CMS Criteria
Under Chapter 8 guidelines, the number of times per week someone needs to receive skilled therapy services.
What is 5 times?
The maximum number of Medical Adjusters that can be selected.
What is 3?
The other name for the Front Page.
What is the Patient Care Plan (PCP) Page?
The section within the Engagement Tab where you document a confirmation of admission call.
What is Administrative Communications?
The decision date and time used when approving a review meeting Chapter 8 criteria for SNF.
What is the day/time completing the approval?
Medicare Advantage Plans are under which part of Medicare?
What is Part C?
The Usual Living Setting (ULS) selected when a member was living alone but plans to discharge home with their daughter.
What is Home Alone?
The button you click to create a new chevron.
What is "Begin Patient Transition?"
In the Discharge Planning tab, the Current Care Setting selected for all members you oversee.
What is SNF?
The authorization line status where the MD Review Form hyperlink is created (no decision has been made by the MD).
What is Pending?
The daily calorie requirement for enteral feeding to be skilled.
What is at least 26%?
The name of all 3 areas of the Predict Function.
What are Basic Mobility (BM), Daily Activities (DA), and Applied Cognition (AC)?
The number of times an Outcome Report should be generated.
What is 1?
The date of this section in Clinical Notes should match the Predict Function date.
What is Current Level of Function (CLOF)?
After completing the MD Review Form, the link that is clicked to notify the MD to review for a NOMNC.
What is TQ Task?
The number of hours of therapy per week to meet Chapter 1 criteria for Acute Inpatient Rehab (AIR)?
What is 15 hours/week?
The best score on the FCI for someone using an Assistive Device (AD).
What is 3?
Comorbidities are selected for this reimbursement type.
What is PDPM?
The tab used to document wound care progress.
What is the Medical Tab?
The folder clicked to generate a NOMNC form.
What is Create Patient Letters?
Home health services are found in this chapter.
What is Chapter 7?
The Severity Adjuster that we don't input because it's based on the member's Zip Code.
What is Social Determinants of Health (SDoH)?
Requests for additional clinicals can be made on the PCP page using either of these 2 methods.
What are Access and Email?
If a member meets Chapter 8 Guidelines on an Interim Review, the Free Text Narrative is selected in this tab.
What is Clinical Impression?
When the member has discharged from SNF, the status of the authorization page is changed to this.
What is Closed?