Failure to Rescue: Why Documentation, Risk Adjustment, and Quality Integrity Matter More Than Ever

CMS is transforming how hospitals are evaluated by replacing the traditional Patient Safety Indicator (PSI) Failure-to-Rescue measure with a new 30-day Risk-Standardized Failure-to-Rescue outcome measure. This change shifts the focus beyond identifying complications to evaluating whether hospitals successfully recognize, escalate, and manage those complications while accurately representing patient complexity through documentation and risk adjustment.

Many organizations are unaware that documentation integrity now plays a significant role in these outcomes. Failure-to-Rescue is no longer solely a quality metric—it has become a multidisciplinary responsibility involving CDI, coding, physician advisors, quality, case management, utilization review, and physician documentation.

This webinar will explain the new CMS methodology, how expected mortality is calculated using Elixhauser comorbidities and other risk-adjustment variables, and why incomplete documentation can artificially worsen hospital performance. Participants will learn how documentation affects observed versus expected mortality, how surgical complications are evaluated, and how organizations can proactively prepare for this evolving quality measure.

Rather than viewing Failure-to-Rescue as simply a mortality metric, attendees will understand it as a measure of documentation integrity, clinical escalation, patient complexity, and overall organizational performance.

Course Description

CMS is changing how hospitals are measured—and documentation has never mattered more.

Failure-to-Rescue is evolving from a traditional patient safety indicator into a sophisticated, risk-standardized quality outcome that evaluates a hospital's ability to recognize, manage, and successfully treat serious complications. But behind every quality score is the medical record.

Join nationally recognized CDI leader Penny Jefferson as she explains the new CMS methodology, the growing importance of risk adjustment and Elixhauser comorbidities, and why documentation integrity has become a critical driver of quality performance. Learn how CDI, coding, physician advisors, quality professionals, and providers can work together to ensure patient complexity is accurately represented while improving organizational performance in an increasingly transparent healthcare environment.