pdpm nta list

%%EOF You can see in the histogram that not only are there a lot fewer rural facilities, but they also appear to have lower average case-mix. Base rates are either rural or urban as determined by geographic location. These nurses are also trained to complete a full All Rights Reserved By Nursingcecentral 2022 |. The general method for calculation of any NTA category is as follows: Explain the impact of the variable per diem rate in the NTA component and how it impacts PDPM payment. Each component has its case mix index to determine the component rate. yid T[KaEev0D/wRDQhDB['QgDTBEB)2"xt"Xn2 QN[%=> FhzdBI^8/HD The map below shows every SNF in the US that accepted Medicare Part A patients in 2017. The functional scoring is based on residents performance in eating, oral hygiene, toileting hygiene, sit to lying, lying to sitting on side of bed, sit to stand, chair/bed-to-chair transfer, and toilet transfer assessed on the first three days of admission to the facility with the admission day counted as day 1. Specialties What Is a SANE Nurse? One can see from the table above that if comorbidities are missed, the facility could possibly miss out on reimbursement. Formulate a PDPM group to review the chart and come up with the residents primary or principal diagnosis and do the ICD-10 clinical category mapping. The general method for calculation of any NTA category is as follows: The Fiscal Year (FY) 2021 PDPM ICD-10-CM Mappings file includes the NTA Comorbidity to ICD-10-CM Mapping, which maps comorbidities in the NTA component captured in item I8000 to allowable ICD-10 codes. The MDS software programs such as PointClick Care, Matrix, Net Solutions, to name just a few, automatically calculate the PDPM rates once the MDS assessment is completed. CMS stated in the final rule for FY 2023 that they intend to take a more cautious approach to mitigate the potential negative impacts on the nursing home industry with this parity adjustment by spreading it across a two-year period. There is also the impact of the Variable Per Diem Adjustment Factor that is applied to the NTA Component. The resulting sum is the NTA comorbidity score, which is used to classify each resident into an NTA case-mix group. Yes, you can, just not in I0020B. This has been a key consideration in designing the various elements of the new model. .center {text-align: center;}, Foot Code, Except Diabetic Foot Ulcer Code, Once we have totaled the score from the table above, we use it to map to a case-mix group and case-mix index. CMS identified a list of 50 conditions and extensive services that were associated with increases in NTA costs. Share our insider knowledge and tips! With this component being paid at a 3x rate for 1st 3 days of . var divElement = document.getElementById('viz1528375166404'); var vizElement = divElement.getElementsByTagName('object')[0]; vizElement.style.width='100%';vizElement.style.height=(divElement.offsetWidth*0.75)+'px'; var scriptElement = document.createElement('script'); scriptElement.src = 'https://public.tableau.com/javascripts/api/viz_v1.js'; vizElement.parentNode.insertBefore(scriptElement, vizElement); Use the rate filter to show only the highest or lowest NTA rates. 18% of the Nursing adjustment factor is multiplied to the Nursing rate only patients with diagnosis of AIDS. b!+XQ{ +LgOIYe/Q6RVpYY_N/.~iMu1fY*eR}W_E[,7vrR!XSF};qZW&e"S5!CW}3GU|muc?_X`dcg7(zRU8k? Find toolkits, webinars, on-demand trainings, templates, and much more to meet the needs of your facility. The required MDS data would be entered in the sub-items listed below the item group identifier. (This isnt going to work well on mobile devices, FYI.). Luckily, code diving is a lot of fun, right? last. hWmo6+( But toward the end of January, reporter Maggie Flynn poked holes in the idea that ICD-10 mastery was a necessity. Also notice there are very few facilities with low NTA rates in the Appalachians. Intermittent Catheterization? In this post Im going to take a deeper look at it and calculate the average NTA payment by state and facility. Under PDPM, long-term care facilities will receive reimbursement based on services that each resident receives. The following ICD-10 codes qualify: 41 Body mass index (BMI) 40.0-44.9, adult, 42 Body mass index (BMI) 45.0-49.9, adult, 44 Body mass index (BMI) 60.0-69.9, adult, 45 Body mass index (BMI) 70 or greater, adult, 01 Morbid (severe) obesity due to excess calories, 2 Morbid (severe) obesity with alveolar hypoventilation, Cross-train. With the transition from Resource Utilization Group Version IV (, ) to the Patient-Driven Payment Model (PDPM) on October 1, 2019, the. The choice of PDPM diagnosis has become rocket science for MDS nurses as this gives more weight in the calculation of the PDPM rate for the facility. ;iHIBK = >N]Y}dZ}HvtZ04D8YV4r4Od^/NJ x/i"9WirMdy2d*{E^lEu}Jg t@C`[aNOGgg0?bd'r EVm@Av;*%f?Wp :1&[+cZhqhU;IKBU (By the way, we created a PDPM Calculator for you to experiment with and get a better understanding of how PDPM works. - Corrected typo in minimum point value thresholds used to ify patients into groups "NA" and "NB" under the NTA component. @.dFo8L.3.#V0 F6Qa)bJ3oR/-5F=8tJ7r8*o{ VFh6Em4~qLh8Km,nLjwjW'm,|w>cy?^UKqZ`TU$7h"M9D*;XYi@ YhZ|453}R;|/F>!KLd{mQ*z7-.r|T_]Y^]K42Ca1g_AVYJo1ox/,e*M'LM ThY^SC w{i0[y0j|[1;hfD$;qp4UgNurGg2gKE)dtA6g!kJ|wpl; INTRODUCTION. The decision to change the definition was because CMS believes that therapists, using their clinical judgment, will allow for more flexibility and that residents often benefit from the psychosocial aspects of group therapy. Reimbursement, LW Consulting, Inc.5925 Stevenson Avenue, Suite GHarrisburg, PA 17112, Ph:800-320-5401Local Ph: 717-233-6100Fx:717-233-4633. This NTA CMI is added to the other components to calculate the total reimbursement for the patient. Of importance to note is the condition of HIV/AIDS under the NTA component. endstream endobj 1695 0 obj <>stream Seek advice from experts, trainers and other MDS nurses when needed to clarify any areas in the MDS assessment or PDPM calculation. Below is the full listing of conditions and services used for NTA classification and the associated number of points for that comorbidity. Admittedly, thats a lot to look through. Other ancillary services include room and board, activity planning, housekeeping, laundry, and maintenance of fixtures/equipment. Admitted in the Skilled nursing facility (SNF) within a short time (generally 30 days) of leaving the hospital and require skilled services related to hospital stay. thead { The Non-Therapy Ancillaries (NTA) component of PDPM can significantly increase revenue depending on MDS and ICD-10 coding. These are: Physical Therapy (PT): 14 MDS items Occupational Therapy (OT): 14 MDS items Speech Language Pathology (SLP): 33 MDS items Nursing: 129 MDS items Non-Therapy Ancillary (NTA): 33 MDS items RUG-IV: Resource Utilization Groups version 4 The administration of IV fluids may qualify for the Parenteral/IV Feeding - High or Parenteral/IV Feeding - low NTA points. At the direction of the attending physician, a patient needs skilled care from and/or under the supervision of a skilled nursing or therapy staff daily. A good first resource is the PDPM NTA Comorbidity Mapping spreadsheet. These maps look significantly different from a lot of the others weve seen. !on!$ Q7ER}x;:lRcP%?9w_ mm ' Diligent review of the medical history and clinical record is essential. What do I need to know? and the grouper software will pick it up from I8000. Contact us now and sign up to receive our newsletters here. Updates the ICD-10 mapping used to classify patients under the PDPM framework. Refer to the PDPM Calculation Worksheet for more information. . startxref Lets breakdown the PDPM model to better understand how reimbursement is determined. There are two look back periods that must be met when coding conditions on the MDS: #1 Diagnosis Identification - Documented by the physician or physician extender within the last 60 days. Wound Care? endstream endobj 451 0 obj <>stream Suctioning? Documentation by the physician and nursing must also support the skilled nature of the codes that are recorded as NTA conditions. These groups and indices, combined with other components of the payment system, provide a total reimbursement process that 0000001865 00000 n For the NTA, an adjustment factor of 3.0 is applied to the total NTA CMI for days 1-3. Yes, I get that is bad. 0000277284 00000 n The FY 2022 SNF PPS Final Rule: Learn the Facts behind the headlines Part 2 ICD-10 Revisions and PDPM. 0000005276 00000 n Patient classification system where patients are grouped according to their care and resource needs. With several big changes ahead, the margin for error slim for most providers. The AHCA Patient Driven Payment Model (PDPM) Resource Center provides AHCA provider members with a suite of original content, tools, and training options and resources to assist providers in how to be successful in implementing the new Medicare Part A PDPM SNF PPS, effective October 2019. Condition/Extensive Service Source Points Aseptic Necrosis of Bone MDS Item I8000 1 Asthma COPD Chronic Lung Disease MDS Item I6200 2 Variable Per Diem Adjustment Factors and ScheduleNTA. Ill also compare urban versus rural facilities when it comes to NTA case-mix. I wish I could be in your training the 29th. Love what you read? The Ministry of Education (MoE), Government of India (GoI) has established the National Testing Agency (NTA) as an independent, autonomous, and self-sustained premier testing organization under the Societies Registration Act (1860) for conducting efficient, transparent, and international standardized tests in order to assess the competency of candidates for admission to premier . This button displays the currently selected search type. (PPS) based primarily on the type and intensity of therapy services provided to the patients regardless of their acuity, unique characteristics, specific needs, or goals. NTA Componenet NTA Component NTA Comorbidity Score NTA Case Mix Group CMI 12+ NA 3.25 9-11 NB 2.53 6-8 NC 1.85 3-5 ND 1.34 1-2 NE 0.96 0 NF 0.72 Presumption of Coverage Comorbidities Included in NTA Comorbidity Score and Assigned Points Condition/Extensive Service MDS Item Points HIV/AIDS SNF Claim ICD-10 B20 8 Parenteral IV Feeding: Level High They are assisted by certified nursing assistants (CNAs) and licensed staff assist them during medication administration ordered by the patients attending physician in the facility. Everyone I've talked to agrees the NTA payment is a good idea. 8cq1o22#|Bm1il,4iw&C|E^F+oq:>_|M\v+iTOigWJ:dCa$Qv_n/q|wCuukk+e';iJB2C &!Ar8c _~r The non-therapy ancillary (NTA) part of the patient driven payment model (PDPM) is considered by most people Ive talked to as being better than what were currently doing. If the Primary Diagnosis you listed in I0020B also happens to be a SLP Comorbidity qualifier from the SLP Comorbidity list, the grouper software will pick it up as a comorbidity from I8000. A} 2?d`aYW!3,8h|J/K\J:s&Ve>1|9WiixusVo\sGP8saBT!+(z$lYnAZZp@6Y1m`[ jKeMQ5i.7HCGIC1iGIc' SLP: NSG: NTA: This audit format form contains the MDS 3.0 items that drive payment for the Part A Medicare PDPM SNF-PPS payment. NTA has been separated as an independent component, and NTA classification is determined by the presence of certain conditions or the use of certain extensive services that were found to be correlated with increases in NTA costs for SNF patients. Given that CMS has released the distribution of case-mix groups for NTA for all skilled nursing facilities, we can calculate an average case-mix index for everyone. ! color: white; We earn 1 NTA point for second or third degree burn coded in M1040F. CMS 100-2 Chapter 8 Series Part I: Access to Medicare Part A Benefits In a SNF. or privately paid by the patient if he/she does not qualify under the Medi-Cal program. A year later, he falls and sustains a hip fracture. For the NTA component, the CMI is multiplied against the applicable per diem adjustment factor and is then applied to determine the case-mix adjusted payment associated with each of these payment components for each utilization day under PDPM. Ensure you have staff who are trained in ICD-10 coding. Yes, Im aware that if you dont look at every. hb```b``ia`e`ff@ a(meU=r%::@`uH@V01:000x1p`5`gy4AuG/Dg* ZF:&'[-@ >` t!R Often overlooked, Non-Therapy Ancillaries or NTAs will be more important than ever in PDPM. Hoo0#=)HU64*)T%DH!$swwb4fc|i]\/8gr? More than half of them come from I8000 and many of these have multiple qualifying ICD-10 diagnosis codes. Click the comorbidity and see the ICD-10 codes that are most likely to occur. Just 1 NTA point can have an average worth of anywhere from $18 to $55 per day. Overview In July 2018, CMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. Below is a summary of the determinants of payment and which section on the MDS assessment form they are derived from. Classroom Walkthrough Checklist Resource Center K 12 Resources Frontline Education April 18th, 2019 - Broken Arrow Public Schools a large urban suburban district with deep roots in the community serves more than 19 000 students Recognized as one of the top When RUG classification was used as the basis of reimbursement, all patients with different patient characteristics were classified in the same RUG level based on the volume and intensity of therapy services provided. Remember that after the 3 day interrupted stay he is considered a new admission for purposes of Part A PDPM. Stay tuned. This does not include conditions that are resolved. The Clinical Categories by Diagnosis mapping file only applies to the code listed in I0020B. This information is essential. You only need one SLP co-morbidity (either in one of those check boxes or listed in I8000) to meet that SLP co-morbidity qualifier. The table below shows how the sum of the NTA points converts to an NTA Case Mix Group and a corresponding NTA CMI. HU]o0}G?G< m*-$R5k'EC(K@!BE`;s 2I2,[fy@770&05 Bal[|# f1 `j[>,Uf[OrGUXore:qVKP2T(r`~F& +g80qjM8#)A{)@c}A,F^Ec{HN"!l!]_J3? hbspt.cta._relativeUrls=true;hbspt.cta.load(2297384, '30c35813-92d3-4fa1-bc3f-6b232de017b1', {"useNewLoader":"true","region":"na1"}); Topics: PDPM includes a new pay category, the non-therapy ancillary or NTA. Center for Medicare and Medicaid Services. The NTA looks at conditions and extensive services that are associated with significant increase in costs for a skilled nursing facility. Inappropriate Schizophrenia Diagnosis/Coding and Survey Citation Posting, Regulatory Reminders: Consolidated Billing Update 2023. The most up to date guidelines are available at. Points (1-8) are assigned to specific conditions. The Non-Therapy Ancillary Services (NTA) component is a total score of all listed conditions and/or extensive services that apply to the resident. 0000002280 00000 n Facilities that work to establish these best practices associated with the NTA component will increase revenue and see other benefits such as improved Quality Measures, reduced readmission rates, and improve skilled documentation. 1694 0 obj <>stream The FY 2022 SNF PPS Final Rule: Learn the Facts behind the headlines Part 2 ICD-10 Revisions and PDPM. To further understand the difference between long-term care facilities and skilled nursing/rehabilitation facilities, we will focus on the services they offer. Retrieved from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html, Center for Medicare and Medicaid Services. MDS 3.0 Section I Thats a lot of white space. 0000004207 00000 n If the 25% is exceeded, a non-fatal warning will appear on the final validation report during the MDS submission process. Its interesting to note that the data CMS provided, that I am using here, came from some assessments that we no longer will be doing. Comorbidities associated with higher increases in NTA costs are grouped into higher point tiers, while those that are associated with lower increases in NTA costs are grouped into lower point tiers. requires an analytical mind and financial knowledge to determine the highest allowable reimbursement for the facility. Some sources even noting companies are finding losses of $500 to just over $1500 due to missed diagnoses, of both malnutrition and obesity, throughout total admissions spans of residents 2. The patients functional score which is coded on Section GG of the MDS form is derived by assessing the patients usual self-performance in the ADL task areas during the first three days of facility stay. SNF PDPM Provider-Specific Impact File. Lastly, lets look a little more closely at rural versus urban. Identification of NTA conditions and services should start even before the SNF admission. Always be on the lookout for new updates which usually happen every year and usually effective by October 1 of each updated year. HUO0~^iq3N&@-0*Si$L9)-ziwg';q_}(Ak"CwKi "@~|iA`!c Try Now! PDPM HIPPS Coding Crosswalk In order to accommodate the new payment groups, the PDPM HIPPS algorithm is . Other codes can still be listed in I8000. The five CMGs then convert to a corresponding case mix index (CMI), which is a multiplier to the base rate for a particular CMG. Based on that, we can calculate the rate. Other specific items will be recorded in various parts of the MDS including Section K, M, N, and O. (2019). 0000001085 00000 n As under the previous RUGIV model, the presence of an AIDS diagnosis continues to be identified through the . "FE"u PsFO;416ib_z/[E>#~.G+Y6l|)31}Q50B}Wk?/1wo USIek~)zR*u:1\np2}HPs}@I#RM=e1JtJ22;3(TYt&8W1UN@ID7{V Z +MykUW? Request for labs, imaging studies and surgical reports whichever is applicable. (At this point, I can feel the cold stares from our MDS Experts. Inappropriate Schizophrenia Diagnosis/Coding and Survey Citation Posting, Regulatory Reminders: Consolidated Billing Update 2023, Osteomyelitis of vertebra, site unspecified, Other acute osteomyelitis, unspecified ankle and foot, Staphylococcal arthritis, unspecified knee, Other acute osteomyelitis, unspecified site, Pneumococcal arthritis, unspecified joint, Other chronic osteomyelitis, unspecified ankle and foot, Other acute osteomyelitis, unspecified tibia and fibula, Other chronic osteomyelitis, unspecified site, Direct infection of unspecified joint in infectious and parasitic diseases classified elsewhere, Staphylococcal arthritis, unspecified hip, Direct infection of unspecified knee in infectious and parasitic diseases classified elsewhere, Staphylococcal arthritis, unspecified shoulder, Other chronic osteomyelitis, unspecified tibia and fibula, Other acute osteomyelitis, unspecified femur, Direct infection of vertebrae in infectious and parasitic diseases classified elsewhere, Other chronic osteomyelitis, unspecified thigh, Direct infection of multiple joints in infectious and parasitic diseases classified elsewhere, Other acute osteomyelitis, multiple sites, Staphylococcal arthritis, unspecified ankle and foot, Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission, Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, Infection and inflammatory reaction due to unspecified internal joint prosthesis, initial encounter, Embolism due to internal orthopedic prosthetic devices, implants and grafts, initial encounter, Embolism due to vascular prosthetic devices, implants and grafts, initial encounter, Other mechanical complication of unspecified internal joint prosthesis, initial encounter, Dislocation of unspecified internal joint prosthesis, initial encounter, Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter, Infection and inflammatory reaction due to internal fixation device of unspecified site, initial encounter, Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter, Other mechanical complication of aortic (bifurcation) graft (replacement), initial encounter, Other mechanical complication of other internal orthopedic devices, implants and grafts, initial encounter, Breakdown (mechanical) of internal fixation device of unspecified bone of limb, initial encounter, Infection and inflammatory reaction due to cardiac valve prosthesis, initial encounter, Mechanical loosening of unspecified internal prosthetic joint, initial encounter, Broken internal joint prosthesis, unspecified site, initial encounter, Embolism due to genitourinary prosthetic devices, implants and grafts, initial encounter, Secondary esophageal varices without bleeding, Secondary esophageal varices with bleeding, Alcoholic cirrhosis of liver without ascites, Antineoplastic chemotherapy induced pancytopenia, Agranulocytosis secondary to cancer chemotherapy, Acute respiratory failure, unspecified whether with hypoxia or hypercapnia, Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia, Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia, Acute and chronic postprocedural respiratory failure, Acute pulmonary insufficiency following thoracic surgery, Acute and subacute infective endocarditis, Acute and subacute endocarditis, unspecified, Endocarditis and heart valve disorders in diseases classified elsewhere, Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus, Epilepsy, unspecified, intractable, with status epilepticus, Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus, Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus, Respiratory bronchiolitis interstitial lung disease, Respiratory disorders in diseases classified elsewhere, Other alveolar and parieto-alveolar conditions, Idiopathic interstitial pneumonia, not otherwise specified, Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema, Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema, Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema, Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema, Morbid (severe) obesity due to excess calories, Morbid (severe) obesity with alveolar hypoventilation, Body mass index (BMI) 70 or greater, adult, Ulcerative colitis, unspecified, without complications, Crohns disease, unspecified, without complications, Other ulcerative colitis without complications, Ulcerative (chronic) pancolitis without complications, Ulcerative (chronic) proctitis without complications, Crohns disease of small intestine without complications, Crohns disease of large intestine without complications, Idiopathic aseptic necrosis of unspecified femur, Idiopathic aseptic necrosis of unspecified bone, Idiopathic aseptic necrosis of bone, other site, Systemic lupus erythematosus, organ or system involvement unspecified, Ankylosing spondylitis of unspecified sites in spine, Wegeners granulomatosis without renal involvement, Polymyositis, organ involvement unspecified, Dermatopolymyositis, unspecified, organ involvement unspecified, Systemic involvement of connective tissue, unspecified, Unspecified inflammatory spondylopathy, site unspecified, Refractory anemia without ring sideroblasts, so stated, Other specified disorders involving the immune mechanism, not elsewhere classified, Disorder involving the immune mechanism, unspecified. Comorbidities are assigned points based on the cost in care associated with the condition or service, with points ranging from 1 to 8. They are assisted by certified nursing assistants (. Coding of these areas will affect the, Postpartum Preeclampsia Diagnosis and Management, Hyperemesis Gravidarum: More Than Just Morning Sickness. The more comorbidities a patient has, the more medications he or she probably requires. We know now that every diagnosis and condition counts. PDPM or Patient-Driven Payment Model is the new system, replacing the RUG-IV, for calculating reimbursement by Medicare in the skilled nursing setting. We earn 1 NTA point when Other Skin Problems (foot ulcers/lesions) is coded in MDS item M1040A (infection of the foot such as cellulitis or purulent drainage), M1040B (diabetic foot ulcer), or M1040C (other open lesion of foot). As a result, patients with AIDS are assigned the highest point value (8 points) of any condition or service for purposes of classification under the PDPMs NTA component, and they also receive a special 18% add-on to the nursing component of the payment. (difference of NE-NF and NA-NB). Remember this is using 2017 data so it assumes that providers make no adjustments which is not realistic. View D0AD3F24-D6BD-4273-B139-8FCA97487E6A.jpeg from NURSING MISC at St. Clair County Community College. Item I0020 and I0020B: Item I0020 (primary medical condition category that best describes the primary reason for admission lists several options. Either way, you must still also code the I0020B primary condition I0010 through I8000. These clinical categories are PT, OT, and SLP. With supportive documentation, it can be coded in I5600. xref Custodial care does not require the assistance of a licensed staff. Great info! And so, you will need to determine how your facility will obtain the initial Diagnosis Identification documentation by the ARD, because it is a "look back" period. Whats in it for me? View fullsize Le^#N"TaAKTt In summary, the NTA component is an important component to capture and reimburse the facility for costly medications and supplies that are needed to support patient characteristics. Section I of MDS 3.0 is reserved for Active Diagnoses and Item I8000 is you to enter up to 10 additional active diagnoses with corresponding ICD-10 codes. PATIENT DRIVEN PAYMENT MODEL |4 . (10 items fit). (2019) Fact Sheet: NTA Comorbidity Score https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/Downloads/PDPM_Fact_Sheet_NTAComorbidityScoring_v2_508.pdf, Center for Medicare and Medicaid Services. Group therapy now allows for as few as 2 residents and as many as 6 residents. These conditions, along with the number of points associated with the condition and how it is reported, can be found by downloading the CMS document titled Fact Sheet: NTA Comorbidity Score. The adjusted PT, OT, and NTA per diem rates are then added together with the unadjusted SLP and nursing component rates and the non-case-mix component, as is done under RUG-IV, to determine the full per diem rate for a given resident. Ive done that for urban and rural for every state. Five of the six are case-mix adjusted. oYyTQb`y{y;..nI^vY5[3?O%5;5E8_kT}m}02|E}}q4:>9=6 /W=.8,w,8m_?Y\Y\v &0,/}["JO=>?]"y;?P'WY4[;of}7gh.RF)# `,J Z5FXMM:&Dh,A*hJtiL."%oKt

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