The Standardized Readmission Ratio (SRR) for a dialysis facility is the ratio of the number of observed index discharges from acute care hospitals to that facility that resulted in an unplanned readmission to an acute care hospital within 4-30 days of discharge to the expected number of readmissions given the discharging hospitals and the characteristics of the patients and based on a national norm. Note that the measure is based on Medicare-covered dialysis patients.
Measure Specs
General Information
Numerator
Each facility’s observed number of hospital discharges that are followed by an unplanned hospital readmission within 4-30 days of discharge.
Denominator
The denominator for a given facility is the expected number of the observed index hospital discharges that result in an unplanned readmission in days 4-30 and that are not preceded by an unplanned or competing event. The expectation accounts for patient-level characteristics, including measures of patient comorbidities, and the discharging hospital, and is based on estimated readmission rates for an overall population norm that corresponds to an “average” facility.
Exclusions
Index Discharge Exclusions:
A live inpatient hospital discharge is excluded if any of the following hold:
• Associated with a stay of 365 days or longer
• It is against medical advice
• It Includes a primary diagnosis of cancer, mental health or rehabilitation
• It Includes revenue center codes indicating rehabilitation
• It occurs after a patient’s 12th hospital discharge in the calendar year
• It is from a PPS-exempt cancer hospital
• It is followed within 3 days by any hospitalization (at acute care, long-term care, rehabilitation, or psychiatric hospital or unit) or any other competing event (see S.5).
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