HSP_ACCT_SNF_PPS

Description: |
When Minimum Data Set (MDS) assessments are performed per requirements of the CMS Skilled Nursing Facility Prospective Payment System (SNF PPS), the HIPPS codes generated will be coded to the appropriate hospital accounts. The HSP_ACCT_SNF_PPS table contains the data generated from the assessments required for billing and claims.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
HSP_ACCOUNT_ID | 1 |
LINE | 2 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | HSP_ACCOUNT_ID | NUMERIC | No |
This column stores the unique identifier for the hospital account.
2 | LINE | INTEGER | No |
The line number for the information associated with this record. Multiple pieces of information can be associated with this record.
3 | ASMT_UNIQ_ID | VARCHAR | No |
This column stores the unique identifier for the assessment entry for this hospital account. A single MDS assessment can general multiple assessment entries for a hospital account (for example, a therapy portion as well as a non-therapy portion could create two entries). There may be multiple RUG codes generated from a single MDS assessment record. Each RUG code may also have payer/plan overrides defined as well. ASMT_UNIQ_ID is used to identify the RUG code generated from the minimum data set (MDS) assessment, and OVRD_EPP_ID in addition is used to identify the payer/plan-specific RUG code.
4 | ASMT_DESC | VARCHAR | No |
This columns contains the description for the assessment.
5 | ASMT_RDI_ID | NUMERIC | No |
This column contains the a pointer to the Minimum Data Set (MDS) assessment record.
6 | OVRD_PLAN_ID_BENEFIT_PLAN_NAME | VARCHAR | No |
The name of the benefit plan record.
7 | RUG_CODE | VARCHAR | No |
This column stores the resource utilization group (RUG) code generated by the minimum data set (MDS) assessment.
8 | MDS_ASSESS_INDIC_C_NAME | VARCHAR | No |
This column stores the assessment indicator (AI) of the minimum data set (MDS) assessment.
May contain organization-specific values: No
Category Entries:
Interim Payment Assessment
5-day assessment
Not used for PPS
5-day or readmission return
5-day or readm with Unscheduled OBRA/CCA
5-day or readm with Start of Therapy OMRA
5-day with SOT & Unscheduled OBRA/CCA
5-day or readm with EOT OMRA without Resumption
5-day or readm with SOT & EOT without Resumption
5-day & Unscheduled OBRA/CCA & SOT/EOT w/o Resumption
5-day or readmission with Medicare Short Stay Assessment
14-day assessment
14-day with Unscheduled OBRA/CCA
14-day with Start of Therapy OMRA
14-day with SOT & Unscheduled OBRA/CCA
14-day with EOT OMRA without Resumption
14-day with SOT & EOT without Resumption
14-day & Unscheduled OBRA/CCA & SOT/EOT w/o Resumption
30-day assessment
30-day with Unscheduled OBRA/CCA
30-day with Start of Therapy OMRA
30-day with SOT & Unscheduled OBRA/CCA
30-day with EOT OMRA without Resumption
30-day with SOT & EOT without Resumption
30-day & Unscheduled OBRA/CCA & SOT/EOT w/o Resumption
60-day assessment
60-day with Unscheduled OBRA/CCA
60-day with Start of Therapy OMRA
60-day with SOT & Unscheduled OBRA/CCA
60-day with EOT OMRA without Resumption
60-day with SOT & EOT without Resumption
60-day & Unscheduled OBRA/CCA & SOT/EOT w/o Resumption
90-day assessment
90-day with Unscheduled OBRA/CCA
90-day with Start of Therapy OMRA
90-day with SOT & Unscheduled OBRA/CCA
90-day with EOT OMRA without Resumption
90-day with SOT & EOT without Resumption
90-day & Unscheduled OBRA/CCA & SOT/EOT w/o Resumption
Uncombined OBRA
Tracking record (no valid RUG)
Default code due to missed assessment
Unscheduled OBRA or Swing Bed CCA
Start of Therapy OMRA
SOT OMRA with Unscheduled OBRA/CCA
End of Therapy OMRA without Resumption
SOT with EOT without Resumption
SOT/EOT without Resumption with Unscheduled OBRA/CCA
Medicare Short Stay Assessment
End of Therapy with Resumption
Start of Therapy with End of Therapy Reporting Resumption
SOT/EOT-R with Unscheduled OBRA or Swing Bed CCA
Change of Therapy OMRA
5-day or readmission with EOT with Resumption
5-day or readmission with SOT & EOT-R
5-day or readm with SOT/EOT-R & OBRA/CCA
14-day with EOT with Resumption
14-day with SOT & EOT-R
14-day with SOT/EOT-R & OBRA/CCA
14-day with Change of Therapy
30-day with EOT with Resumption
30-day with SOT & EOT-R
30-day with SOT/EOT-R & OBRA/CCA
30-day with Change of Therapy
60-day with EOT with Resumption
60-day with SOT & EOT-R
60-day with SOT/EOT-R & OBRA/CCA
60-day with Change of Therapy
90-day with EOT with Resumption
90-day with SOT & EOT-R
90-day with SOT/EOT-R & OBRA/CCA
90-day with Change of Therapy
PDPM Default
9 | ASMT_REF_DT | DATETIME | No |
This column stores the assessment reference date (ARD) of the minimum data set (MDS) assessment.
10 | BILL_START_DT | DATETIME | No |
This column contains the assessment billing effective start date.
11 | BILL_END_DT | DATETIME | No |
This column contains the assessment billing effective end date.
12 | BILL_DAYS | INTEGER | No |
This column stores the number of days that are billable by this minimum data set (MDS) assessment at the calculated RUG code specific to this hospital account. A single MDS assessment may span multiple hospital accounts; a single assessment's billing effective dates may extend beyond the billable dates of the hospital account.
13 | USR_OVERRIDE_YN | VARCHAR | No |
This column stores whether the payer/plan-specific resource utilization group (RUG) code was automatically calculated from the minimum data set (MDS) assessment or manually entered by a user. This column will have no value for the facility-defined Medicare lines of this table.
May contain organization-specific values: No
Category Entries:
No
Yes
14 | LOA_DAYS | INTEGER | No |
This column contains the total number of leave of absence days for this assessment period.
15 | PPS_CODE_TYPE_C_NAME | VARCHAR | No |
This related group stores coding grouper data for skilled nursing facilities based on clinical assessments. This item stores the type of prospective payment system code that is being stored in SNF PPS: PPS Code (I HAR 3505) for this assessment line.
May contain organization-specific values: No
Category Entries:
Resource Utilization Group
Patient Driven Payment Model
16 | PDPM_CODE | VARCHAR | No |
This column stores the patient driven payment model (PDPM) code generated by the minimum data set (MDS) assessment.