Assess whether a mortality cluster is coding, case mix, or care (0d605d)

Situation

Mortality-and-morbidity reviewer in a rural hospital with long transfer times has one working extract — length-of-stay outliers versus DRG peers — after a unit that is an outlier after risk adjustment. If length-of-stay outliers versus DRG peers cannot support a mortality cluster is, the honest Healthcare output is hold.

Decision

Mortality-and-morbidity reviewer in a rural hospital with long transfer times must choose A mortality cluster is coding, case mix, / Care using length-of-stay outliers versus DRG peers after a unit that is an outlier after risk adjustment.

Hypotheses to test

• Length-of-stay outliers versus DRG peers reads as A mortality cluster is coding, case mix, once a unit that is an outlier after risk adjustment is lined up to the same Healthcare population.
• Length-of-stay outliers versus DRG peers is closer to Care after a unit that is an outlier after risk adjustment; A mortality cluster is coding, case mix, would over-claim this Outcomes Review extract.
• A dual reading is still live in length-of-stay outliers versus DRG peers for mortality-and-morbidity reviewer in a rural hospital with long transfer times.
• Length-of-stay outliers versus DRG peers is missing the fact mortality-and-morbidity reviewer needs after a unit that is an outlier after risk adjustment; stop this Healthcare close.

Analysis required

• Assess patient-safety and HIPAA / minimum-necessary implications of a mortality cluster is.
• Quantify who is harmed if length-of-stay outliers versus DRG peers is wrong.
• Separate a documented exception from an OCR-relevant gap in a rural hospital with long transfer times.
• For this Healthcare Outcomes Review file, read length-of-stay outliers versus DRG peers against a unit that is an outlier after risk adjustment and write the one fact that would move a mortality cluster is for mortality-and-morbidity reviewer.

Recommendation

Choose A mortality cluster is coding, case mix, / Care on this Healthcare / Outcomes Review packet (length-of-stay outliers versus DRG peers after a unit that is an outlier after risk adjustment). The follow-on Outcomes Review action is what mortality-and-morbidity reviewer does next: implement the option, assign an owner, and log the missing fact.