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Agent invocation · 5/9/2026, 8:05:52 AM

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

Latency

17.2s

Tools

1

Tokens

5,067

Model

claude-opus-4-7

Final response

I found 1 resident at CaraDay Demo Facility with a PT component in the A–D range (below the typical benchmark for an active rehab population, which usually sits in the E–J range).

Resident with Low PT Component

Evelyn Strickland (ID: 21e38564) — PT Component: B

  • Age: 88
  • Primary Diagnosis: S72.002A — Displaced left femoral neck fracture (closed), initial encounter
  • Admitted: 2026-01-30 (LTC insurance)
  • Current HIPPS: BBADD
  • MDS Date: 2026-02-03
  • Risk: High

Why this stands out: A hip fracture admission would typically support a much higher PT/OT function score. A "B" PT letter suggests the GG self-care/mobility items on the MDS may be coding her as more independent than her actual post-op functional status — or that documentation supporting her assistance levels isn't flowing into Section GG.

She also has compounding documentation issues flagged:

  • Unwitnessed fall on 2/8
  • Depressed mood, tearfulness, decreased appetite — but no PHQ-9 score documented
  • Stage 1 pressure injury without a clearly documented wound care plan
  • MDS C0500 = 13 (cognitive concern)

Plain-language refresher on the PT component

The PT (Physical Therapy) letter in the HIPPS code is driven by the resident's clinical category (e.g., Major Joint Replacement / Spinal Surgery, Non-Orthopedic Surgery, Medical Management) combined with her GG function score. A hip fracture lands in a favorable clinical category, so the function score is the most likely lever — and it's almost always a documentation/coding question, not a clinical one.

Recommended Next Step

Run a HIPPS optimization analysis on Evelyn Strickland to see exactly which Section GG items and supporting notes may justify a higher PT component. Want me to pull that now?

Tool chain

  1. 01Query residents
    55ms
    input
    {
      "limit": 25,
      "hipps_pt_letter_max": "D"
    }
    result preview
    {"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":"high","riskSummary":"Multiple compounding documentation gaps: an unwitnessed fall on 2/8 alongside documented depressed mood, tearfulness, and decreased appetite without a PHQ-9 score, plus a Stage 1 pressure …[truncated 134 chars]

Audit ID

449480ff-3f0a-45f8-aad9-bdee5b73f113

Session

i6a7kh780