Patient-Driven Groupings Model (PDGM)
Report
Institutional Facilities Casemix Weight / HIPPS LUPA Threshold Clinical Groups Comorbidities
HIPPS Code Structure
Position #1 Source & Timing 1 Community Early 2 Institutional Early 3 Community Late 4 Institutional Late Position #2 Clinical Group A MMTA_OTHER B Neuro Rehab C Wounds D Complex Nursing E MS Rehab F Behavioral Health G MMTA - Surgical Aftercare H MMTA - Cardiac I MMTA - Endocrine J MMTA - GI/GU K MMTA - Infectious L MMTA - Respiratory Position #3 Functional Level A Low B Medium C High Position #4 Comorbidity 1 No 2 Low 3 High Position #5 Placeholder 1
Instituional Facilities
acute 282N00000X Hospitals / General Acute Care Hospital /
acute 282NC2000X Hospitals / General Acute Care Hospital / Children
acute 282NC0060X Hospitals / General Acute Care Hospital / Critical Access
acute 282NR1301X Hospitals / General Acute Care Hospital / Rural
post-acute 314000000X Nursing & Custodial Care Facilities / Skilled Nursing Facility /
post-acute 283X00000X Hospitals / Rehabilitation Hospital /
post-acute 273Y00000X Hospital Units / Rehabilitation Unit /
post-acute 282E00000X Hospitals / Long Term Care Hospital /
post-acute 283Q00000X Hospitals / Psychiatric Hospital /
post-acute 323P00000X Residential Treatment Facilities / Psychiatric Residential Treatment Facility /
post-acute 273R00000X Hospital Units / Psychiatric Unit /