HIT 230 Exam Questions AND Correct Answers
______________________________ is the most commonly used measure of
independence, and, because of its reliability and validity, it has been
incorporated into the IRF-PAI. - ✔✔The Functional Independence Measure or
FIM®
60 percent rule - ✔✔One of the criteria to define a hospital as an IP Rehab
Facility (IRF). Requires that at least 60 percent of the patients treated have at
least one of 13 qualifying medical conditions
A hospital that meets the CMS criteria to be classified as an inpatient
rehabilitation facility is not reimbursed through the MS-DRG system under the
acute inpatient prospective payment system, but, instead, under
_____________________________. - ✔✔the inpatient rehabilitation facility
prospective payment system (IRF PPS)
acute rehabilitation unit - ✔✔a designated unit in a hospital to watch patients
can be transferred for rehabilitation after treatment for the original acute illness
or injury; length of stay in these units is typically 2 to 4 weeks
Although quality measures can be used to compare quality at different inpatient
rehabilitation facilities, there are no reimbursement implications for QRP data. -
✔✔False. (IRFs that fail to report quality data are subject to a 2 percentage
point reduction to the applicable market-based increase factor.)
ambulation aids - ✔✔devices that provide additional stability and support for
an individual who has trouble walking
,Briefly describe the inpatient rehabilitation prospective payment system (IRF
PPPS - ✔✔Under the IRF PPS, a rehabilitation hospital is reimbursed for each
patient admission. Patient stays are classified into case-mix groups (CMGs),
which determine the payment the facility will receive from Medicare.
The factors that influence the assignment of a case into a particular CMG
include rehabilitation impairment categories (RICs), functional measurements,
age, and co-morbidities. Diagnosis codes determine the RICs, which group cases
that are similar in clinical characteristics and resource use. Functional measures
that influence CMG assignment are motor and cognitive scores. Some, but not
all, CMG categories also consider the patient's age. Finally, co-morbidities, or
secondary diagnoses, affect CMG assignment and are classified into three
categories, or tiers, based on whether the costs are considered high, medium, or
low. Most of the CMGs are subject to four relative weights—the three that
reflect the co-morbidity tiers and one for patients with no co-morbidities. Co-
morbidity tiers do not apply to the CMG for patients discharged before the
fourth day (short-stay outliers) or to the CMGs for the relatively unusual cases in
which patients expire in a rehabilitation facility.
broad categories of assistive devices used in rehabilitation? - ✔✔orthotics,
prosthetics, ambulation aids, wheelchairs, high-tech assistive devices such as
computers
Case Mix Group (CMG) - ✔✔any of 100 categories into which an inpatient
rehabilitation stay can be classified based on data submitted on the IRF-PAI; the
CMG is determined by factors such as rehabilitation impairment category (RIC),
functional measurements, age, and comorbidities
CMS provides software titled ______________________________ free of charge
to facilities that wish to use it to submit the IRF-PAI data. - ✔✔Inpatient
Rehabilitation Validation and Entry (IRVEN, or jIRVEN for Java-based software)
, Disability - ✔✔is a restriction or inability to perform an activity in the manner or
within the range considered normal for a human being, mostly resulting from
impairment.
disability - ✔✔restriction or lack of ability to perform an activity in the manner
or within the range considered to be normal for a human being, mostly resulting
from impairment
encoded - ✔✔with regard to the IRF-PAI encoding refers to using a specified
computer program to enter data that subsequently will be transmitted to the
Centers for Medicare and Medicaid services (CMS)
environmental control units (ECU's) - ✔✔equipment that allows a person who
has limited mobility to perform many everyday functions in the home, at work,
or at school, such as turning on lights, using appliances, and opening and closing
doors and windows
FIM scores lend themselves readily to quality and outcome measurements. In
addition, costs can be analyzed in light of changes in FIM scores. - ✔✔True
freestanding rehabilitation hospitals - ✔✔inpatient rehabilitation facilities that
may operate both acute and postacute rehabilitation units
Functional Independence Measure (FIM) - ✔✔a rating tool for measuring
function in motor and cognitive areas. FIM documents the severity of disabilities
as well as outcomes in rehabilitation and has been incorporated into the IRF-PAI
______________________________ is the most commonly used measure of
independence, and, because of its reliability and validity, it has been
incorporated into the IRF-PAI. - ✔✔The Functional Independence Measure or
FIM®
60 percent rule - ✔✔One of the criteria to define a hospital as an IP Rehab
Facility (IRF). Requires that at least 60 percent of the patients treated have at
least one of 13 qualifying medical conditions
A hospital that meets the CMS criteria to be classified as an inpatient
rehabilitation facility is not reimbursed through the MS-DRG system under the
acute inpatient prospective payment system, but, instead, under
_____________________________. - ✔✔the inpatient rehabilitation facility
prospective payment system (IRF PPS)
acute rehabilitation unit - ✔✔a designated unit in a hospital to watch patients
can be transferred for rehabilitation after treatment for the original acute illness
or injury; length of stay in these units is typically 2 to 4 weeks
Although quality measures can be used to compare quality at different inpatient
rehabilitation facilities, there are no reimbursement implications for QRP data. -
✔✔False. (IRFs that fail to report quality data are subject to a 2 percentage
point reduction to the applicable market-based increase factor.)
ambulation aids - ✔✔devices that provide additional stability and support for
an individual who has trouble walking
,Briefly describe the inpatient rehabilitation prospective payment system (IRF
PPPS - ✔✔Under the IRF PPS, a rehabilitation hospital is reimbursed for each
patient admission. Patient stays are classified into case-mix groups (CMGs),
which determine the payment the facility will receive from Medicare.
The factors that influence the assignment of a case into a particular CMG
include rehabilitation impairment categories (RICs), functional measurements,
age, and co-morbidities. Diagnosis codes determine the RICs, which group cases
that are similar in clinical characteristics and resource use. Functional measures
that influence CMG assignment are motor and cognitive scores. Some, but not
all, CMG categories also consider the patient's age. Finally, co-morbidities, or
secondary diagnoses, affect CMG assignment and are classified into three
categories, or tiers, based on whether the costs are considered high, medium, or
low. Most of the CMGs are subject to four relative weights—the three that
reflect the co-morbidity tiers and one for patients with no co-morbidities. Co-
morbidity tiers do not apply to the CMG for patients discharged before the
fourth day (short-stay outliers) or to the CMGs for the relatively unusual cases in
which patients expire in a rehabilitation facility.
broad categories of assistive devices used in rehabilitation? - ✔✔orthotics,
prosthetics, ambulation aids, wheelchairs, high-tech assistive devices such as
computers
Case Mix Group (CMG) - ✔✔any of 100 categories into which an inpatient
rehabilitation stay can be classified based on data submitted on the IRF-PAI; the
CMG is determined by factors such as rehabilitation impairment category (RIC),
functional measurements, age, and comorbidities
CMS provides software titled ______________________________ free of charge
to facilities that wish to use it to submit the IRF-PAI data. - ✔✔Inpatient
Rehabilitation Validation and Entry (IRVEN, or jIRVEN for Java-based software)
, Disability - ✔✔is a restriction or inability to perform an activity in the manner or
within the range considered normal for a human being, mostly resulting from
impairment.
disability - ✔✔restriction or lack of ability to perform an activity in the manner
or within the range considered to be normal for a human being, mostly resulting
from impairment
encoded - ✔✔with regard to the IRF-PAI encoding refers to using a specified
computer program to enter data that subsequently will be transmitted to the
Centers for Medicare and Medicaid services (CMS)
environmental control units (ECU's) - ✔✔equipment that allows a person who
has limited mobility to perform many everyday functions in the home, at work,
or at school, such as turning on lights, using appliances, and opening and closing
doors and windows
FIM scores lend themselves readily to quality and outcome measurements. In
addition, costs can be analyzed in light of changes in FIM scores. - ✔✔True
freestanding rehabilitation hospitals - ✔✔inpatient rehabilitation facilities that
may operate both acute and postacute rehabilitation units
Functional Independence Measure (FIM) - ✔✔a rating tool for measuring
function in motor and cognitive areas. FIM documents the severity of disabilities
as well as outcomes in rehabilitation and has been incorporated into the IRF-PAI
