PDGM
New for CMS 2020 patient-centered care and interdisciplinary team approach to home health care delivery.
What is the basis for the PDGM Model.
Every 30 days.
What is the payment period in PDGM.
Scheduler who rides a motorcycle.
Who is Donna Lee.
At SOC visit, what percentage is used to evaluate patients' functional ability in OASIS response in last 24 hours.
What is greater than 50% of the time on the day of the assessment.
‘Hazardous’ medications that could pose a health risk to healthcare workers.
What is USP-800.
Length of the Home Health certification period or episode of care.
What is 60 days.
Variable threshold between 2-6 visits.
What is the LUPA rate.
Patient ability to prepare, retrieve, and take all oral medications.
What is M2020 Management of Oral Medications question.
Ability in this OASIS question will impact numerous other responses eg. medications, transferring.
What is M1860 Ambulation.
Having the highest level of risk or consequence to the patient if not performed exactly each and every time. For example- Name and Date of Birth.
What are Red Rules.
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Process of connecting to Internet, go to Care Plan Task, visit pattern for the episode.
What is scheduling visits for PDGM.
Wounds, Musculoskeletal rehab, Neuro, Complex nursing, MMTA (Medication Management, Teaching, & Assessment)- other, Cardiovascular, surgical, Complex circulatory, Endocrine, GI/GU, Respiratory, Infectious disease, Behavioral health.
What are the 12 clinical grouping categories.
Data collection is optional and clinicians may enter an equal sign (=) for 19 OASIS questions.
What is the response to certain questions included in the OASIS Recertification.
Verbal assistance and safety taken into consideration for every question.
What are cues.
Lead the patient through a series of functional activities, real and/or simulated, observing for environmental barriers and the presence and use of assistive devices and adaptive equipment.
What is the OASIS Walk.
Found in thumbnail summary, alerts, and patient schedule for visits recommended.
What are visit count warnings.
Secondary diagnoses that can affect the Plan of Care in terms of services provided and time spent with patients that must be included.
What is Comorbidity adjustment. For example HF.
Consider when determining ability (hip or spinal precautions, weight bearing, wounds /dressings-no showering).
What are medical restrictions.
When questioning which functional response to choose.
What is starting from the bottom/lower functioning level.
At SOC if admission is questionable eg. sending to the hospital, homebound, or safety, who you gonna call?
Who are GHOST BUSTERS!
YOUR TEAM MANAGER!!!!!
Tells the story.
What is reasonable and necessary documentation.
OASIS questions that effect payment in PDGM.
What are Functional impairment and Risk for Hospitalization questions.
A question geared towards determining how at risk the patient is for hospitalization, so, you must check All items that apply.
What is M1033 Risk for Hospitalization.
Functional M questions are more global while GG questions are task specific. eg. M1820 Lower Body Dressing vs GG130 G Lower Body Dressing & GG130 H Putting on Footwear.
What are the DIFFERENCES between M and GG OASIS functional questions.
* DOUBLE JEOPARDY*
Three items that must match in the EMR and in the patients' home.
What are the Emergency Preparedness Plan, Medication List and My Treatment Plan.