CMS-10431 Oncology Cares Measures Paper Submission

PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program (CMS-10431)

PQ 2018-07-02 V1 Data Collection - Oncology Care Measures Paper Form

PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program

OMB: 0938-1175

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PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program

Clinical Process/Oncology Care Measures

Paper Submission for FY2021 and Subsequent Years



(NQF 0210) Proportion of Patients Who Died from Cancer Receiving Chemotherapy in the Last 14 Days of Life

Shape1 Q1 Q2 Q3 Q4

NUMERATOR

Shape2

Patients who died from cancer and received chemotherapy in the last 14 days of life.









Shape3 DENOMINATOR

Shape4

Patients who died from cancer.








(NQF 0215) Proportion of Patients Who Died from Cancer Not Admitted to Hospice

Shape5 Q1 Q2 Q3 Q4

Shape6

Proportion of patients not enrolled in hospice.

NUMERATOR



Shape7

Shape8

Patients who died from cancer.


DENOMINATOR















(NQF 0383) Oncology: Plan of Care for Pain – Medical Oncology and Radiation Oncology

Shape9 Q1 Q2 Q3 Q4

NUMERATOR

Shape10

Patient visits that included a documented plan of care to address pain.

Documented plan of care may include: use of opioids, nonopioids analgesics, psychological support, patient and/or family education, referral to a pain clinic, or reassessment of pain at an appropriate time interval.













Shape11 DENOMINATOR

Shape12

All selected surgical patients with a catheter in place postoperatively.







(*) indicates required for providers participating in the PPS-Exempt Cancer Hospital Quality Reporting Program.

* Facility Name:

* CEO Signature: * Date:

* CEO Email Address:

Complete and submit this form via email to: [email protected].

Following receipt of the request form, an email acknowledgement will be sent confirming the form has been received.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitlePCHQR Clinical Process/Oncology Care Measures
SubjectPCHQR Clinical Process/Oncology Care Measures
AuthorCMS
File Modified0000-00-00
File Created2021-01-15

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