Compliance & Ethics
Some employees may accept gratuities or kickbacks. True or false?
False
When should Discharge Planning begin in the resident's stay in the facility?
Upon admission.
When do we notify a resident/representative for a room transfer?
Prior to the room change.
What is trauma?
Results from an event, series of events or set of circumstances that is experienced by an individual that has lasting adverse effects.
When does PDPM become effective in our industry?
October 1, 2019
A resident made a previous request to not disclose their information to their kids. The resident is transferred to the acute hospital. Their daughter calls to ask what hospital their mother transferred to. How should the facility handle the question?
We will not disclose where the resident was transferred to.
IDT Discharge Planning Observation in Matrix is to be completed by?
Ideally within 48 hours from admission.
Can we continue billing MediCal for a bed-hold if a facility discovers that a resident was admitted to another SNF?
No.
What is the best thing to do first to care for residents who suffer from trauma?
Know your residents.
What does the acronym PDPM stand for?
Patient Driven Payment Model
Intentional violations of the False Claims Act, Anti-kickback Statue, and HIPAA laws may result in?
Fines and possible jail time.
Which departments can complete the Discharge Plan Care Plan and within what time-frame?
Social Services and Nursing. To be completed within 48-hours of admission.
Only residents who have MediCal will be put on a 7-day bed-hold. True or false?
False. Regardless of payer source, residents/representatives will be informed in writing of the bed-hold and return policy prior to transfers and therapeutic leaves.
Name at least two departments in your facility who should be highly involved in Trauma Informed Care.
Social Services, Activities, Nursing, Therapy, etc.
How many MDS Assessments are required for payment for PDPM?
1 - 5-day MDS
(Part A PPS Discharge MDS does not control payment and the IPA is optional)
If an employee is on the clock and is showing obvious signs of being high on an illegal substance, what should happen to the employee?
Termination.
How often should the discharge plan be re-reviewed?
At least quarterly and upon significant changes.
Who must be notified of a room change?
1) Resident
2) Resident Representative
3) Roommates
4) Roommates' representatives
There are 4 aspects for Trauma Informed Care. Name at least one of them.
Biological, Psychological, Spiritual, Social/Behavioral
How many components are calculated into the scoring for reimbursement Levels?
5
(PT, OT, SLP, Nursing, NTA)
How much is the fine for violating the Anti-kickback Statute?
$25,000
(plus jail time)
What is the definition of Discharge Planning?
(Must include all 3)
1) Identifying each resident's discharge goals and needs
2) Developing and implementing interventions to address them
3) Continuously evaluating them throughout the resident's stay to ensure a successful discharge
When is the Bed-hold Notification Form completed?
Upon admission AND upon transfer.
Just like with any particular resident, as clinicians, what do we need to do to properly care for residents who suffer from trauma?
Individualized, resident-centered care.
On the ICD-10 Mapping Excel File from CMS, what is the term for ICD/diagnosis that will not be paid/reimbursed?
Return to Provider