CMS and Care Science (Premier QualityAdvisor) mortality risk models only include diagnoses that are Present On Admission (POA).
Document all diagnoses including possible/probable/likely/suspected diagnoses in your history and physical (H&P) so they are included in the mortality risk calculation.
Diagnoses that greatly increase the risk of mortality in Premier’s model include:
- Encounter for Palliative Care (Z51.5)
o Are you managing symptoms for your patient with a terminal
illness?
▪ Nausea, vomiting and/or pain control?
▪ Document it!
- Failure to Thrive
- Do Not Resuscitate/DNR
- Sepsis
- Malnutrition (mild, moderate or severe)
Providers may be queried to clarify if these conditions were POA. A response is important for risk calculation.
Download the complete tip, Mortality Metric Optimization.