IPA?
There is new physician documentation that changes the primary diagnosis and PT/OT clinical category.
What is yes?
Name the two questions on Section K that impact the speech component
What are Swallowing Disorders and Mechanically Altered Diet?
This common condition is worth 2 points and requires documentation of a current active diagnosis, a HgA1c lab result, or an active medication order on the MDS.
What is Diabetes Mellitus?
Nursing Function Score 11
Isolation for active COVID Infection/single room droplet isolation with all care and services provided in room
What is ES1?
What is no?
How to get points for cognitive deficit
What is BIMS of 12 points or less?
Total NTA points for a resident that has the diagnosis of DM II, epilepsy, morbid obesity and has a UTI w/MRSA.
What is 4 points?
A condition for which you could utilize incentive spirometry to go from Clinically complex to Special care high
What is Pneumonia?
COPD AND SHORTNESS OF BREATH WHILE LYING FLAT
PHQ2-9 SCORE 12
NURSING FUNCTION SCORE 16
What is CA2?
Resident completes the 14-day IV course.
What is No? Centers Medicare & Medicaid Services (CMS) does not require an "End of Service" assessment like old payment systems did. Completing an IPA after an intensive service ends would lower the PDPM tier and intentionally cut the facility's active daily rate early
Newly admitted trach resident, recently intubated resident or resident with oral thrush might have this complaint in section K
What is K0100D- complaints of pain with swallowing?
SThese three high-acuity treatments or conditions are each worth 5 points—the second-highest point tier in the NTA component.
What are Parenteral/IV Feeding (High Intensity), Intravenous Medication Post-Admission, and Ventilator/Respirator Care?
A resident has one venous ulcer and one stage 2 pressure injury. You need this to get into Special care low.
What is 2 or more treatments?
Nursing function score 14
BIMS 6
Two Qualifying Restorative Programs with both at least 6 days a week
What is BA2?
A resident with mild cardiac weakness is admitted. During the initial 5-day assessment, they are coded in Section GG as needing only supervision or limited assistance with bed mobility, transfers, and toileting. On Day 9, the resident suffers a severe urinary tract infection (UTI) leading to delirium and profound physical deconditioning. The resident becomes bedridden and now requires assistance of two staff members for all functional transfers and toileting
What is Yes? While therapy minutes do not drive PDPM, a significant drop in Section GG functional scores (meaning a reduction in independence) changes the case-mix index. Capturing this decline on the IPA ensures the facility is compensated for the heavy labor required by nursing and rehab
Resident chews on meat for a time and then spits it out. This is a potential s/s of what item is section K
What is K0100B-holding food in mouth/cheeks or residual food in mouth after meals?
Your resident has a diagnosis of morbid obesity w/BMI of 50 and has a CXR that show chronic atelectasis and chronic fibrocalcific lung changes. The resident states they are SOB while lying flat and they use a CPAP at night for OSA. You have the following NTA opportunities.
What is morbid obesity and chronic lung disease for 2 points?
A resident is admitted for standard orthopedic therapy after a knee replacement, mapping into the Clinical Conditions nursing tier. On Day 6, they develop a surgical site infection, and the physician orders post-admission IV antibiotics. This single medical intervention automatically upgrades their nursing component to this tier.
What is the Special Care High tier?
Dx Parkinson's disease is active
Nursing Function Score 12
PHQ2-9 = 0
What is PBC1?
A resident is admitted for short-term rehabilitation following a planned orthopedic surgery. After completion of review of the resident's status and inputting the information into the MDS, the Non-Therapy Ancillary (NTA) component had zero points. On Day 12, the resident develops severe shortness of breath, a high fever, and is diagnosed with acute bacterial pneumonia. The physician orders immediate IV antibiotics and continuous Oxygen Therapy. Nursing staff increase monitoring for respiratory distress.
What is yes?
A resident is admitted to your facility directly from the hospital following an acute ischemic stroke. They are alert and oriented with no swallowing issues, but the physician documents aphasia. Because of these specific acute neurologic factors, the resident qualifies for this specialized PDPM category tier.
What is the Acute Neurologic clinical category for SLP.
A resident has the diagnosis of osteomyelitis with a sensitivity report that shows an organism resistant to two different ABT classes. They have a feeding tube w/enteral feedings continuous, are on IV ABTs and toenails are thick, yellow and peeling and one toe is red, inflamed and painful to the touch. Your NTA opportunities are and total number of points.
What is osteomyelitis (1), MDRO (1), feeding tube (1), IV ABTs (5), other foot problem/foot infection(1)
A resident is admitted with a primary diagnosis of severe dehydration, mapping into the Clinical Conditions tier. During the look-back, they score a 13 on the PHQ-9 (depression screen), and Section GG calculations show a nursing functional score of 12. This is the exact 3-letter PDPM nursing code they will receive.
What is CDE2?
Returned from hospital yesterday
Nursing Function Score = 5
PHQ2-9 = 10
Received IV fluids for documented hydration purposes while in the hospital (2 days ago)
What is HDE2?