What is PDPM code?

What is PDPM code?

Under PDPM, the HIPPS code is structured differently. In order to represent five components plus an AI in a five position code, the first position of the code represents both the Physical and Occupational Therapy case-mix group. The second position represents the Speech-Language Pathology case-mix group.

What is a good case mix score?

The average CMI of all 25 hospitals is 3.48, though CMIs range from 3.02 to 5.26. This is a shift up from the last reporting period, which ranged from 2.75 to 4.88. CMI does not appear to correlate to the number of annual discharges, with discharges from the top 10 hospitals ranging from 5,531 to 87 annually.

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What is a SNF Part A interrupted stay?

TRICARE follows Medicare requirements for skilled nursing facility (SNF) admissions. 1, 2019, TRICARE is adopting Medicare’s interrupted stay policy for SNF admissions. An interrupted SNF stay is one in where a patient is discharged from an SNF and subsequently readmitted to the same SNF within three days.

What is a Interrupted stay?

An interrupted stay is defined as a SNF stay in which a resident is discharged from SNF care and subsequently resumes SNF care in the same SNF for Medicare Part A covered stay during the interruption window.

When would a SNF Part A PPS discharge assessment not be required?

Under new PDPM rules and the interrupted stay policy, a SNF PPS Discharge would not be completed if the resident returned within the 3-day interruption window. The OBRA Discharge assessment would still be completed if the individual was admitted to the hospital or if the observation stay was >24 hours.

How do you do a bill interrupted stay?

To bill an interrupted stay, report the following on the UB-04: The “from” date is the original date of admission. The “through” date is the final date of discharge. Payable days are reported in the Covered Days field (value code 80).

What is occurrence span code 74?

Occurrence span code 74 — the from/through dates for a period at a non-covered level of care in an otherwise covered stay, excluding any period reported with occurrence span codes 76, 77, or 79. Codes 76 and 77 apply to most non-covered care.

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What is ARD in skilled nursing?

Assessment Reference Date: The Assessment Reference Date (ARD) is the date that signifies the end of the look back period. This date is used to base responses to all MDS coding items.

When should a death in facility tracking record be completed for a resident in a skilled nursing facility?

If a resident goes to the hospital and dies before being out of the facility > 24 hours which do you do, discharge tracking, discharge assessment, or death in facility record? If resident dies during an observation stay less than 24 hours, they are on a LOA and should do a death record.

When should the BIMS be completed?

Keep in mind the RAI manual states the BIMS and PHQ-9 interview is to be completed the day before or of the ARD. If these interviews are completed upon admission, they should not be used for an assessment with a later date.

What is the goal of restorative care?

Restorative care helps to prevent the complications of immobility. When providing restorative care the goal is to keep the client functioning at the highest level possible. This is done by promoting activity so the strength of the body muscles is not lost. It also helps to prevent dependence.

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What does RAI mean in nursing?

Resident Assessment Instrument Minimum Data Set Version 2.0

What is Interai?

interRAI is an international collaborative to improve the quality of life of vulnerable persons through a seamless comprehensive assessment system.

What is the RAI Cha assessment tool?

interRAI Community Health Assessment (CHA): The core comprehensive assessment tool for Community Support Services (CSS) assists the client and assessor to determine the most appropriate services and provides standardized, clinical information to inform decision making, planning, performance monitoring and quality of …

What is interRAI used for?

interRAI assessments are used by health organizations to assess people at the point of care, generating real-time electronic reports that flag risks and inform care planning.