Kareplexity

Sub-benchmark PT residents at CaraDay Demo Facility

Only one resident is currently flagged with a PT component below the facility's case-mix benchmark.

Facility benchmark context:

Average PT letter: M
PT distribution skews high — 22 residents at O, 18 at K, plus a handful at L/N
Only 1 resident (per the subBenchmarkPtCount metric) sits meaningfully below benchmark

The flagged resident:

| Resident | ID | HIPPS | PT | Primary Dx | Payer | |---|---|---|---|---|---| | Evelyn Strickland | 21e38564-49f8-4546-81e6-a4bf3d468875 | BBADD | B | Left femoral neck fracture, displaced (S72.002A) | LTC insurance |

What this means in plain terms: PT in PDPM is driven by clinical category + the resident's Section GG functional score. A "B" letter is near the bottom of the scale — it indicates either very high independence (unlikely post-hip-fracture at age 88) or, more commonly, incomplete Section GG functional scoring on the 5-day MDS. Evelyn was admitted 2026-01-30 with a displaced femoral neck fracture, which typically generates a Major Joint Replacement or Orthopedic Surgery clinical category and a much higher PT letter when functional limitations are fully captured.

Her existing risk summary already notes documentation gaps in nursing and NTA areas as well — so she's a strong candidate for a full HIPPS review.

Next step: Run a HIPPS optimization analysis on Evelyn Strickland to see exactly which Section GG items or clinical category fields are under-captured before her MDS modification window closes.

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Run the HIPPS optimization analysis for Evelyn Strickland Show me residents with high-severity HIPPS optimization recommendations Which residents have the biggest gap between documented diagnoses and MDS-coded conditions

{"facilityId":"2ff057db-734f-4d27-824f-d4cbc864cac8","census":50,"activeResidents":31,"discharged":9,"payerMix":{"medicare":27,"managed_medicare":13,"ltc_insurance":5,"private":5},"hippsAvgLetters":{"pt":"M","ot":"M","slp":"F","nursing":"I","nta":"B"},"ptDistribution":[{"letter":"B","count":1},{"letter":"F","count":1},{"letter":"K","count":18},{"letter":"L","count":3},{"letter":"N","count":5},{"letter":"O","count":22}],"subBenchmarkPtCount":1,"recommendationsBySeverity":{"medium":132,"high":4,"low":12},"recommendationsBreakdown":[{"severity":"high","type":"hipps_optimization","n":2},{"severity":"high","type":"survey_risk","n":2},{"severity":"low","type":"hipps_optimization","n":11},{"severity":"low","type":"survey_risk","n":1},{"severity":"medium","type":"survey_risk","n":47},{"severity":"…[truncated 45 chars]

{"facilityId":"2ff057db-734f-4d27-824f-d4cbc864cac8","appliedFilters":{"payer":null,"ptLetterMax":"D","diagnosisPrefix":null,"admittedAfter":null,"riskLevel":null,"limit":25},"matchCount":1,"residents":[{"id":"21e38564-49f8-4546-81e6-a4bf3d468875","firstName":"Evelyn","lastName":"Strickland","primaryPayer":"ltc_insurance","currentStatus":"active","admissionDate":"2026-01-30","age":88,"hippsCode":"BBADD","ptComponent":"B","mdsDate":"2026-02-03","primaryIcd10":"S72.002A","primaryDiagnosis":"Fracture of left femoral neck, displaced, initial encounter for closed fracture","riskSeverity":"medium","riskSummary":"Documentation describes both depressive symptoms and an active pressure injury, but neither is captured in the MDS fields that would drive Nursing and NTA classification."}]}

Which residents have HIPPS PT components below their case mix benchmark?

Sub-benchmark PT residents at CaraDay Demo Facility

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