All Things PDPM
Major joint replacement/spinal surgery, other orthopedic, medical management, non-ortho surgery/acute neurologic.
What are the clinical categories under PDPM?
Acute neurologic condition, SLP related comorbidity, cognitive impairment, mechanically altered diet, and presence of a swallowing disorder.
What are the clinical categories under ST CMG?
Needs to be completed by Day 3 in order to capture GG items.
What is the POC?
Group and concurrent can only be provided for this amount of time for each discipline.
What is 25%
Primary Dx. of Metabolic Encephalopathy, Function Score of 8, Mech Soft Diet, BIMS of 13.
What is TNSE?
Section C, Section GG, and Section K.
What are the sections of the MDS that are therapy driven?
The total number of SLP case mix groups?
What is 12?
The number of CMGs for PT/OT?
What is 16?
The 3-day period starting with the calendar day of discharge and including the 2 immediately following calendar days, ending at midnight.
What is an Interrupted Stay?
Primary Dx - Total Knee Replacement (TKR), BIMS of 5, H/O CVA, Function Score of 15.
What is TCSG?
This optional assessment is completed when there is a significant clinical change in a patient's condition that may change the patient's initial PDPM classification.
What is the Interim Payment Assessment (IPA)?
Speech and Language Deficits, Oral Cancer, Laryngeal Cancer, Dysphagia, Apraxia, and ALS.
What are the SLP ICD-10 Comorbidity Crosswalk Categories?
The clinical category that has the highest case mix index?
What is Major Joint Replacement?
Restorative nursing program must by completed by this day in order to capture it as part of the PDPM
What is by day 3 of admission?
Primary Dx - CHF, Function Score of 3, BIMS of 10, c/o difficulty swallowing
What is TISE?
Principal medical diagnoses that cannot be used.
What are "return to provider" ICD-10 codes?
The 2 ST RNP program that supports the nursing CMI index under PDPM.
What are Swallowing and Communication?
These areas need to be treated daily in addition to additional functional deficits and underlying impairments.
What are the GG items for PT and OT?
This determines the amount of time per day that is appropriate for the patient for each discipline.
What are the underlying impairments and established goals on the POC?
Primary Dx - Right Ankle Fx, Function Score of 21, BIMs - 14, Mech Soft Diet, C/o pain with swallowing, residual pocketing.
What is TGSC?
This document was implemented to assist you as the DOR with managing skilled residents that fall under PDPM.
What is the Medicare Worksheet?
The CMG that has at least 2 out of 3 ST indicators and a mechanically altered diet.
What is SH?
The 10 Section GG items that determine the PT/OT function score.
What are eating, oral hygiene, toileting hygiene, sit to lying, lying to sitting on side of bed, sit to stand, chair/bed-to-chair transfer, toilet transfer, walk 50 feet with 2 turns, and walk 150 feet?
The 6 components of payment for PDPM.
What are PT, OT, ST, NTA, Nursing, and Non-Case Mix?
Primary Dx - CVA, BIMs of 6, NPO on admission but ST upgraded to pureed 2 days before ARD (day 8), c/o pain with swallowing, loss of foods/liquids and coughing/choking, Function Score of 5.
What is TMSL?