Starting with the CY2028 reporting period, CMS will require hospitals to report new Stage 2 pressure injuries for the first time. The measure is voluntary today, but most hospitals still catch pressure injuries through periodic manual skin checks — which means the injuries now coming into scope, Stage 2s, are exactly the ones most likely to slip through.
The CMS Hospital Harm – Pressure Injury measure (CMS0826v3) is an electronic clinical quality measure that tracks new Stage 2, Stage 3, Stage 4, unstageable, and deep tissue pressure injuries that develop more than 24 hours after hospital admission. Reporting is elective through the 2027 performance period and becomes mandatory starting January 1, 2028.
This post covers what the rule actually requires, why Stage 2 injuries are so easy to miss, and what hospitals can do now — before 2028 turns this into a compliance scramble.
Key takeaway: CMS will require hospitals to report Stage 2 and deeper pressure injuries starting in 2028 — but the measure is already being scored today, and reimbursement implications are expected to follow. Hospitals that wait until 2028 to build detection capability will be reporting on injuries they could have caught and prevented years earlier. Ambient vision AI platforms like VirtuSense's VSTOne offer continuous, contact-free monitoring that can flag at-risk patients well before manual checks would.
CMS0826v3 requires hospitals to electronically report new Stage 2 and deeper pressure injuries that develop during an inpatient stay. It's optional now, and becomes mandatory starting the 2028 reporting period.
The measure covers any pressure injury identified more than 24 hours after admission that is staged as Stage 2, Stage 3, Stage 4, unstageable, or deep tissue. Injuries a patient already had on arrival don't count — this is specifically about harm that occurs during the hospital stay. The National Pressure Injury Advisory Panel puts the current hospital-acquired pressure injury rate at roughly 8.4%, within an overall pressure injury prevalence of about 12.8% — a meaningful share of patients, and one CMS is now moving to track more closely.
For the full technical specification, see CMS's Hospital Harm – Pressure Injury measure page.
Stage 2 pressure injuries involve only partial-thickness skin loss, so they're frequently missed between scheduled turning and skin-check intervals.
Most hospitals rely on Braden Scale scoring plus periodic — often every-two-hour — manual skin checks. That process works only as well as staffing levels and consistency allow. On a busy unit, a two-hour check interval can stretch, and a Stage 2 injury can develop and progress in the gap. It's the same staffing-driven blind spot that shows up across patient safety programs: the risk isn't a lack of protocol, it's finding the nursing time to execute the protocol every single interval, every single shift.
Continuous, contact-free monitoring can flag prolonged immobility and repositioning gaps in real time, closing the window where Stage 2 injuries typically form.
Here's how the main approaches compare:
Wearables can help, but they only work while they're actually on the patient — and applying and maintaining them is one more task added to the nursing workload they're meant to reduce. Ambient vision AI removes that step entirely: there's nothing to put on the patient and nothing for staff to manage beyond responding to alerts.
VSTOne uses edge AI — LiDAR and computer vision that process video entirely on-device — to monitor patients continuously without pads, wearables, or physical contact. Because processing happens on the edge, no video ever leaves the room, which matters for both patient dignity and HIPAA compliance.
Emory Healthcare, which hosted a VSTOne breakout session at AONL 2026, has seen a 5.5x ROI using the platform, and Northwell Health has reported a 4x ROI. VSTOne is also one of the few ambient monitoring platforms built to cover both fall prevention and pressure injury risk in the same system, rather than requiring separate tools for each.
When does CMS require hospitals to report Stage 2 pressure injuries?
Reporting is voluntary through the 2027 performance period. Starting with the CY2028 reporting period, hospitals must report new Stage 2, Stage 3, Stage 4, unstageable, and deep tissue pressure injuries under CMS's Hospital Harm – Pressure Injury eCQM (CMS0826v3).
What counts as a hospital-acquired pressure injury under this measure?
Any new Stage 2 or deeper pressure injury identified more than 24 hours after inpatient admission. Injuries present on arrival are excluded.
How can hospitals prepare before the 2028 deadline?
Start capturing accurate Stage 2 data now, even while reporting is voluntary, and invest in monitoring that catches immobility risk earlier — for example, ambient vision AI platforms like VirtuSense's VSTOne, which continuously track patient movement without wearables or pads.
Does ambient AI monitoring replace nursing skin assessments?
No. It's a continuous layer that flags immobility and repositioning gaps between assessments; nurses still perform clinical skin checks. VSTOne is designed to reduce how often those gaps go unnoticed.
The 2028 mandate is a compliance deadline, but the real risk window is now. Hospitals that build detection capability today will report better numbers in 2028 — not scramble to catch up when reporting becomes mandatory.
See how VSTOne supports pressure injury and fall prevention in one platform → Request a demo
Related reading: How to Build a Hospital Pressure Injury Prevention Program