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
LUPA Threshold
Year Comorbidity Group / Functional Timing & Admission Source Comorbidity Adjustment Visit Threshold HIPPS