ADL's
The percentage of Medicaid RUGs impacted by the ADL score
What is 100%?
The three End Splits that can impact your Medicaid CMI
What are ADL's, Depression, and Restorative Nursing?
The number of minutes per day nebulizer treatments have to be given all 7 days to qualify for a RUG
What is 15 minutes per day?
Mrs. Green has Dx Schizophrenia and exhibited hallucinations one time during 7 day look back period. Her ADL score is 0. She does not receive any restorative nursing programs
What is BA1?
Which RUG has a higher weight - BB1 or BB2?
What is BB2 - 2 Restorative Nursing programs
The four late loss ADL's that impact the RUG score
What are bed mobility, eating, transfers, and toileting?
This PHQ-9 score results in capturing the Depression end split for qualifying categories
What is 10 or greater?
Fever is this number of degrees above baseline per RAI guidelines
What is 2.4 degrees above baseline?
Mr. Smith receives hemodialysis 3 times a week with an ADL score of 2. Her PHQ-9 score is 0
What is LB1?
Which RUG has a higher weight - HE1 or HE2
What is HE2 - Depression End split - PHQ-9 10 or greater
The minimum ADL score to group into the Extensive Services category for RUG IV (OH, IN, VA, and MD)
What is 2?
The number of restorative programs provided 6-7 days/week 15 minutes total per day required to capture this end split for qualifying categories
What is 2?
5 diagnosis qualifiers (must have minimum ADL score) that will qualify to group into a high nursing category
What are Cerebral Palsy, Multiple Sclerosis, Quadriplegia, Hemiplegia, and Parkinsons
Parkinsons will not qualify under RUG III (PA and WV)
Mrs. Jones has Dx Asthma. She tells the nursing assistant not to crank her head down because she breathes easier upright. ADL score is 6. Her PHQ-9 score is 11
What is HC2?
True or False - HE2 has a higher weight than any rehab RUG
What is True - Therapy isn't always the highest burden of care
This late loss ADL is scored differently than the others
What is Eating - only one episode of assistance (limited, extensive, or total) during a 7 day look back period results in an ADL score of 2 for eating alone
Categories that are impacted by 2 Restorative Nursing Programs delivered 6-7 days/week at least 15 minutes per day
What are Behavior Problems/Impaired Cognition and Reduced Physical Function categories?
When paired with fever, these clinical qualifiers will increase RUG score
What are pneumonia, weight loss, vomiting, and tube feeding
Dehydration is also included under RUG III (PA and WV)
The minimum number of therapy minutes per week required to group into a therapy category if 2 restorative nursing programs are received 6 days/week 15 minutes per day
What is 45 minutes/week? Must be delivered at least 3 days of 7
Which has a higher RUG if ADL score is 2 and PHQ-9 score is 10
Rehab
or
COPD Dx with Shortness of Breath while lying flat
What is COPD with SOB while lying flat?
The least document opportunity to impact the Eating ADL score?
What is documentation of hydration during the night shift - must document in POC under eating prn task
These restorative nursing programs when delivered together 6-7 days/week at least 15 minutes per day will only count as one program
What are:
Active ROM and Passive ROM
and
Bed mobility and Walking
To code this on the MDS< you must have this Dx and one of the following symptoms:
1) Documentation of presence of
2) Observation of
3) Resident report of
4) Avoidance of
What is Dx COPD with shortness of breath while lying flat
Mrs. Reynolds has a trach with an ADL score of 1
What is CA1?
Which RUG has higher weight - PD1 or LC1
What is PD1?