{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:31Z","timestamp":1791352231975,"version":"4.3.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Centers for Medicare &amp; Medicaid Services recently introduced 2 clinical quality measures that intend, in part, to disincentivize hospital boarding: a patient safety concern that involves holding admitted patients in the emergency department while an inpatient bed is unavailable. The Age-Friendly Hospital Measure (AFHM), a structural measure, asks hospitals to attest to having protocols in place to reduce boarding for older patients. The Emergency Care Access and Timeliness (ECAT) measure, an intermediate outcome measure, will require hospitals to report on the proportion of boarded patients. Each measure was developed under a different parent quality reporting program\u20141 inpatient and 1 outpatient\u2014which has the unintended consequence of producing meaningful variation between the measures. We describe opportunities to standardize and synergize the AFHM and ECAT to capture the prevalence of boarding uniformly, prevent gamesmanship, and enhance their impact on hospital performance. In particular, we highlight the importance of stratifying ECAT by the older-adult patient population to complement AFHM and since older adults are uniquely vulnerable to boarding and its associated safety risks.<\/jats:p>","DOI":"10.1093\/haschl\/qxag226","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T11:43:55Z","timestamp":1787399035000},"source":"Crossref","is-referenced-by-count":0,"title":["Boarded patients, blurred benchmarks: an opportunity for CMS"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0069-1417","authenticated-orcid":false,"given":"Elyssa F L","family":"Grogan","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, NYU Grossman School of Medicine , New York, NY 10016 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Sifnugel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, NYU Grossman School of Medicine , New York, NY 10016 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8248-0567","authenticated-orcid":false,"given":"Arjun K","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yale School of Medicine , New Haven, CT 06519 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3715-3073","authenticated-orcid":false,"given":"Ula","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, NYU Grossman School of Medicine , New York, NY 10016 ,","place":["United States"]},{"name":"Geriatric Research, Education, and Clinical Center, James J. Peters VA Medical Center , Bronx, NY 10468 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"10","key":"2026100701013601700_qxag226-B1","doi-asserted-by":"publisher","DOI":"10.1093\/haschl\/qxaf187","article-title":"Stranded in the emergency department: an analysis of boarding trends in older adults in the United States","volume":"3","author":"Sifnugel","year":"2025","journal-title":"Health Aff Sch"},{"issue":"12","key":"2026100701013601700_qxag226-B2","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1001\/jamainternmed.2023.5961","article-title":"Overnight stay in the emergency department and mortality in older patients","volume":"183","author":"Roussel","year":"2023","journal-title":"JAMA Intern Med"},{"key":"2026100701013601700_qxag226-B3"},{"key":"2026100701013601700_qxag226-B4"},{"key":"2026100701013601700_qxag226-B5"},{"key":"2026100701013601700_qxag226-B6","author":"Centers for Medicare and Medicaid Services"},{"key":"2026100701013601700_qxag226-B7","author":"The Joint Commission"}],"container-title":["Health Affairs Scholar"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/advance-article-pdf\/doi\/10.1093\/haschl\/qxag226\/70783591\/qxag226.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article-pdf\/4\/9\/qxag226\/70783591\/qxag226.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article-pdf\/4\/9\/qxag226\/70783591\/qxag226.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:01:45Z","timestamp":1791349305000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article\/doi\/10.1093\/haschl\/qxag226\/8770276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":7,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/haschl\/qxag226","relation":{},"ISSN":["2976-5390"],"issn-type":[{"value":"2976-5390","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,25]]},"article-number":"qxag226"}}