Hospitals with less than 100 licensed beds are considered low volume. Low volume refers to the occasion when there is a small number of cases or a smaller denominator. Low volume could impact patient confidentiality and also limit the ability to reliably identify quality differences. Low volume is a frequent problem in performance measurement, especially when using measures based on rare occurrences such as Sentinel Events. For example, a single hospital may only have one death in a year. It would be difficult to ensure protection of patient confidentially in this instance.