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Another commenter expressed concern that less publicized extraordinary circumstances will not prompt CMS to issue an ECE without request, and that the process to submit an ECE request via the HQR portal, email, or secure fax may be unavailable if an emergency event severely disrupts operations for months

It also reversed corticosteroid-induced impairment of burn healing

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One commenter explained that these hospitals often have limited Safety of Care measures available for reporting, making the Safety of Care measure group heavily weighted in their Overall Hospital Quality Star Rating