Tough Pill to Swallow
What BIMS score is considered cognitively impaired?
12 or under
What PHQ score indicates depression?
10 or higher.
How many NTA points are IV antibiotics?
5 NTA points
How many buildings in Bandera West are 5-star QM?
15 out of 16 Bandera West Buildings are at a 5-star QM!
How often should you meet for IDT Technical Meeting?
Daily!
What Does DAP stand for?
Differential Adjusted Payments
What do the initials "MDS" stand for?
Minimum Data Set
A patient is admitted with a clear liquid diet. Can we code as mechanical altered diet in section K of the MDS?
No, a clear liquid diet is not considered an "altered" diet. A liquid diet is not considered "altered" unless we need to change the consistency (i.e. thickening).
An 85-year-old patient was admitted s/p fall with rib fractures and a history of COPD. How many days would we need of the Nursing Respiratory Program to get the Special Care High Nursing Category?
Respiratory therapy for all 7 days of the MDS lookback. Each day must have a minimum of 15 minutes of treatment.
How many NTA points is an NA-NTA category group?
12+ NTA points
Which QM is now considered “hybrid”?
Antipsychotic Medications - Long stay
When must the Social Determinates of health be completed?
Within the 7-day ARD window
Which Medication type is being monitored by DAP?
Antipsychotic Medications
What does ARD stand for?
Assessment Reference Date
If a patient requires Hypodermoclysis or subcutaneous hydration, can we code this in section K - Parenteral/IV feeding?
Yes, we can code this as Parenteral/IV feeding if the patient needs it for hydration purposes.
A 64-year-old patient was admitted to your facility and requires dialysis. What nursing category would they be?
Special Care Low
What stage pressure ulcer gives 1 NTA point?
Stage 4 pressure ulcer
For the long stay measure - “Indwelling Urinary Catheter”, what are the 2 exclusion diagnoses for this QM?
Neurogenic Bladder coded on MDS- I1550
Obstructive Uropathy coded on MDS- I1650
When should the IDT GG be completed on a new admit?
Any time between days 1-3
AHCCCS will be increasing the Skilled Nursing DAP opportunity. What is the percentage change for 2027?
FY 2027 will increase from 2.0% to 2.25% for CYE 2027
How do we verify the patients name in the MDS for section A?
Compare with the Common Working File or what name is listed on the social security card.
A 76-year-old patient was admitted to your facility after a CVA. Speech therapy has evaluated them and noted “oral residue and unable to clear without cueing”. What question in section K0100 can we code this under?
B. Holding food in mouth/cheeks or residual food in mouth after meals
What is considered “surgical” wound care for the nursing case mix?
Surgical wound care may include any intervention for treating or protecting any type of surgical wound. Examples may include topical cleansing, wound irrigation, application of antimicrobial ointments, application of dressings of any type, suture/staple removal, and warm soaks or heat application.
Why don't the 8 NTA points for HIV don’t show up on the MDS?
How many days does a long stay fall with major injury stay on their QMs?
275 days
What days should the 5-day ARD be set?
Any time between days 1-8
What are 2 of the DAP measures that we monitor on our MDS score card?
Antipsychotic Medication Performance Measure and Depressive Symptoms Performance Measure
When should the initial cert be filled out?
Must be obtained at the time of admission or as soon as "reasonable and practicable," generally recommended within 72 hours.
A 52-year-old patient was admitted to your facility after a MVA s/p fractured jaw. Speech therapy has evaluated them and noted “bolus escape while eating and drinking”. What question in section K0100 can we code this under?
A. Loss of liquids/solids from mouth when eating or drinking
A 70-year-old patient was admitted on 5/1 with a UTI; she also has diabetes. The MD added a sliding scale insulin order on 5/2 and on 5/4 added a long-acting insulin in the evenings. What nursing category would they be?
Special Care High - Diabetes with both of the following: Insulin injections (N0350A) for all 7 days Insulin order changes on 2 or more days (N0350B)
What type of epilepsy gives 1 NTA point?
Intractable Epilepsy
For the short stay measure – “Percentage of Residents who were Re-hospitalized After a Nursing Home Admission”, what is the monitoring period following entry/discharge for this QM?
The number of nursing home stays where the resident had one or more unplanned inpatient admissions or one or more outpatient claims for an observation stay within 30 days of entry/reentry. This includes inpatient or observation stays occurring after discharge from the nursing home but within the 30-day timeframe.
Where can you find the “Expected DC Score Met” question on the Daily Skilled Technical Review Sheet?
SimpleLTC > Analytics > Clinical > Function Scores
Which DAP measure do we not track on the MDS Monthly Score Card?
Health Information Exchange Integration
Name 2 items that go against our QRP if dashed in section K?
Height, Weight, Nutritional Approaches: Parenteral/IV feeding, Nutritional Approaches: Feeding tube, Nutritional Approaches: Mechanically altered diet, Nutritional Approaches: Therapeutic diet
Name any 3 comorbidities that qualify as an SLP comorbidity.
ALS, Apraxia, Dysphagia, Laryngeal Cancer, Oral Cancers, Speech and Language Deficits, Aphasia, CVA, TIA, or Stroke, Hemiplegia or Hemiparesis, Traumatic Brain Injury, Tracheostomy Care While a Patient, Ventilator or Respirator While a Patient
A 28-year-old patient is admitted to your facility with IV antibiotics, who had IV hydration at the hospital the day before arriving to the facility. Their GG function score is 16. What nursing category would they be?
Clinically complex. If the patient's PDPM Nursing Function Score is 15 or 16, he or she classifies as Clinically Complex even if they meet the other special care high conditions.
A patient was admitted with diabetes, COPD, respiratory failure, and a BMI of 35. How many NTA points do they have?
6 NTA points. Diabetes is 2 NTA points. COPD is 2 NTA points. Respiratory failure is 1 NTA point. For a BMI of 35+ with a comorbidity, we should query the MD for a diagnosis of morbid obesity, this is 1 NTA point.
For the “Need for Help with ADL’s has Increased” long stay QM, what are the 4 late loss ADLS that affect this QM?
Late Loss ADL’s: Eating, Sit to Lying, Sit to Stand, and Toilet Transfer
List all IDT members who should attend the PDPM Daily Technical Meeting.
1. ED 2. DON 3. MDS 4. HIMS 5. DOR 6. BOM 7.CM/SS 8. Other Clinical Partner
What are the dates of the current DAP FY?
10/01/2025-09/30/2026
How many MDS’s did all of Bandera West transmit in the month of March?
4,156 MDS's were transmitted in March 2026 by Bandera West MDS Nurses.