Quality Measures
Which diagnosis are exclusions for catheter left in bladder?
Neurogenic bladder, obstructive uropathy
Which days of a medicare stay have an NTA adjustment factor of 3?
Days 1-3
How often should CMI estimator be updated?
As often as possible, at minimum weekly
If Respiratory therapy services were provided over the last 7 days as follows , Sunday thru Thursday for 10 minutes each day ..how do you code O0400D1and O0400D 2 ?
O0400D1=50 and O0400D2 equals 0
In order to qualify for the cog imp category a dementia dx must be confirmed in the chart (TRUE FALSE?)
FALSE
Which diagnosis are exclusions for residents receiving antipsychotic medications?
Schizophrenia, Tourette’s, Huntington’s
Does a higher GG score indicate more dependence or independence?
Independence
What is case mix a measure of?
Resident acuity
TRUE OR FALSE : a resident self administers a neb tx daily for 7 days and fifteen minutes per day without the supervision of a resp therapist or nurse , this will qualify as resp therapy in section O
FALSE
what are the 5 clinical categories ?
major joint replacement ,other orthopedic,medical management, non orthopedic , acute neurologic
What is the criteria for coding a UTI excluding hospital diagnosis?
Evidenced based criteria and physician diagnosis of UTI in last 30 days
How is HIV included in medicare reimbursement?
diagnosis on UB Claim
What factors compose case mix score?
Therapy, clinical acuity, ADL, depression
Name 2 areas of Respiratory therapy services other than IS and Neb tx:
answers :coughing, deep breathing, assessing breath sounds, cupping, clapping
What are the 2 criteria that determines which case mix groups the resident will classify into for the pt/ot component?
clinical category and function score
What Section G self performance ADL’s are measured in improvement in function?
Transfers, walk in corridor, locomotion on unit
What are the 5 SLP components?
Acute neuro clinical classification, SLP comorbidities, cognitive impairment, mechanically altered diet, presence of swallowing disorder
For TN CMI, how is a resident determined to be Medicaid for CMI?
Not a Medicare 5 day and MDS A0700 with Medicaid or Medicaid pending
Name the pulmonary diagnosis that can be coded in section I6200
A. COPD
B. Emphysema
C. Chronic bronchitis
D. Asthma
E. Bronchiectasis
F. All the above
G. A, B, C and D
F. All the above -answer
how many available co morbidities are there that impact cmi?
50
Which short stay quality measure utilizes SNF QRP calculations?
% of patients with new or worsening pressure ulcers
Besides the non-casemix base rate, which components do NOT have a variable per diem adjustment factor?
SLP, Nursing
For TN CMI, what therapy factor impacts CMI the most? ANd what is if it was for NY CMI?
TN: LOS
NY: RUG/Intensity
Name all the ICD-10 codes you would exclude from J99 Respiratory disorder in disease classification.
A. ankylosing spondylitis (M45)
B. cystic fibrosis with pulmonary manifestations (E84.0)
C. restrictive lung disease due to kyphoscoliosis (J98)
D. morbid Obesity (E66.01)
E. A and D answer
F. A and B
G. A , C and D
E. A and D answer
true or false the higher the number of co morbidities the lower the rate
false