Uniform Data Systemfor Medical Rehabilitation

270 Northpointe Parkway, Suite 300Amherst, New York 14228tel: 716-817-7800fax: 716-568-0037www.udsmr.org

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A FIM System® Subscription provides:• A simple, valid way to demonstrate your

program’s effectiveness

• Reliable data to market your program

• A precision case management tool for monitoring each patient’s functional progress

A FIM System® subscription enables you to:• Support your admission decision by

documenting functional decline as a result of medical conditions

• Generate data that differentiates your program with referring hospitals, physicians, families, and payers

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• Generate key data to support your CARF accreditation initiatives

See what other programs around the country are discovering!

2015 UDSmr SNF Case Mix

© 2006–2012 Uniform Data System for Medical Rehabilitation. FIM, The FIM System, and the UDSmr logo are trademarks of Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.

9/26

/16

Stroke 6Ortho 30Cardiac 9Pulmonary 4Debility 8Med Complex 31All Others 12

6%

30%

9%4%8%

31%

12%

Stroke

Ortho

Cardiac

Pulmonary

Debility

Med Complex

All Others

Uniform Data Systemfor Medical Rehabilitation

270 Northpointe Parkway, Suite 300Amherst, New York 14228tel: 716-817-7800fax: 716-568-0037www.udsmr.org

The BenefitsReportsBenchmark reports provide facility outcomes with national comparative data. Corporate reports are also available.

Clinical benefits• Use total FIM® ratings as a predictor of the burden of care as measured by minutes of care

required daily.

• Use FIM®profilereportstocharacterizepatientdeficits,targetinterventions,monitorprogress, and facilitate team conferences.

• Set rehabilitation goals and monitor goal attainment.

• Access impairment-level outcomes, such as discharge destination and expected length of stay.

• Improve communication with patients and families.

• Track quality indicators (e.g., pain, pressure ulcers, and safety issues).

Program benefits• Track data by referring physician or hospital, and provide critical performance feedback.

• Document positive performance indicators in marketing materials.

• Obtainquantitativedatafornegotiationswithpayersinmanagedcareorganizations.

• Compare performance to external reference points provided solely for SNFs.

Education, training, and consultation• Trainingandcredentialing: UDSmr offers a variety of training programs and resources. We

also conduct a two-phase credentialing process that ensures proper collection of data by each facility.

• Consultation: UDSmrprovidestheclinicalexpertisesubscribersneedtoanalyze,interpret,and apply data in support of their unique needs. On-site clinical consultative services are also available.

Patient Profile For Jones, Sally

SNF Test FacilityFacility : Report Date : 11/13/2009

Toilet Transfer

Bed, Chair, Wheelchair Transfer

Bowel

Bladder

Eating

Toileting

Dressing (Lower)

Dressing (Upper)

Bathing

GroomingMemory

Problem Solving

Social Interaction

Expression

Comprehension

Stair Locomotion

Walk/Wheelchair Locomotion

Tub, Shower Transfer

Grooming

Eating

Bathing

Dressing - Upper Body

Dressing - Lower Body

Toileting

Bladder Management

Bowel Management

Bed, Chair, Wheelchair Transfer

Toilet Transfer

Problem Solving

Social Interaction

Memory

Expression

Comprehension

Walk/Wheelchair

Tub, Shower Transfer

Stairs

Self Care

Mobility

Motor Skills Subtotal

Motor Skills Average

Cognition

Cognitive Skills Subtotal

Cognitive Skills Average

FIM Total

Aqua

69

10/09/2009

Admission

43

3.6

23

4.6

3.8

5

3

4

4

3

4

3

3

4

4

3

3

3

4

5

5

4

5

Lime

Discharge

10/27/2009

103

69

5.8

29

5.8

5.7

7

6

5

6

6

5

5

6

6

6

5

6

5

5

6

6

6

6

Red

Goal

Case Based Goal

114

75

6.3

33

6.6

6.3

6

7

6

7

7

5

6

6

6

7

6

6

6

6

6

7

7

7

FIM Levels

No Helper

Complete Independence

(Timely, safely)

Modified Independence

(Device)

Helper - Modified Dependence

Supervision

(Subject = 100%)

Moderate Assistance

(Subject = 50% or more)

Helper - Complete Dependence

Maximal Assistance

(Subject = 25% or more)

Total Assistance

(Subject = less than 25%)

7

6

5

3

2

1

Minimal Assistance

(Subject = 75% or more)

4

Legend:

Type:

Date:

Sphincter Control

A.

B.

C.

D.

E.

F.

G.

H.

I.

J.

K.

L.

M.

N.

O.

P.

Q.

R.

Locomotion

Social Cognition

FIM Average

FIM™ ("FIM") Assessment:

0 Activity does not occur;

Use this code only at Admission

Note : Tub/Shower score is not included in the 'Motor Score' total calculation; however, it is included in the

'Total FIM Score'.

1 2 3 4

PATIENT SUMMARY

Patient ID:

Birth Date:

Age at Admission:

Gender:

CASE SUMMARY

Admission Class:

Admission

Impairment Group Code:

Onset Date:

Etiologic Diagnosis:

Actual Length of Stay:

25252525

Female

71 years

Primary Pay Source:

438.0

09/24/2009

02/15/1938

Initial Rehab

02 - Medicare non-MCO

20 days

Admission Date: 10/07/2009

Discharge Date: 10/27/2009

Discharge Living Setting: 01 - Home

1.1 - Left Body Involvement (Right Brain)

SNF-CMG: A0104

Date: 11/13/2009 10:14:15AM Page 1 of 1© 2009 Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc. (UBFA). All rights reserved. All marks associated with FIM and FIM-PAI are owned by UBFA.