After a month of intermittent antibiotic use, the patient is admitted.

The relevant Hospital Value-Based Purchasing domain is the Safety domain, corresponding most closely to option D. CMS's FY 2026 Hospital VBP program maintains a Safety domain that includes healthcare-associated infection performance measures, including C. difficile infection. CMS's current VBP Safety dataset specifically identifies C. difficile among its healthcare-associated infection measures.

It is important to distinguish the domain from an individual measure. “Hospital-acquired infection” describes the type of quality measure, but the formal broader scoring domain is Safety. PSI 90 is also associated with patient safety measurement, but it is not the name of the overall VBP domain.

From a CDI standpoint, documentation accuracy matters because coded and quality-reporting data can influence organizational performance assessment. However, documentation of C. difficile alone does not automatically establish that an infection qualifies as a hospital-onset event for every quality program. Timing and the applicable measure specifications determine whether an individual episode enters a particular healthcare-associated infection metric.

Therefore, CDI professionals should accurately capture the infection and its clinical circumstances without attempting to classify an event as hospital acquired solely to influence quality scores.

CCDS Reference Topics: Hospital VBP; Safety domain; healthcare-associated infections; C. difficile; quality reporting.

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