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  • Quality Reporting Center Measure Exception Form For Pc Ed & Hai Data Submission 2016

Get Quality Reporting Center Measure Exception Form For Pc Ed & Hai Data Submission 2016

N Form must be renewed at least annually. This Measure Exception Form may be used for the following measures: Perinatal Care (PC-01), Emergency Department (ED-1 and ED-2), and Healthcare-Associated Infection Surgical Site Infection (SSI), Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infection (CLABSI) . This form may be used by the following programs: Hospital Inpatient Quality Reporting (IQR), Hospital ValueBased Purchasing (VBP), and Hospital-Acquir.

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How to fill out the Quality Reporting Center Measure Exception Form For PC ED & HAI Data Submission online

This guide provides clear instructions on how to complete the Quality Reporting Center Measure Exception Form for PC, ED, and HAI data submission online. By following these steps, users can ensure a thorough and accurate completion of the form.

Follow the steps to successfully complete the Measure Exception Form.

  1. Press the ‘Get Form’ button to access the Measure Exception Form and open it for editing.
  2. Begin by filling out the 'IPPS Measure Exception Information' section. Select all applicable measures based on your facility's circumstances. Make sure to specify the correct calendar year and applicable quarter(s).
  3. For the Perinatal Care (PC-01) measure, indicate if the hospital has an obstetrics department and enter the required calendar year and selected quarters.
  4. For the Emergency Department measures (ED-1 and ED-2), indicate if the hospital provides emergency care and fill out the relevant timeframes.
  5. If applicable, complete the section for Specified Colon and Abdominal Hysterectomy Surgical Procedures, noting the procedures performed in the prior calendar year and requesting exclusions as necessary.
  6. Complete the sections for Catheter-Associated Urinary Tract Infection (CAUTI) and Central Line-Associated Bloodstream Infection (CLABSI) by confirming whether your hospital has the required facilities for these infections and detailing the appropriate year and quarters.
  7. Fill out the Facility Contact Information section, providing the CMS Certification Number, facility name, and contact details for the CEO or designee. All fields marked with an asterisk (*) are mandatory.
  8. Review the certification statement to ensure that all the information is accurate and that the facility meets the exception criteria.
  9. Once all sections are completed, you can proceed to submit the form. Save your changes, and choose to download, print, or share the document as needed. Ensure it is submitted via email, secure fax, or the designated portal.

Complete your Measure Exception Form online to ensure timely submission and compliance.

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Get Quality Reporting Center Measure Exception Form For PC ED & HAI Data Submission
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Quality Reporting Center Measure Exception Form For PC ED & HAI Data Submission
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