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	NUMERIC	No
	This column stores the unique identifier for the plan if any payer/plan-specific overrides have been defined. A blank value in this column indicates the line of data applies to the facility-defined Medicare payer/plan. 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 MDS assessment, and OVRD_EPP_ID in addition is used to identify the payer/plan-specific RUG code.
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.