This is my understanding on the PC-05 originally they wanted to know how many babies left the facility who were exclusively breastfeed. The denominator was how many babies that were born and the numerator was 'of those born how many left exclusively breastfed'. Joint Commission had a very small list of babies who would not be included in the denominator. 

Then, it appeared there was some 'talk/response' directed toward Joint Commission because facilities assumed in order to get their numbers as high as joint commission wanted then they needed to be 'forcing' mothers who did not want to breastfeed to breastfeed just so that hospital could get 'higher numbers".

As a result of that backlash Joint Commission added in PC-05a - considering a mother's choice. They still want the original numerator and denominator but they also want a second set of numbers. For this set the hospital is allowed to remove all mothers who 'chose not to breastfeed originally' from the denominator. By doing this the hospital should have  higher values. 

Joint Commission does not provide 'verbiage' on how the hospital will collect the information. 

So it does not matter how your hospital chooses to word their question. At admission a 'soon to be mother' needs to be asked about her preference for breastfeeding. Does she have plans to: 1) Exclusively breastfeed   2) Provide breastmilk and formula  3) Exclusively formula feed.   

At discharge this babies record will be looked at and for PC-05 it doesn't matter what mothers feeding preference was. For PC-05a if mother stated that she wanted to exclusively formula feed then her child would have been eliminated from that data set.  

I hope this helps. I had a really hard time trying to figure this out in the beginning as well. There are great resources available: 
http://www.usbreastfeeding.org/Portals/0/Publications/Implementing-TJC-Measure-EBMF-2013-USBC.pdf

http://www.usbreastfeeding.org/HealthCare/HospitalMaternityCenterPractices/ToolkitImplementingTJCCoreMeasure/tabid/184/Default.aspx

http://www.jointcommission.org/assets/1/6/S11.pdf

http://www.jointcommission.org/assets/1/6/S7_TS_V11_N7.pdf

Your hospital has an outside representative who collects this data. This person is a great resources because they can show you what they look at and how they are collecting the data. 

You can email joint commissions as well

Jessica Callahan RN, IBCLC
NC, USA

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