Global Malnutrition Composite Score

The Global Malnutrition Composite Score electronic clinical quality measure (eCQM), stewarded by the Academy of Nutrition and Dietetics, assesses the percentage of hospitalizations of adults aged 65 years and older at the start of the inpatient encounter during the measurement period with a length of stay equal to or greater than 24 hours who received optimal malnutrition care where care performed was appropriate to the patient's level of malnutrition risk and severity.

The GMCS is the first nutrition-focused quality measure to be included in the Centers for Medicare and Medicaid (CMS) Hospital Inpatient Quality Reporting (IQR) Program in the FY 2025 Inpatient Prospective Payment System (IPPS) Final Rule. It also was endorsed by unanimous vote of the National Quality Forum (NQF) Consensus Standards Approval Committee (CSAC) in 2021. In August 2024, it was announced that the GMCS eCQM measure will be expanded to adults 18 and older beginning with the CY 2026 reporting period.

The GMCS incentivizes screening all older adults for malnutrition risk at hospital admission, utilizing registered dietitian nutritionists to assess those found to be malnourished and at risk for malnutrition, documenting diagnosed malnutrition, and developing a nutrition care plan with implementing intervention and treatment before discharge which then follows patients as they transition to the next point of care setting.

Resources:

• The GMCS FAQs answer questions for key stakeholders in topics such as general information, reporting on the GMCS, implementing MQii, and provides resources.
• The GMCS Specification Manual serves as a guide for practitioners to readily implement the malnutrition electronic clinical quality measures within their hospital systems. This manual provides an overview of the measures, specification of each measure including its rationale, available resources, and data element dictionary.
• "Measuring Malnutrition and Food Insecurity to Facilitate Quality Care and Health Equity" (Supplement to the October 2022 Journal of the Academy of Nutrition and Dietetics)

Specifications and Data Elements:

• Access and download an HTML file detailing the measure specification; XML files coded for hospital adoption into an electronic health record system; and an excel spreadsheet with corresponding informatics value sets. (Note: National Quality Forum #3592. Centers for Medicare & Medicaid Services Number CMS986v4.)