PDPM
QRP
VBP
Readmission | QMs
Kicks & Giggles & MDS Updates
100

What does PDPM stand for? 

Patient-Driven Patient Model

100

What does QRP stand for? 

Quality Reporting Program

100

What does VBP stand for?

Value-Based Purchasing

100

When do we not report Fall with Major injury on MDS? 

NEVER

100

Section GG - # of days of assessment window from ARD

What is 3 days based on ARD?

200

Cognitive Level = BIMS Score 0-7

What is severe impairment? 

200

November 15, 2025

What is the modification deadline?
200

True or False: The 2% withheld is returned to all facilities equally regardless of performance? 

False, dollars are redistributed based on performance

200

Cut-Point for 5 star

What is 1456?

200

True or False: During therapy, patient falls to the ground. This is NOT considered a fall. 

FALSE. It is CONSIDERED a fall as of Oct 1, 2025

300

Nursing Component Criteria = 

Pnemonia, Hemiplegia, Open lesions with any skin treatment or surgical wounds, burns, chemotherapy while a resident, oxygen therapy, transfusion, IV medication 

What is CLINICALLY COMPLEX?

300

Ensign's QRP Compliance passing percentage threshold

What is 92%?

300

True or False: VBP purchasing affects Medicare A Fee for services, Part C plans, or Medi-Cal Rates?

False: VBP only directly affects Medicare A

300

Number of days Falls with Major stays on

What is 275 days?

300

If unstageable on ADMISSION -> Later changes to another unstageable status 

still Present on Admission at new status 

400

 What is the difference between ES2 and ES3?

ES2 = Trach OR Vent/Respirator
ES3 = Trach AND Vent/Respirator

400

How many measures contribute on the SNF QRP Resident-Level Quality Measure (QM) Report ? 

400

True or False: For the SNF readmission measure, the 30 day window starts from admission to the SNF?

False, it starts from the prior hospital discharge date.

400

Flagstone Readmission Rate Goal

What is 14%?

400

Current version of MDS 3.0 RAI User's Manual

What is v1.20.1?

500

SLP CMG - Primary Diagnosis of Metabolic Encephalopathy, laryngeal cancer, BIMS score 12, presence of swallowing disorder and has mechanically altered diet. 

What is SI?

500

What does PBJ stand for?

Payroll-Based Journal

500

True or false : VBP can be below or above  depending on the facilities performance?

TRUE

500

What are the 4 late-loss ADLs for decline? 

1. Eating
2. Lying to Sitting
3. Sit to Stand
4. Toilet Transfer

500

Full names of Pacific Coast Market Lead and Clinical Market Lead

William Looper & Corona Moore

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