RAV Resident Assessment Virtuoso

Resident ID
Assessment Type
Facility Name
Default Clinical Category (I0020A)
Days
Section GG
Functional Abilities at Admission
GG0130A - Self-care: Eating  
N

The ability to use suitable utensils to bring food to the mouth and swallow food once the meal is presented on a table/tray. Includes modified food consistency.

GG0130B - Self-care: Oral Hygiene  

The ability to use suitable items to clean teeth. [Dentures (if applicable): The ability to remove and replace dentures from and to the mouth, and manage equipment for soaking and rinsing them.]

GG0130C - Self-care: Toileting Hygiene  
N

The ability to maintain perineal hygiene, adjust clothes before and after using the toilet, commode, bedpan, or urinal. If managing an ostomy, include wiping the opening but not managing equipment.

GG0170B - Sit to Lying  
N

The ability to move from sitting on side of bed to lying flat on the bed.

GG0170C - Lying to Sitting on Side of Bed  
N

The ability to safely move from lying on the back to sitting on the side of the bed with feet flat on the floor, and with no back support.

GG0170D - Sit to Stand  
N

The ability to safely come to a standing position from sitting in a chair or on the side of the bed.

GG0170E - Chair/Bed-to-Chair  
N

The ability to safely transfer to and from a bed to a chair (or wheelchair).

GG0170F - Toilet Transfer  

The ability to safely get on and off a toilet or commode.

GG0170I - I. Does the resident walk 10 feet?  

GG0170J - Walk 50 Feet with Two Turns  

Once standing, the ability to walk at least 50 feet and make two turns.

GG0170K - Walk 150 Feet  

Once standing, the ability to walk at least 150 feet in a corridor or similar space.

Speech and Language Pathology
Nursing
PDPM CMGCategoryConditions / ServicesGG Score
  ES1Extensive Services Isolation or Quarantine for Active Infectious Disease0 - 14
  ES2Extensive Services Tracheostomy Care OR Ventilator/Respirator0 - 14
  ES3Extensive Services Tracheostomy Care AND Ventilator/Respirator0 - 14
  HBC1Special Care High More Details6 - 14
  HBC2Special Care High More Details6 - 14
  HDE1Special Care High More Details0 - 5
  HDE2Special Care High More Details0 - 5
  LBC1Special Care Low More Details6 - 14
  LBC2Special Care Low More Details6 - 14
  LDE1Special Care Low More Details0 - 5
  LDE2Special Care Low More Details0 - 5
  CA1Clinically Complex More Details15 - 16
  CA2Clinically Complex More Details15 - 16
  CBC1Clinically Complex More Details6 - 14
  CBC2Clinically Complex More Details6 - 14
  CDE1Clinically Complex More Details0 - 5
  CDE2Clinically Complex More Details0 - 5
  BAB1Behavioral Cognitive Symptoms Restorative Nursing Services - 0 or 111 - 16
  BAB2Behavioral Cognitive Symptoms Restorative Nursing Services - 2 or More11 - 16
  PA1Reduced Physical Function Restorative Nursing Services - 0 or 115 - 16
  PA2Reduced Physical Function Restorative Nursing Services - 2 or More15 - 16
  PBC1Reduced Physical Function Restorative Nursing Services - 0 or 16 - 14
  PBC2Reduced Physical Function Restorative Nursing Services - 2 or More6 - 14
  PDE1Reduced Physical Function Restorative Nursing Services - 0 or 10 - 5
  PDE2Reduced Physical Function Restorative Nursing Services - 2 or More0 - 5
Non-Therapy Ancillaries

 SNF Claim ICD-10 dB20 - HIV/AIDS - 8 Point(s)

 H0100C - Bladder and Bowel Appliances: Ostomy - 1 Point(s)
 H0100D - Bladder and Bowel Appliances: Intermittent catheterization - 1 Point(s)

 I1700 - Active Diagnoses: Multi-Drug Resistant Organism (MDRO) Code - 1 Point(s)
 I2500 - Wound Infection Code - 2 Point(s)
 I2900 - Active Diagnoses: Diabetes Mellitus (DM) Code - 2 Point(s)
 I5200 - Active Diagnoses: Multiple Sclerosis Code - 2 Point(s)
 I5600 - Active Diagnoses: Malnutrition or At Risk for Malnutrition - 1 Point(s)
 I6200 - Active Diagnoses: Asthma COPD Chronic Lung Disease Code - 2 Point(s)
 I8000 - Lung Transplant Status - 3 Point(s)
 I8000 - Major Organ Transplant Status, Except Lung - 2 Point(s)
 I8000 - Opportunistic Infections - 2 Point(s)
 I8000 - Bone/Joint/Muscle Infections/Necrosis - Except: Aseptic Necrosis of Bone - 2 Point(s)
 I8000 - Chronic Myeloid Leukemia - 2 Point(s)
 I8000 - Endocarditis - 1 Point(s)
 I8000 - Immune Disorders - 1 Point(s)
 I8000 - End-Stage Liver Disease - 1 Point(s)
 I8000 - Narcolepsy and Cataplexy - 1 Point(s)
 I8000 - Cystic Fibrosis - 1 Point(s)
 I8000 - Specified Hereditary Metabolic/Immune Disorders - 1 Point(s)
 I8000 - Morbid Obesity - 1 Point(s)
 I8000 - Psoriatic Arthropathy and Systemic Sclerosis - 1 Point(s)
 I8000 - Chronic Pancreatitis - 1 Point(s)
 I8000 - Proliferative Diabetic Retinopathy and Vitreous Hemorrhage - 1 Point(s)
 I8000 - Complications of Specified Implanted Device or Graft - 1 Point(s)
 I1300 - Inflammatory Bowel Disease - 1 Point(s)
 I8000 - Aseptic Necrosis of Bone - 1 Point(s)
 I8000 - Cardio-Respiratory Failure and Shock - 1 Point(s)
 I8000 - Myelodysplastic Syndromes and Myelofibrosis - 1 Point(s)
 I8000 - Systemic Lupus Erythematosus, Other Connective Tissue Disorders, and Inflammatory Spondylopathies - 1 Point(s)
 I8000 - Diabetic Retinopathy - Except : Proliferative Diabetic Retinopathy and Vitreous Hemorrhage - 1 Point(s)
 I8000 - Severe Skin Burn or Condition - 1 Point(s)
 I8000 - Intractable Epilepsy - 1 Point(s)
 I8000 - Disorders of Immunity - Except : RxCC97: Immune Disorders - 1 Point(s)
 I8000 - Cirrhosis of Liver - 1 Point(s)
 I8000 - Respiratory Arrest - 1 Point(s)
 I8000 - Pulmonary Fibrosis and Other Chronic Lung Disorders - 1 Point(s)

 K0520A2, K0710A2 - Parenteral IV Feeding: Level High - 7 Point(s)
 K0520A2, K0710A2, K0710B2 - Parenteral IV feeding: Level Low - 3 Point(s)
 K0520B3 - Nutritional Approaches While a Resident: Feeding Tube - 1 Point(s)

 M0300D1 - Highest Stage of Unhealed Pressure Ulcer - Stage 4 - 1 Point(s)
 M1040A, M1040B, M1040C - Other Foot Skin Problems: Foot Infection Code, Diabetic Foot Ulcer Code, Other Open Lesion on Foot Code - 1 Point(s)

 O0110B1b - Special Treatments/Programs: Radiation Post-admit Code - 1 Point(s)
 O0110D1b - Special Treatments/Programs: Suctioning Post-admit Code - 1 Point(s)
 O0110E1B - Special Treatments/Programs: Tracheostomy Post-admit Code - 1 Point(s)
 O0110F1b - Special Treatments/Programs: Ventilator Post-admit Code - 4 Point(s)
 O0110H1b - Special Treatments/Programs: Intravenous Medication Post-admit Code - 5 Point(s)
 O0110I1b - Special Treatments/Programs: Transfusion Post-admit Code - 2 Point(s)
 O0110M1b - Special Treatments/Programs: Isolation Post-admit Code - 1 Point(s)
DISCIPLINEPAYCATEGORYGG SCOREGROUPCMI
PT0
OT0
SLP
NURSING0
NTA0 IPA
NCM
TOTAL (1-3)$0
TOTAL (4-20)$0
AVG (1-20)$0
PPD DAY 1$0 0 IPA
HIPPS CODE-

*HIPPS Code final results may vary based on supporting documentation.