Question

Describe how the patient-driven payment model (PDPM) assigns residents to payment categories based on individual patient characteristics. Include at least three factors as evidence.

Answer 1

The PDPM assigns residents to payment categories based on individual patient characteristics, including clinical, functional, and cognitive factors.

Step-by-step explanation:

The Patient-Driven Payment Model (PDPM) assigns residents to payment categories based on individual patient characteristics. There are several factors that PDPM considers when assigning residents to payment categories:

1. Clinical characteristics: PDPM takes into account the resident's primary diagnosis, comorbidities, and the complexity of their medical conditions.
2. Functional characteristics: PDPM assesses the resident's ability to perform activities of daily living (ADLs) and mobility. This includes evaluating their independence in areas such as eating, bathing, and walking.
3. Cognitive characteristics: PDPM considers the resident's cognitive status, including their ability to understand and make decisions.

These factors help determine the appropriate payment category for each resident, ensuring that they receive the appropriate level of care and reimbursement.