CMS-10210 Population and Sampling

Hospital Reporting Initiative--Hospital Quality Measures (CMS-10210)

11. Population and Sampling_vFINAL(508)

OMB: 0938-1022

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Hospital Inpatient Quality Reporting Program
Population and Sampling
Please Note: A data collection tool available within the Hospital Quality Reporting system via
the Hospital Quality Reporting Secure Portal allows hospitals to complete and submit their
population and sampling data. This document is a representation of the text contained in the
population and sampling data form and is for reference purposes only.
IQR – SEPSIS
Severe Sepsis and Septic Shock
Sampling Frequency (Drop Down)
• Monthly
• Quarterly
• Not Sampled
• N/A submission not required
Population
All fields must be filled in if you have no data for a particular item you must put in “0.”

Medicare







0

Non-Medicare
Total

Total

0

0

0

0
0

Sampling
All fields must be filled in if you have no data for a particular item you must put in “0.”

Medicare







0

Non-Medicare
Total
Cancel

January 2023

Total

0

0
Save & Return

0

0
0

Hospital Inpatient Quality Reporting Program
Population and Sampling
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submit your documents, please contact the Inpatient Value, Incentives, and Quality Reporting Outreach and Education
Support Contractor at (844) 472-4477.

January 2023


File Typeapplication/pdf
File TitleHospital Inpatient Quality Reporting Program Population and Sampling
SubjectHospital, Inpatient Quality Reporting, Program, Population and Sampling
AuthorHSAG
File Modified2023-06-12
File Created2023-06-12

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