[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-573312-105":53,"doc-detail-573312-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","pdpm-nursing-component-clinical-consultantquality-educator-slides","PDPM - Nursing Component - Clinical Consultant/Quality Educator Slides","","PDPM: Nursing Component material explains how the Patient Driven Payment Model moves from an intensity-driven payment approach to a characteristic-need driven model. It contrasts RUG-IV classification with PDPM, detailing how therapy and non-therapy nursing groupings affect billing. It specifies five case-mix adjusted components and the Nursing determinants of payment, then focuses on Section GG and Section G changes. Section GG functional score items and general coding tips for assessing usual performance during the first three admission days are provided.",{"@graph":63,"@context":122},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":11,"@type":70,"position":76},"https://docshare.wps.com/template/presentations/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/pdpm-nursing-component-clinical-consultantquality-educator-slides/573312/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/pdpm-nursing-component-clinical-consultantquality-educator-slides/573312.png","ImageObject",442,249,{"name":88,"@type":89},"Alexandar","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-18","2026-10-14",true,{"@type":98,"interactionType":99,"userInteractionCount":9},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114,118],{"name":105,"@type":106,"acceptedAnswer":107},"How does PDPM differ from the RUG-IV model for nursing payment classification?","Question",{"text":108,"@type":109},"PDPM shifts from an intensity-driven payment model to a characteristic-need driven model. It also modifies the nursing functional scoring approach compared with RUG-IV.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What are the five case-mix adjusted components in PDPM patient classification?",{"text":113,"@type":109},"PT, OT, SLP, Nursing, and NTA. Each uses different criteria, including functional scores for PT/OT and specific condition and impairment criteria for SLP, plus Nursing criteria aligned to RUG-IV.",{"name":115,"@type":106,"acceptedAnswer":116},"What timing and purpose does Section GG have for the Nursing component?",{"text":117,"@type":109},"Section GG determines the new nursing functional score used for payment, and it must be completed on the first 3 days of admission for all admissions.",{"name":119,"@type":106,"acceptedAnswer":120},"What general rules apply when coding Section GG usual performance?",{"text":121,"@type":109},"Assess and record usual performance during the assessment period, not the best or worst performance. If the resident does not attempt the activity and a helper does not complete it throughout the assessment period, code the appropriate reason an activity was not attempted.","https://schema.org",{"og:url":78,"og:type":124,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":126,"canonical":78},"index,follow",{"doc_id":128,"site_id":56},573312,1792359822,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":88,"user_avatar":133,"doc_module":9,"category_id":8,"category_name":11,"doc_title":59,"doc_description":61,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":9,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":139,"language":140,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":61,"update_tm":144,"read_time":145},962090768658,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","9/20/2019  \nPDPM: NURSING COMPONENT  \nCRYSTAL PLANK, BSN, RN, RAC-CT  \nClinical Consultant/Quality Educator MU MDS and Quality Research Team Sinclair School of Nursing  \nQIPMO  \nPDPM  \nTotal PDPM  \nRate  \n9/20/2019  \nRUG-IV VS PDPM  \nRUG-IV  \nClassifies residents into a therapy RUG based on therapy minutes and days. Non-therapy RUGs were based on certain resident characteristics. The resident’s RUG was either a therapy RUG or Non-therapy (Nursing) RUG.  \nTherapy RUGs are used to bill over 90% of Part A days  \nPDPM  \nMoves away from intensity driven model of payment to characteristic need driven model of payment.  \nUtilizes the same nursing classification structure as RUG-IV, except there are some modifications:  \nMDS 3.0 Section GG (Functional Score) and Functional groups decreased from 43 to 25.  \nRUG-IV  \nCLASSIFICATION  \nUnder the RUG-IV model, both patients would be classified into the same payment group because they received the same number of therapy minutes and received no extensive services, despite significant differences between them  \n9/20/2019  \n\n| | PDPM PATIENT CLASSIFICATION |  |  |\n| --- | --- | --- | --- |\n|  | Under PDPM, residents are classified into a group for each of the five case-mix adjusted components: PT, OT, SLP, Nursing and NTA\u003Cbr>Each component utilizes different criteria as the basis for patient classification: PT: Clinical Category & Functional Score\u003Cbr>OT: Clinical Category & Functional Score\u003Cbr>SLP: Presence of Acute Neurologic Condition, SLP-related Comorbidity or Cognition Impairment, Mechanically-altered Diet & Swallowing Disorder\u003Cbr>Nursing: Same characteristics as under RUG-IV\u003Cbr>NTA: NTA Comorbidity Score\u003Cbr>Non-Case Mix (fixed cost) based on geographic area and includes costs incurred regardless of resident characteristics. |  |  |\n|  | | |  |\n\nFor services furnished on or after October 1, 2019, the following classifiers under the Patient Driven Payment Model (PDPM):  \nThose nursing groups encompassed by the:   \nExtensive Services,  \nSpecial Care High,  \nSpecial Care Low,  \nClinically Complex nursing categories,  \nBehavioral Symptoms,  \nCognitive Performance,  \nReduced Physical Function  \n• PT and OT groups TA, TB, TC, TD, TE, TF, TG, TJ, TK, TN, TO, TP;  \n• SLP groups SA, SB, SC, SE, SF, SH, SI, SJ, SK, and SL;  \n• The NTA component’s uppermost (12+) comorbidity group. If a patient meets any of the four PDPM-related  \ncriteria above, the patient qualifies for the presumption.  \n9/20/2019  \n\n| DETERMINANTS OF PAYMENT IN PDPM FOR THE NURSING COMPONENT |  |\n| --- | --- |\n| Clinical information from the SNF stay Functional status\u003Cbr>Extensive services received Presence of depression\u003Cbr>Restorative nursing services received |  |\n| | |\n\nSECTION G AND SECTION GG  \nSection G  \nWill no longer determine the ADL component for payment.  \n(Bed Mobility, Eating,Toileting and Transfer)  \nSection GG  \nDetermines the new nursing functional score needed for the nursing component for payment.  \nThis section must be done on the first 3 days of admission for all admissions.  \n9/20/2019  \nSECTION GG FUNCTIONAL SCORE  \nSection GG items included in the Nursing Functional Score:  \nSection GG Item Functional Score Range  \n| GG0130A1‐ Self‐care: Eating | 0‐4 |\n| --- | --- |\n| GG0130C1‐ Self‐care: Toileting Hygiene | 0‐4 |\n| GG0170B1‐ Mobility: Sit to Lying | 0‐4\u003Cbr>(average of 2 items) |\n| GG0170C1‐ Mobility: Lying to Sitting on side of bed |  |\n| GG0170D1‐ Mobility: Sit to Stand | 0‐4\u003Cbr>(average of 3 items) |\n| GG0170E1‐ Mobility: Chair/bed‐to‐chair transfer |  |\n| GG0170F1‐ Mobility: Toilet Transfer |  |\n\n| DEFINITIONS OF SECTION GG FOR THE NURSING COMPONENT |\n| --- |\n| \u003Cbr>\u003Cbr>Self‐Care: Eating Self‐Care: Mobility: Sit to Mobility: Lying to Mobility: Sit to Mobility: Mobility: Toilet Toileting Lying Sitting on the the\u003Cbr>Side of the Bed Stand Chair/Bed to\u003Cbr>Chair Transfer Transfer The ability to use\u003Cbr>suitable utensils\u003Cbr>to bring food\u003Cbr>and/or liquids to\u003Cbr>the mouth and\u003Cbr>swallow food\u003Cbr>and/or liquid\u003Cb","cbCaieggGaVMUNbn","https://ap.wps.com/l/cbCaieggGaVMUNbn","pdf",1071164,26,"English","# PDPM Overview\n## RUG-IV vs PDPM Classification\n# PDPM Patient Classification Components\n## Component Criteria by PT/OT/SLP/Nursing/NTA\n# Nursing Component: Determinants of Payment\n# Section G and Section GG\n## Section GG Functional Score Timing\n## Section GG Items and Functional Score Ranges\n# Definitions for Nursing Component Activities\n# General Coding Tips for GG0130 and GG0170","[{\"question\":\"How does PDPM differ from the RUG-IV model for nursing payment classification?\",\"answer\":\"PDPM shifts from an intensity-driven payment model to a characteristic-need driven model. It also modifies the nursing functional scoring approach compared with RUG-IV.\"},{\"question\":\"What are the five case-mix adjusted components in PDPM patient classification?\",\"answer\":\"PT, OT, SLP, Nursing, and NTA. Each uses different criteria, including functional scores for PT/OT and specific condition and impairment criteria for SLP, plus Nursing criteria aligned to RUG-IV.\"},{\"question\":\"What timing and purpose does Section GG have for the Nursing component?\",\"answer\":\"Section GG determines the new nursing functional score used for payment, and it must be completed on the first 3 days of admission for all admissions.\"},{\"question\":\"What general rules apply when coding Section GG usual performance?\",\"answer\":\"Assess and record usual performance during the assessment period, not the best or worst performance. If the resident does not attempt the activity and a helper does not complete it throughout the assessment period, code the appropriate reason an activity was not attempted.\"}]","PDPM - Nursing Component - Clinical Consultant/Quality Educator Slides | PDF",1791936908,9]