PDPM
Quality Measures
Compliance
Acronyms
100

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?

100

Long stay falls with major injury can trigger the QMs for this amount of time?

What is 1 year or 365days or 12 months?

100

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? 

100

A Score of 10 or above on this assessment type impacts the Nursing portion of PDPM reimbursement

What is PHQ9?

200

This assessment is used to determine if the resident has a cognitive impairment

What is the BIMS?

200

These 2 diagnoses are exclusions for Foley Catheters for Long Stay residents

What are neurogenic bladder and obstructive uropathy? 

200

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?

200

This score for PDPM is determined by the presence of comorbidities and/ or other extensive services

What is NTA?

300

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?

300

This common diagnosis will exclude an antipsychotic medication from triggering for the Long Stay antipsychotic measure

What is Schizophrenia? 

300

An admission MDS must be signed by this day of the residents stay?

What is day 14?

300

What does ARD stand for?

What is Assessment Reference Date?

400

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? 

400

Which single MDS item has the power to drop your 5‑Star rating overnight?

What is Falls with Major Injury

400

Resident interviews must be completed by this date? 

What is the ARD?

400

This process was created to assess whether providers are proactive in identifying and reconciling potential clinically significant medications issues

What is DRR?

500

Under PDPM, how many payment components are used for each resident?

What is Six total components? 

  • PT, OT, SLP, NURSING, NTA, NON-CASE MIX
500

A resident must remain in the facility for this number of days before triggering for Long Stay quality measures 

What is 101 days? 

500

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? 

500

What does PDPM stand for?

What is Patient‑Driven Payment Model?

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