Ch. 6-Medicare Skilled Nursing Facility Services Payment System

Question 1

Case-mix group (CMG)

Answer 1

Classification system used in the Medicare Skilled Nursing Facility Services Payment System’s patient-driven payment model to group residents into groups based on clinical reason for stay and function level

Question 2

Patient-driven payment model (PDPM)

Answer 2

Reimbursement model that assigns residents to payment categories based on individual patient characteristics

Question 3

Skilled nursing facility (SNF)

Answer 3

Facility that is certified by Medicare to provide 24-hour skilled inpatient nursing care and rehabilitation services in addition to other medical services for short-term care

Question 4

Skilled nursing facility value-based purchasing program (SNF VBP)

Answer 4

Medicare value-based purchasing program that ties facility performance for established quality measures into the Skilled Nursing Facility Services Payment System

Question 5

Variable day adjustment