Free Throw Fundamentals
PDPM is an acronym for this
Patient Driven Payment Model
Primary diagnosis selection impacts these PDPM components
PT, OT, and SLP
This interview impacts the Nursing component
PHQ-2 to 9 (depression)
This tool is used to collect resident data and calculate the PDPM score
Minimum Data Set (MDS)
Name the five case-mix adjusted PDPM components
PT, OT, SLP, Nursing, and NTA
PDPM replaced the RUG-IV model on this date
October 1, 2019
Coughing during meals/drinking, loss of food/fluids from mouth, and complaints of pain or difficulty swallowing are all signs of this
The resident's functional status is captured in this section of the MDS
GG
Accurate capture of PDPM qualifiers is solely the responsibility of the MDS Coordinator - true or false
False
This process is vital to PDPM success and is a non-negotiable
PDPM Huddle
Unlike RUG-IV, PDPM focuses on resident characteristics instead of this
Comorbidity identification impacts these PDPM components
SLP, Nursing, and NTA
To qualify for the nursing component, respiratory therapy must be received by the resident for this many days
7
To capture the respiratory therapy qualifier, documentation must include these 6 things
Evaluation which identifies a deficit or a pulmonary condition
MD order supporting necessity with end date and defined goals
Care Plan
at least 15 minutes over the day
pre and post lung evaluation
must occur daily for 7 days
Nursing function (GG) score of this will prevent a resident from qualifying for the extensive services, special care high and special care low categories in the Nursing component, even when clinical qualifiers are documented and captured
15-16
The PDPM score is calculated using this many case-mix adjusted components
Five (PT, OT, SLP, Nursing, and Non-Therapy Ancillary/NTA)
This interview impacts the SLP component
BIMS (cognition)
Diagnoses should be supported as active by documentation from these team members
Physician, nursing, rehab
Section GG (ADL) coding should be determined by IDT collaboration and must be supported by documentation in the medical record - true or false
True
Documentation of this condition with a diagnosis of COPD/chronic lung disease will qualify a resident for the Special Care High category in the Nursing component
Small misses in capture of appropriate qualifiers can add up to this
Significant underpayment for care and services provided
To capture IV feedings, documentation must include proof of administration and this
Support for hydration and/or nutrition need
Interviews should be completed during this timeframe to be captured on the MDS
On or prior to the ARD
Missing or inaccurate documentation can result in this
Lost reimbursement and missed identification of risk areas
Documentation of any of these 3 things will qualify a resident for the Extensive Services category in the Nursing component
Trach while a resident
Vent while a resident
Isolation while a resident