PDPM Case Mix
Groups / ICD10 coding
Groups / ICD10 coding
Best practice is to complete these within 48-72 hours
What are ICD-10 codes due for new admssions?
This a report used to identify changes in functional ability.
What is the ADL Significant Change Analysis - Section GG report?
This Long Stay MDS Quality Measure flag can be avoided with a diagnosis of Tourette Syndrome.
What is a Prevalence of Psychotropic Medication?
Evaluations will ONLY populate the MDS if done in this time frame.
What is during the appropriate look back window?
This Federal regulation is required after the completion of each transmitted assessment.
What are Care Plan Reviews?
This is a Special Care High qualifier that will be captured in a nursing order if the NSF score is <=14
What is COPD & SOB while lying flat?
This standard meeting is held weekly 2-3 weeks prior to an ARD.
What are Functional Rounds?
These are short stay MDS Quality Measures with a max score of 100 points
What are:
Residents newly receiving an Antipsychotic
Residents with new or worsened pressure ulcers/injuries
This is a type of document that is completed for all residents.
What is an evaluation?
This meeting is completed to get a baseline picture of a residents needs and goals.
What is a QOC/72hr meeting?
These are the ONLY diagnosis submitted to CMS.
What are active diagnosis (ICD-10) codes?
Not completing this item in Net Health will limit your ability to close timely.
What are GGs?
These are Long Stay MDS Quality Measures with a max score of 150 points
What are:
Residents whose need for help with ADLs has increased
Residents whose ability to walk Independently has worsened
Residents who receive an Antipsychotic
This evaluation is completed on days 1 & 2 to avoid credit for an in-house acquired wound.
What is the Skin Issue evaluation?
This team member, besides the resident, responsible party and provider, is required to be part of the development of the care plan.
What is a CNA?
This is an indicator greater than or equal to 10 in the PHQ 2-9.
What is the depression qualifier?
This information is brought by rehab to Functional Rounds.
What are Discharge Summaries?
These are the Functional Quality Measures that affect the 5 Star rating
What are ADL Function, Bathing/Toileting, Transfers and Mobility
This is the best time to review Scheduled and In Progress evaluations.
What is Morning Meeting?
This is a report used to identify triggered items from any MDS.
What is the Outcome Summary Report?
This letter is NOT used 99% of the time in ICD 10 coding.
What is the letter A?
These 4 IDT members are required for Functional Rounds.
NAC, Rehab rep, Unit manager or representative, and a CNA.
These are the specific late loss functional ADLs.
What are Eating, Toileting Hygiene, Sit to Lying, Lying to sitting on the side of the bed, Sit to Stand, Chair/bed-to-chair transfer, Toilet transfer
This evaluation must be completed collaboratively
What is the NAdv Functional Abilities evaluation?
This document must be completed within 48 hours of admission.
What is the Baseline Care plan?