Question

For the five PDPM components that are adjusted for resident characteristics, the CMG assigned for the resident has an associated ______ that is a proxy for resource intensity.

Answer 1

The Case-Mix Group (CMG) assigned to a resident under the PDPM has an associated case-mix index (CMI) which serves as a measure of the resources required to care for them.

Step-by-step explanation:

For the five Patient-Driven Payment Model (PDPM) components that are adjusted for resident characteristics, the Case-Mix Group (CMG) assigned for the resident has an associated case-mix index (CMI) that is a proxy for resource intensity. The PDPM is a classification system utilized by Medicare to categorize skilled nursing facility residents for the purpose of reimbursement. Each of the five components (Physical Therapy, Occupational Therapy, Speech-Language Pathology, Nursing, and Non-Therapy Ancillaries) utilizes resident data to assign a CMG based upon various factors including clinical diagnosis, functional status, and service needs. The respective CMI for each CMG is reflective of the relative amount of resources needed to care for residents with similar attributes.