PDPM
If resident has COPD w/HOB elevated and got IVF in Hospital when should you set your ARD.
You are fine to set it on day 8 since both of these will qualify you for a Special Care High (H) category.
When should information for GG be collected on a New admit vs a LTC resident?
New Admit- first 3 days of stay including day of admission.
LTC resident- Last 3 days of ARD which includes the ARD date.
What should you do prior to submitting your OBRA assessment.
Compare it to previous RUG.
Schizophrenia, Huntington's, Tourette's.
When should the baseline care plan be completed?
Within 72 hours of admission.
Where should you look for documentation r/t swallowing difficulties.
Nurses Notes, EMAR notes, and ST evals.
If a resident require 2 person assistance, how would you code this in section GG?
Dependent- 1
What letter in the HIPPS code is the nursing category?
3rd
What does obstructive uropathy mean?
Is when something is blocking the urinary stream such as BPH, bladder cancer, etc.?
When a resident switches Hospice companies what should you do if anything as far as MDS assessments.
You must complete another Significant Change.
Which chronic lung diseases do not automatically pull to section I of the MDS from your diagnosis list.
Chronic pulmonary HTN
Chronic Pulmonary edema
Pulmonary Fibrosis (must also be on list at bottom)
Interstitial Lung disease
What are the 4 late loss ADLs that effect payment and QMs?
Bed Mobility
Transfers
Toileting
Eating
What Nursing Category does Restorative count?
P- Reduced Physical Function
and
B- Behavior/Cognition
What documentation should you have to confirm an actual diagnosis of UTI?
McGreer Criteria (who is completing this at your facility)
If a admitted pressure ulcer worsens while at facility how should this be coded in section M?
This wound is now considered Acquired.
Where should you look for IPA opportunities.
24 hour report
Order listing report
MD notes
If a resident requires weight bearing assistance what level you would code in column 1 of section G?
Extensive assistance.
What should the PHQ-9 score be to get and end split of 2?
10
What is a fall with major injury?
Bone Fractures, joint dislocations, closed head injury with altered consciousness, or subdural hematomas.
To be considered skilled Nursing only vs Therapy only how many days must the skill include?
Nursing 7 days a week
Therapy is 5 days a week
What is the process for capturing residents with HIV (8 NTA points)
You cannot code on MDS, you must notify your biller of this diagnosis so that they can add to the UB.
How do you code an in use New G tube in GG vs an in use established G-tube if they are NPO?
New G-Tube- code as 88- Not attempted due to medical condition or safety concerns.
Established G-Tube- 9 Not Applicable
Nursing Category for IVF is expected to be a Special Care High (H) except in what situation?
When the Function Score is 15-16.
What are the 3 claims based QMs?
Rehospitalization
ER visit
Discharge to community
A resident admitted with an infected prosthetic and/or has and infection r/t indwelling foley. Adding these T Code DX will affect what part of your HIPPS CODE.
NTA