Which reimbursement methodology is used in the snf

Question

Question 1: Which reimbursement methodology is used in the SNF services payment system?

Question 2: List the six components used in PDPM. Which components are case-mix adjusted?

Question 3: Regina is a resident at Community SNF. Her clinical reason for admission is major joint replacement. Her function score is 8. Use table 6.1 to determine the CMG and CMI for the PT component of PDPM.

Question 4: Rashaun is a resident at Memorial SNF. His nursing category is "condition requiring complex medical care." Rashaun has depression and his function score is 15. Use table 6.5 to determine the CMG and CMI for the nursing component of PDPM.

Question 5: How are PDPM components adjusted for residents that are living with HIV/AIDS?

Question 6: Why does the NTA variable day adjustment impact the first three days of the resident's admission?

Question 7: What services or supplies are included in the non-case-mix component?

Question 8: List the steps for SNF payment determination.

Question 9: Review example 6.2. Explain why there are three different total per diem rates for this admission.

Question 10: What percentage of the withhold does CMS pay back to providers in incentive payments under SNF VBP?