No one in their right mind would argue with the need to measure the quality of care delivered in post-acute care. What is hard to understand is the quality measure development and deployment process. How can a facility be asked to collect the same construct (i.e. eating) on the same patient with two different data elements, using two different scales and two different risk-adjustment methodologies? Additionally, how can a “quality measure” that is identified for one venue of care then be required of facilities in another venue of care in order to meet a deadline, without regard to its applicability to patients in that venue of care or its representativeness of quality delivered by providing facilities in that venue of care? We understand and support the desire to measure in a standardized way! We believe there are common elements to a patient’s “need for assistance” in their restoration process that can, and should be measured in a standardized way!