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Quality reporting form 2026

The document outlines the Measure Exception Form for the Inpatient Prospective Payment System (IPPS) Quality Reporting Programs by the Centers for Medicare & Medicaid Services (CMS). It details the requirements and procedures for hospitals to request exceptions for specific quality measures related to Perinatal Care, Emergency Department services, and Healthcare-Associated Infections. The form must be renewed annually and includes sections for hospitals to specify applicable quarters and provide facility contact information. Additionally, it emphasizes compliance with reporting standards and submission instructions.

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Click ‘Get Form’ to open the quality reporting form in our editor.
Begin by filling out the required fields marked with an asterisk (*). Start with the 'Facility Contact Information' section, entering your CMS Certification Number (CCN), Facility Name, and CEO/Designee details.
Next, specify the applicable quarter(s) for your Measure Exception request. Select from options provided for Perinatal Care, Emergency Department, and Surgical Procedures. Ensure you enter the correct Calendar Year.
For each measure exception, indicate if your hospital meets the criteria by checking the appropriate boxes and providing any necessary data regarding procedures performed.
Finally, review all entries for accuracy. Once completed, submit the form via email or secure fax as instructed at the bottom of the document.

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Who full form in quality assurance?

WHO quality assurance policy for the procurement of essential medicines and other health products. Geneva: World Health Organization; 2021.

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A quality reporting program, also known as a quality reporting system or quality reporting initiative, is a healthcare program that aims to measure and report on the quality of care provided by healthcare providers, facilities, or organizations.

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What are the 5 functions of quality assurance?

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