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Frequently Asked Questions

What Provider Care Settings do you have data for?

What is your data source?

We get our data from Medicare Part A claims data released by the Centers for Medicare & Medicaid Services (CMS)

How do you protect the claims data?

All reported data is reported in accordance with the CMS suppression policy.

What selection criteria can I use in the reports?

We offer the ability to filter by:

  1. State
  2. County
  3. Transfer From Location/Provider
  4. Transfer To Location/Provider
  5. Period
  6. Conditions (optional) – up to 3
  7. Report

What reports do you offer?

  1. Summary report
  2. Admit/Discharge report
  3. Case Mix Index (PDPM) report
    • (Currently SNF only)
  4. Episode Cost
    • Shows the amount paid by Medicare
  5. Length of Stay report
    • STACH – shows days through discharge
    • SNF – shows days through final claim
    • HHA and hospice – days of service with stay ended if no services within 30 days
  6. Readmission Rate report
    • Shows returns to an STCH within 30 days of transfer to location/provider
  7. Unit Cost report

How long of a reporting period can I select?

You can select a reporting period of up to 24 months

How do you decide what episodes are reported?

How do you identify conditions?

We use the diagnosis codes reported on admission claim at the Transfer To Location/Provider to identify a patients conditions.

What conditions can I select from?

  1. Acute Infections
  2. Acute Neurologic
  3. Cancer
  4. Cardiovascular and Coagulations
  5. Major Joint Replacement or Spinal Surgery
  6. Medical Management
  7. Non-Orthopedic Surgery
  8. Non-Surgical Orthopedic/Musculoskeletal
  9. Orthopedic Surgery – (Except Major Joint Replacement or Spinal Surgery
  10. Pulmonary

Note: patient data may be included in multiple condition areas

How do you determine readmission rates?

Number of readmissions to STACH setting within 30 days of admission to care setting divided by the total number of episodes at care setting

My 2019Q1 data doesn't look correct?

Claims data for patients that were admitted to SNFs in 2018 is not available or included in the 2019 data. The claims data for the STACH stay is available and included in the 2019 data. This may result in an understatement of average length of stay and episode cost for SNF services that ended in first quarter 2019.