PDPM
This section of the MDS is used to determine the resident’s Function Score. This score impacts the PT/OT and Nursing categories of PDPM
What is Section GG?
Long stay falls trigger on QMs for this amount of time?
What is 275 days?
To bill under traditional fee-for-service Medicare Part A, skilled nursing facilities (SNFs) must obtain this from the physician
What is Medicare Part A Certification?
A Score of 10 or above on this assessment type impacts the Nursing portion of PDPM reimbursement
What is PHQ9?
This assessment is used to determine if the resident has a cognitive impairment
What is the BIMS?
These 2 diagnoses are exclusions for Foley Catheters for Long Stay residents
What are neurogenic bladder and obstructive uropathy?
When a resident no longer requires skilled services and will be discharging home, this form must be given to the resident?
What is a NOMNC?
This score for PDPM is determined by the presence of comorbidities and/ or other extensive services
What is NTA?
Patients with this diagnosis are assigned the highest point value (8 points) of any condition or service under the NTA component, and they also receive a special 18% add-on to the nursing component of the payment.
What is HIV?
This common diagnosis will exclude an antipsychotic medication from triggering for the Long Stay antipsychotic measure
What is Schizophrenia?
An admission MDS must be signed by this day of the residents stay?
What is day 14?
This program awards skilled nursing facilities with incentive payments based on the quality of care they provide to Medicare beneficiaries, as measured by performance on a measure of hospital readmissions.
What is SNF QRP?
When a resident has a low BMI, on supplements, failure to thrive, or any condition that impacts over nourishment, we want to look for:
What is Malnutrition?
In order to code a UTI on the MDS, this set of Criteria must be met
What is McGeer's Criteria
Resident interviews must be completed by this date?
What is the ARD?
This process was created to assess whether providers are proactive in identifying and reconciling potential clinically significant medications issues
What is DRR?
Under PDPM, an adjustment is applied to certain PDPM components that varies the per diem payment over the course of the stay.
What is Variable Per Diem Adjustment?
A resident must remain in the facility for this number of days before triggering for Long Stay quality measures
What is 101 days?
The Baseline Care Plan (BCP) must be developed and implemented within ___ hours of admission and needs to include the necessary healthcare information to properly care for the resident immediately upon admission
What is 48 hours?
This was established under the Improving Medicare Post Acute Care Transformation Act of 2014, which requires the Secretary to publicly report quality measures that relate to the care provided by SNFs across the country
What is SNF QRP?