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Please see attachment. Examining Resource Consumption (Level 4—Analyzing) In the Medicare Skilled Nursing Facility Services

February 22, 2025

Please see attachment.

Examining Resource Consumption (Level 4—Analyzing)

In the Medicare Skilled Nursing Facility Services Payment System, the case-mix index value represents the level of resource consumption, similar to the relative weight of MS-DRGs in the Medicare Hospital Acute Inpatient Services Payment System. Examine table 6.5 in the textbook. Using the questions below as a guide, analyze the connection between PDPM nursing elements and resource consumption.

Note:

A higher function score indicates that the resident is more independent (i.e., can perform tasks alone or with some help). A lower function score indicates the resident is dependent on assistance.

See second page

· Review the “Serious Medical Conditions I” rows in table 6.5. How does depression impact the case-mix index?

· Review the “Serious Medical Conditions II” rows in table 6.5. How does the function score impact the case-mix index?

· Review the “Conditions requiring Complex Medical Care” rows in table 6.5. How does the combination of depression and function score impact the case-mix index?

· Examine “Behavioral or Cognitive Symptoms” and “Assistance with Daily Living and General Supervision” rows in table 6.5. How does the use of restorative nursing impact case-mix index?

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