Pressure Injury Hospital Harm Reporting Requirements

The Centers for Medicare and Medicaid Services (CMS) is moving forward with regulations that will ultimately require hospitals to report the number of inpatient hospitalizations for patients aged 18 and older who suffer the harm of developing a new stage 2, stage 3, stage 4, deep tissue, or unstageable pressure injury from the point of entry to the hospital until discharge. The requirement, known as Hospital Harm – Pressure Injury (HH-PI), is a quality measure developed to provide electronic clinical quality measures (eCQMs) for pressure injury stages that impact patient care. This safety eCQM captures the number of patients who experience harm in the form of a pressure injury during their inpatient hospitalization. This measure is part of the Hospital Inpatient Quality Reporting (IQR) Program, which is a pay-for-reporting program that reduces payments to hospitals failing to meet the designated quality measures.

CMS has stated that this eCQM will fill a gap in measurement and provide incentives for hospitals’ quality improvement. Although several pressure injury measures are currently in use, there are no electronic health record (EHR)-based measures intended for use in acute care hospitals. In addition, the intent of this measure is to incentivize greater achievements in reducing harms and enhance hospital performance on patient safety outcomes. The measure defines a new stage 2, stage 3, stage 4, or unstageable pressure injury as found on exam greater than 24 hours after hospital arrival and was not present on admission. The measure defines a new deep tissue pressure injury (DTPI) as found on exam, greater than 72 hours after hospital arrival, and was not present on admission.

CMS has provided best practice guidance in the Clinical Recommendation Statement section of the measure listing.

This measure has been evolving over the last several years and is currently a voluntary program, but will likely become mandatory starting in 2027. Hospitals were originally required to report pressure injuries categorized as Stage 3, 4 Deep Tissue Injury and Unstageable. However, in 2025, hospitals are encouraged to voluntarily report Stage 2 pressure injuries. If your institution is currently not reporting this measure now is the time to start thinking how to start your compliance.

For additional information from the National Pressure Injury Advisory Panel (NPIAP), click here.

The WOCN Society will continue to follow the development of guidance for EQM Pressure injury.