IPPS hospitals in nation during timeframe of interest**
    
    Column 9 - National HAC Count
      Number of HAC occurrences at all IPPS hospitals in nation during timeframe of interest
    
    Column 10 - National HAC rate (per 1,000 discharges)
      National HAC rate  =(National HAC count/National number of eligible discharges)*(1,000)
    
    ** For one measure, "Foreign object retained after surgery," the number of eligible discharges (denominator) for the hospital and national rates includes all surgical discharges.  For all other measures, the denominator includes all medical and surgical discharges.
    
    See www.qualitynet.org > Hospitals-Inpatient > Hospital-Acquired Conditions (HACs) for detailed measure specifications.

    Note that HACs are calculated based on the claims hospitals submit to CMS.  In rare cases, HAC counts and rates may be incorrect due to errors in these claims .  While CMS encourages hospitals to correct errors in claims, CMS is not always able to incorporate all such corrections into the data file used to calculate the HAC measures.
