Exhibit 11 - Financial Tracking Tool.xlsx

XLSX spreadsheet 60 KB Posted

Attached to
Medical and Mental Health Services
Solicitation number
1301
Issued by
Idaho

About this file

Exhibit 11 - Financial Tracking Tool Summary

Exhibit 11 is a Financial Tracking Tool for the Idaho Department of Correction's medical and mental health services contract, documenting quarterly pay-for-performance reconciliation data across four quarters. The tool tracks performance incentives for vendor services delivery to the inmate population at IDOC facilities statewide. The spreadsheet contains detailed performance metrics organized into two primary categories: Medical Criteria (25 performance indicators) and Mental Health Criteria (6 performance indicators). Each performance indicator includes assigned weights, minimum thresholds, actual achievement rates, variance percentages over or under threshold, base per diem equivalents, average daily population (ADP) of 7,500 inmates, and quarterly earnings or amounts owed. Performance indicators span medical services including credentialing, discharge planning, sick call services across general population and segregation units, off-site care, periodic health assessments, chronic disease programs (diabetes, chronic kidney disease, HIV, cirrhosis), oral care, TB screening and treatment, vaccinations, pregnancy care, long-term care, infirmary services, hepatitis C monitoring, transfer screening, diagnostics, infection control, peer review, and resident education, alongside mental health services including screening, restrictive housing management, mental health units, outpatient needs, psychiatric medication services, and multidisciplinary team meetings.

For the vendor with complete data (Quarters 1-4), the Medical Criteria section generated $1,062,893.84 in earned incentives while the Mental Health Criteria section totaled $1,304,460.62, reflecting consistent achievement of 100% threshold performance with facility averages ranging from 2% to 10% over minimum thresholds. Each quarter maintains a base per diem incentive amount of $312,500.00 with a corresponding invoice adjustment of $241,566.78. A separate Centurion vendor section for Quarters 2-4 shows ERROR:#DIV/0! throughout all performance calculations, indicating missing or incomplete data submission for that provider. The tool also includes a "Proposed Wt" (Proposed Weight) section listing 23 performance criteria with current weights and proposed adjustments, suggesting ongoing refinement of the performance metric structure. The data sensitivity is classified as L3 Restricted under IDOC protocols.

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QTR 1 - Outcome Incentives.

QUARTERLY PAY FOR PERFORMANCE PI RECONCILIATION
Vendor
PI #DESCRIPTIONWeightMinimum ThresholdQTR 1 THRESHOLD ACHIEVEDFacility averages% over / under thresholdBase Per Diem EquivalentADPEARNED/

OWED

MEDICAL CRITERIA1Credentialing2%100%100%100.00%0.00%$0.0087500$ - 0
2Discharge Planning3%90%100%100.00%10.00%$0.0127500$ 65,881.85
3RDU Screen3%95%100%100.00%5.00%$0.0127500$ 32,940.92
4Sick Call General Population6%95%100%100.00%5.00%$0.0237500$ 65,881.85
5Sick Call Segregation3%95%100%100.00%5.00%$0.0127500$ 32,940.92
6Sick Call RDU1%95%100%100.00%5.00%$0.0047500$ 10,980.31
7Off-Site Care5%90%100%100.00%10.00%$0.0207500$ 109,803.08
8Periodic Health Assessment5%90%100%100.00%10.00%$0.0207500$ 109,803.08
9CDP - Diabetes4%95%100%100.00%5.00%$0.0167500$ 43,921.23
10CDP - CKD2%95%100%100.00%5.00%$0.0087500$ 21,960.62
11CDP -HIV2%95%100%100.00%5.00%$0.0087500$ 21,960.62
12CDP - Cirrhosis4%95%100%100.00%5.00%$0.0167500$ 43,921.23
13Oral Care3%90%100%100.00%10.00%$0.0127500$ 65,881.85
14TB Screening and Treatment2%98%100%100.00%2.00%$0.0087500$ 8,784.25
15Vaccination Program3%98%100%100.00%2.00%$0.0127500$ 13,176.37
16Pregnant Resident4%95%100%100.00%5.00%$0.0167500$ 43,921.23
17Long Term Care4%95%100%100.00%5.00%$0.0167500$ 43,921.23
18Infirmary3%95%100%100.00%5.00%$0.0127500$ 32,940.92
1923-Hour Observation1%95%100%100.00%5.00%$0.0047500$ 10,980.31
20Hepatitis C Monitoring5%95%100%100.00%5.00%$0.0207500$ 54,901.54
21Transfer Screening1%90%100%100.00%10.00%$0.0047500$ 21,960.62
22Diagnostics3%90%100%100.00%10.00%$0.0127500$ 65,881.85
23Infection Control & CQI2%95%100%100.00%5.00%$0.0087500$ 21,960.62
24Peer Review5%90%100%100.00%10.00%$0.0207500$ 109,803.08
25Resident Education2%98%100%100.00%2.00%$0.0087500$ 8,784.25$ 1,062,893.84
MENTAL HEALTH CRITERIA1Mental Health Screening6%95%100%100.00%5.00%$0.0237500$ 65,881.85
2Restrictive Housing2%95%100%100.00%5.00%$0.0087500$ 21,960.62
3Mental Health Units3%95%100%100.00%5.00%$0.0127500$ 32,940.92$ 1,304,460.62
4Outpatient Needs2%95%100%100.00%5.00%$0.0087500$ 21,960.62
5Psychiatric Medication Services6%95%100%100.00%5.00%$0.0237500$ 65,881.85
6Multidisciplinary Team Meetings3%95%100%100.00%5.00%$0.0127500$ 32,940.92
QUARTERLY BASE PER DIEM INCENTIVE INVOICE ADJUSTMENT$ 312,500.00$ 241,566.78
Please leave information here and hidden. Thank you, Patrick
Contacts & Groups12
Assessment-Tx Planning12$ 241,566.78
Health Services Requests12
Psychiatric Encounters12
Current WtThresholdProposed Wt
1Credentialing / Training2%95%2%
2Transfer DC Meds3%90%3%
3RDU Screen10%95%10%
4Sick Call GP Chart Review9%95%8%
4aSick Call GP Offered95%1%
5SC Segregation Chart Review9%95%8%
5aSick Call Segregation Offered95%1%
6Sick Call RDU Chart Review9%95%8%
6aSick Call RDU Offered95%1%
7Continuity of Care8%90%8%
8Periodic Health Assessment2%85%2%
9Chronic Disease10%95%8%
9aTreatment Plans95%2%
10Oral Care3%85%3%
11Annual TB10%100%8%
12Segregation2%85%2%
13Pregnant Resident3%95%3%
14LTC - Inpatient2%95%2%
15Acute Infirmary Care2%95%2%
1623HR Observation3%95%3%
17HEP C Tracking2%95%2%
18Transfer Screen (RCV)3%95%3%
19LTBI2%100%2%
20MAR2%95%2%
21Diagnostics2%90%2%
22Pharmacy Operations100%2%
23Annual Tool2%90%2%
100%

_x000D_&1#&"Calibri"&10&K000000 IDOC Data Sensitivity Classification - L3 Restricted

QTR 2 - Outcome Incentives.

QUARTERLY PAY FOR PERFORMANCE PI RECONCILIATION
Vendor
PI #DESCRIPTIONWeightMinimum ThresholdQTR 1 THRESHOLD ACHIEVEDFacility averages% over / under thresholdBase Per Diem EquivalentADPEARNED/

OWED

MEDICAL CRITERIA1Credentialing2%100%100%100.00%0.00%$0.0087500$ - 0
2Discharge Planning3%90%100%100.00%10.00%$0.0127500$ 65,881.85
3RDU Screen3%95%100%100.00%5.00%$0.0127500$ 32,940.92
4Sick Call General Population6%95%100%100.00%5.00%$0.0237500$ 65,881.85
5Sick Call Segregation3%95%30%100.00%5.00%$0.0127500$ 32,940.92
6Sick Call RDU1%95%100%100.00%5.00%$0.0047500$ 10,980.31
7Off-Site Care5%90%100%100.00%10.00%$0.0207500$ 109,803.08
8Periodic Health Assessment5%90%40%100.00%10.00%$0.0207500$ 109,803.08
9CDP - Diabetes4%95%100%100.00%5.00%$0.0167500$ 43,921.23
10CDP - CKD2%95%50%100.00%5.00%$0.0087500$ 21,960.62
11CDP -HIV2%95%100%100.00%5.00%$0.0087500$ 21,960.62
12CDP - Cirrhosis4%95%100%100.00%5.00%$0.0167500$ 43,921.23
13Oral Care3%90%100%100.00%10.00%$0.0127500$ 65,881.85
14TB Screening and Treatment2%98%100%100.00%2.00%$0.0087500$ 8,784.25
15Vaccination Program3%98%100%100.00%2.00%$0.0127500$ 13,176.37
16Pregnant Resident4%95%100%100.00%5.00%$0.0167500$ 43,921.23
17Long Term Care4%95%100%100.00%5.00%$0.0167500$ 43,921.23
18Infirmary3%95%100%100.00%5.00%$0.0127500$ 32,940.92
1923-Hour Observation1%95%100%100.00%5.00%$0.0047500$ 10,980.31
20Hepatitis C Monitoring5%95%100%100.00%5.00%$0.0207500$ 54,901.54
21Transfer Screening1%90%100%100.00%10.00%$0.0047500$ 21,960.62
22Diagnostics3%90%100%100.00%10.00%$0.0127500$ 65,881.85
23Infection Control & CQI2%95%100%100.00%5.00%$0.0087500$ 21,960.62
24Peer Review5%90%100%100.00%10.00%$0.0207500$ 109,803.08
25Resident Education2%98%100%100.00%2.00%$0.0087500$ 8,784.25$ 1,062,893.84
MENTAL HEALTH CRITERIA1Mental Health Screening6%95%100%100.00%5.00%$0.0237500$ 65,881.85
2Restrictive Housing2%95%100%100.00%5.00%$0.0087500$ 21,960.62
3Mental Health Units3%95%100%100.00%5.00%$0.0127500$ 32,940.92$ 1,304,460.62
4Outpatient Needs2%95%100%100.00%5.00%$0.0087500$ 21,960.62
5Psychiatric Medication Services6%95%100%100.00%5.00%$0.0237500$ 65,881.85
6Multidisciplinary Team Meetings3%95%100%100.00%5.00%$0.0127500$ 32,940.92
QUARTERLY BASE PER DIEM INCENTIVE INVOICE ADJUSTMENT$ 312,500.00$ 241,566.78
Please leave information here and hidden. Thank you, Patrick
Contacts & Groups12
Assessment-Tx Planning12$ 241,566.78
Health Services Requests12
Psychiatric Encounters12
Current WtThresholdProposed Wt
1Credentialing / Training2%95%2%
2Transfer DC Meds3%90%3%
3RDU Screen10%95%10%
4Sick Call GP Chart Review9%95%8%
4aSick Call GP Offered95%1%
5SC Segregation Chart Review9%95%8%
5aSick Call Segregation Offered95%1%
6Sick Call RDU Chart Review9%95%8%
6aSick Call RDU Offered95%1%
7Continuity of Care8%90%8%
8Periodic Health Assessment2%85%2%
9Chronic Disease10%95%8%
9aTreatment Plans95%2%
10Oral Care3%85%3%
11Annual TB10%100%8%
12Segregation2%85%2%
13Pregnant Resident3%95%3%
14LTC - Inpatient2%95%2%
15Acute Infirmary Care2%95%2%
1623HR Observation3%95%3%
17HEP C Tracking2%95%2%
18Transfer Screen (RCV)3%95%3%
19LTBI2%100%2%
20MAR2%95%2%
21Diagnostics2%90%2%
22Pharmacy Operations100%2%
23Annual Tool2%90%2%
100%

_x000D_&1#&"Calibri"&10&K000000 IDOC Data Sensitivity Classification - L3 Restricted

QTR 3 - Outcome Incentives.

QUARTERLY PAY FOR PERFORMANCE PI RECONCILIATION
Vendor
PI #DESCRIPTIONWeightMinimum ThresholdQTR 1 THRESHOLD ACHIEVEDFacility averages% over / under thresholdBase Per Diem EquivalentADPEARNED/

OWED

MEDICAL CRITERIA1Credentialing2%100%100%100.00%0.00%$0.0087500$ - 0
2Discharge Planning3%90%100%100.00%10.00%$0.0127500$ 65,881.85
3RDU Screen3%95%100%100.00%5.00%$0.0127500$ 32,940.92
4Sick Call General Population6%95%100%100.00%5.00%$0.0237500$ 65,881.85
5Sick Call Segregation3%95%100%100.00%5.00%$0.0127500$ 32,940.92
6Sick Call RDU1%95%100%100.00%5.00%$0.0047500$ 10,980.31
7Off-Site Care5%90%100%100.00%10.00%$0.0207500$ 109,803.08
8Periodic Health Assessment5%90%100%100.00%10.00%$0.0207500$ 109,803.08
9CDP - Diabetes4%95%100%100.00%5.00%$0.0167500$ 43,921.23
10CDP - CKD2%95%100%100.00%5.00%$0.0087500$ 21,960.62
11CDP -HIV2%95%100%100.00%5.00%$0.0087500$ 21,960.62
12CDP - Cirrhosis4%95%100%100.00%5.00%$0.0167500$ 43,921.23
13Oral Care3%90%100%100.00%10.00%$0.0127500$ 65,881.85
14TB Screening and Treatment2%98%100%100.00%2.00%$0.0087500$ 8,784.25
15Vaccination Program3%98%100%100.00%2.00%$0.0127500$ 13,176.37
16Pregnant Resident4%95%100%100.00%5.00%$0.0167500$ 43,921.23
17Long Term Care4%95%100%100.00%5.00%$0.0167500$ 43,921.23
18Infirmary3%95%100%100.00%5.00%$0.0127500$ 32,940.92
1923-Hour Observation1%95%100%100.00%5.00%$0.0047500$ 10,980.31
20Hepatitis C Monitoring5%95%100%100.00%5.00%$0.0207500$ 54,901.54
21Transfer Screening1%90%100%100.00%10.00%$0.0047500$ 21,960.62
22Diagnostics3%90%100%100.00%10.00%$0.0127500$ 65,881.85
23Infection Control & CQI2%95%100%100.00%5.00%$0.0087500$ 21,960.62
24Peer Review5%90%100%100.00%10.00%$0.0207500$ 109,803.08
25Resident Education2%98%100%100.00%2.00%$0.0087500$ 8,784.25$ 1,062,893.84
MENTAL HEALTH CRITERIA1Mental Health Screening6%95%100%100.00%5.00%$0.0237500$ 65,881.85
2Restrictive Housing2%95%100%100.00%5.00%$0.0087500$ 21,960.62
3Mental Health Units3%95%100%100.00%5.00%$0.0127500$ 32,940.92$ 1,304,460.62
4Outpatient Needs2%95%100%100.00%5.00%$0.0087500$ 21,960.62
5Psychiatric Medication Services6%95%100%100.00%5.00%$0.0237500$ 65,881.85
6Multidisciplinary Team Meetings3%95%100%100.00%5.00%$0.0127500$ 32,940.92
QUARTERLY BASE PER DIEM INCENTIVE INVOICE ADJUSTMENT$ 312,500.00$ 241,566.78
Please leave information here and hidden. Thank you, Patrick
Contacts & Groups12
Assessment-Tx Planning12$ 241,566.78
Health Services Requests12
Psychiatric Encounters12
Current WtThresholdProposed Wt
1Credentialing / Training2%95%2%
2Transfer DC Meds3%90%3%
3RDU Screen10%95%10%
4Sick Call GP Chart Review9%95%8%
4aSick Call GP Offered95%1%
5SC Segregation Chart Review9%95%8%
5aSick Call Segregation Offered95%1%
6Sick Call RDU Chart Review9%95%8%
6aSick Call RDU Offered95%1%
7Continuity of Care8%90%8%
8Periodic Health Assessment2%85%2%
9Chronic Disease10%95%8%
9aTreatment Plans95%2%
10Oral Care3%85%3%
11Annual TB10%100%8%
12Segregation2%85%2%
13Pregnant Resident3%95%3%
14LTC - Inpatient2%95%2%
15Acute Infirmary Care2%95%2%
1623HR Observation3%95%3%
17HEP C Tracking2%95%2%
18Transfer Screen (RCV)3%95%3%
19LTBI2%100%2%
20MAR2%95%2%
21Diagnostics2%90%2%
22Pharmacy Operations100%2%
23Annual Tool2%90%2%
100%

_x000D_&1#&"Calibri"&10&K000000 IDOC Data Sensitivity Classification - L3 Restricted

QTR 4 - Outcome Incentives.

QUARTERLY PAY FOR PERFORMANCE PI RECONCILIATION
Vendor
PI #DESCRIPTIONWeightMinimum ThresholdQTR 1 THRESHOLD ACHIEVEDFacility averages% over / under thresholdBase Per Diem EquivalentADPEARNED/

OWED

MEDICAL CRITERIA1Credentialing2%100%100%100.00%0.00%$0.0087500$ - 0
2Discharge Planning3%90%100%100.00%10.00%$0.0127500$ 65,881.85
3RDU Screen3%95%100%100.00%5.00%$0.0127500$ 32,940.92
4Sick Call General Population6%95%100%100.00%5.00%$0.0237500$ 65,881.85
5Sick Call Segregation3%95%100%100.00%5.00%$0.0127500$ 32,940.92
6Sick Call RDU1%95%100%100.00%5.00%$0.0047500$ 10,980.31
7Off-Site Care5%90%100%100.00%10.00%$0.0207500$ 109,803.08
8Periodic Health Assessment5%90%100%100.00%10.00%$0.0207500$ 109,803.08
9CDP - Diabetes4%95%100%100.00%5.00%$0.0167500$ 43,921.23
10CDP - CKD2%95%100%100.00%5.00%$0.0087500$ 21,960.62
11CDP -HIV2%95%100%100.00%5.00%$0.0087500$ 21,960.62
12CDP - Cirrhosis4%95%100%100.00%5.00%$0.0167500$ 43,921.23
13Oral Care3%90%100%100.00%10.00%$0.0127500$ 65,881.85
14TB Screening and Treatment2%98%100%100.00%2.00%$0.0087500$ 8,784.25
15Vaccination Program3%98%100%100.00%2.00%$0.0127500$ 13,176.37
16Pregnant Resident4%95%100%100.00%5.00%$0.0167500$ 43,921.23
17Long Term Care4%95%100%100.00%5.00%$0.0167500$ 43,921.23
18Infirmary3%95%100%100.00%5.00%$0.0127500$ 32,940.92
1923-Hour Observation1%95%100%100.00%5.00%$0.0047500$ 10,980.31
20Hepatitis C Monitoring5%95%100%100.00%5.00%$0.0207500$ 54,901.54
21Transfer Screening1%90%100%100.00%10.00%$0.0047500$ 21,960.62
22Diagnostics3%90%100%100.00%10.00%$0.0127500$ 65,881.85
23Infection Control & CQI2%95%100%100.00%5.00%$0.0087500$ 21,960.62
24Peer Review5%90%100%100.00%10.00%$0.0207500$ 109,803.08
25Resident Education2%98%100%100.00%2.00%$0.0087500$ 8,784.25$ 1,062,893.84
MENTAL HEALTH CRITERIA1Mental Health Screening6%95%100%100.00%5.00%$0.0237500$ 65,881.85
2Restrictive Housing2%95%100%100.00%5.00%$0.0087500$ 21,960.62
3Mental Health Units3%95%100%100.00%5.00%$0.0127500$ 32,940.92$ 1,304,460.62
4Outpatient Needs2%95%100%100.00%5.00%$0.0087500$ 21,960.62
5Psychiatric Medication Services6%95%100%100.00%5.00%$0.0237500$ 65,881.85
6Multidisciplinary Team Meetings3%95%100%100.00%5.00%$0.0127500$ 32,940.92
QUARTERLY BASE PER DIEM INCENTIVE INVOICE ADJUSTMENT$ 312,500.00$ 241,566.78
Please leave information here and hidden. Thank you, Patrick
Contacts & Groups12
Assessment-Tx Planning12$ 241,566.78
Health Services Requests12
Psychiatric Encounters12
Current WtThresholdProposed Wt
1Credentialing / Training2%95%2%
2Transfer DC Meds3%90%3%
3RDU Screen10%95%10%
4Sick Call GP Chart Review9%95%8%
4aSick Call GP Offered95%1%
5SC Segregation Chart Review9%95%8%
5aSick Call Segregation Offered95%1%
6Sick Call RDU Chart Review9%95%8%
6aSick Call RDU Offered95%1%
7Continuity of Care8%90%8%
8Periodic Health Assessment2%85%2%
9Chronic Disease10%95%8%
9aTreatment Plans95%2%
10Oral Care3%85%3%
11Annual TB10%100%8%
12Segregation2%85%2%
13Pregnant Resident3%95%3%
14LTC - Inpatient2%95%2%
15Acute Infirmary Care2%95%2%
1623HR Observation3%95%3%
17HEP C Tracking2%95%2%
18Transfer Screen (RCV)3%95%3%
19LTBI2%100%2%
20MAR2%95%2%
21Diagnostics2%90%2%
22Pharmacy Operations100%2%
23Annual Tool2%90%2%
100%

_x000D_&1#&"Calibri"&10&K000000 IDOC Data Sensitivity Classification - L3 Restricted

QTR 2 - Outcome Incentives

QUARTERLY PAY FOR PERFORMANCE PI RECONCILIATION
Centurion
PI #DESCRIPTIONWeightMinimum ThresholdQTR 2 THRESHOLD ACHIEVEDFacility averages% over / under thresholdBase Per Diem EquivalentADPEARNED/

OWED

MEDICAL CRITERIA1Credentialing2%100%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
2Discharge Planning3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
3RDU Screen3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
4Sick Call General Population6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
5Sick Call Segregation3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
6Sick Call RDU1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
7Off-Site Care5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
8Periodic Health Assessment5%85%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
9CDP - Diabetes Mellitus4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
10CDP - Chronic Kidney Disease2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
11CDP - HIV1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
12CDP - Cirrhosis4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
13Oral Care2%85%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
14TB Screening & Treatment2%98%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
15Vaccination Program3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
16Pregnant Residents4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
17Long-Term Care3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
18Acute Infirmary Care3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
1923 Hour Observation1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
20Hepatitis C Tracking5%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
21Transfer Screening1%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
22Diagnostics3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
23Infection Control & CQI Meetings2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
24Sentinel & Adverse Events5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
25Patient Education5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
26Continuous Quality Improvement*Required per NCCHC standards. Not evaluated or audited per contract.ERROR:#DIV/0!
MENTAL HEALTH CRITERIA1Mental Health Screening6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
2Restrictive Housing2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
3Mental Health Units3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!ERROR:#DIV/0!
4Outpatient Needs2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
5Psychiatric Medication Services6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
6Multidisciplinary Team Meeting (MDT)3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!ERROR:#DIV/0!
QUARTERLY BASE PER DIEM INCENTIVE INVOICE ADJUSTMENTERROR:#DIV/0!
Please leave information here and hidden. Thank you, Patrick
Contacts & Groups12
Assessment-Tx Planning12
Health Services Requests12
Psychiatric Encounters12
Current WtThresholdProposed Wt
1Credentialing / Training2%95%2%
2Transfer DC Meds3%90%3%
3RDU Screen10%95%10%
4Sick Call GP Chart Review9%95%8%
4aSick Call GP Offered95%1%
5SC Segregation Chart Review9%95%8%
5aSick Call Segregation Offered95%1%
6Sick Call RDU Chart Review9%95%8%
6aSick Call RDU Offered95%1%
7Continuity of Care8%90%8%
8Periodic Health Assessment2%85%2%
9Chronic Disease10%95%8%
9aTreatment Plans95%2%
10Oral Care3%85%3%
11Annual TB10%100%8%
12Segregation2%85%2%
13Pregnant Resident3%95%3%
14LTC - Inpatient2%95%2%
15Acute Infirmary Care2%95%2%
1623HR Observation3%95%3%
17HEP C Tracking2%95%2%
18Transfer Screen (RCV)3%95%3%
19LTBI2%100%2%
20MAR2%95%2%
21Diagnostics2%90%2%
22Pharmacy Operations100%2%
23Annual Tool2%90%2%
100%

QTR 3 - Outcome Incentives

QUARTERLY PAY FOR PERFORMANCE PI RECONCILIATION
Centurion
PI #DESCRIPTIONWeightMinimum ThresholdQTR 3 THRESHOLD ACHIEVEDFacility averages% over / under thresholdBase Per Diem EquivalentADPEARNED/

OWED

MEDICAL CRITERIA1Credentialing2%100%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
2Discharge Planning3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
3RDU Screen3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
4Sick Call General Population6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
5Sick Call Segregation3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
6Sick Call RDU1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
7Off-Site Care5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
8Periodic Health Assessment5%85%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
9CDP - Diabetes Mellitus4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
10CDP - Chronic Kidney Disease2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
11CDP - HIV1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
12CDP - Cirrhosis4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
13Oral Care2%85%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
14TB Screening & Treatment2%98%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
15Vaccination Program3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
16Pregnant Residents4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
17Long-Term Care3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
18Acute Infirmary Care3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
1923 Hour Observation1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
20Hepatitis C Tracking5%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
21Transfer Screening1%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
22Diagnostics3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
23Infection Control & CQI Meetings2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
24Sentinel & Adverse Events5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
25Patient Education5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
26Continuous Quality Improvement*Required per NCCHC standards. Not evaluated or audited per contract.ERROR:#DIV/0!
MENTAL HEALTH CRITERIA1Mental Health Screening6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
2Restrictive Housing2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
3Mental Health Units3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!ERROR:#DIV/0!
4Outpatient Needs2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
5Psychiatric Medication Services6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
6Multidisciplinary Team Meeting (MDT)3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!ERROR:#DIV/0!
QUARTERLY BASE PER DIEM INCENTIVE INVOICE ADJUSTMENTERROR:#DIV/0!
Please leave information here and hidden. Thank you, Patrick
Contacts & Groups12
Assessment-Tx Planning12
Health Services Requests12
Psychiatric Encounters12
Current WtThresholdProposed Wt
1Credentialing / Training2%95%2%
2Transfer DC Meds3%90%3%
3RDU Screen10%95%10%
4Sick Call GP Chart Review9%95%8%
4aSick Call GP Offered95%1%
5SC Segregation Chart Review9%95%8%
5aSick Call Segregation Offered95%1%
6Sick Call RDU Chart Review9%95%8%
6aSick Call RDU Offered95%1%
7Continuity of Care8%90%8%
8Periodic Health Assessment2%85%2%
9Chronic Disease10%95%8%
9aTreatment Plans95%2%
10Oral Care3%85%3%
11Annual TB10%100%8%
12Segregation2%85%2%
13Pregnant Resident3%95%3%
14LTC - Inpatient2%95%2%
15Acute Infirmary Care2%95%2%
1623HR Observation3%95%3%
17HEP C Tracking2%95%2%
18Transfer Screen (RCV)3%95%3%
19LTBI2%100%2%
20MAR2%95%2%
21Diagnostics2%90%2%
22Pharmacy Operations100%2%
23Annual Tool2%90%2%
100%

QTR 4 - Outcome Incentives

QUARTERLY PAY FOR PERFORMANCE PI RECONCILIATION
Centurion
PI #DESCRIPTIONWeightMinimum ThresholdQTR 4 THRESHOLD ACHIEVEDFacility averages% over / under thresholdBase Per Diem EquivalentADPEARNED/

OWED

MEDICAL CRITERIA1Credentialing2%100%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
2Discharge Planning3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
3RDU Screen3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
4Sick Call General Population6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
5Sick Call Segregation3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
6Sick Call RDU1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
7Off-Site Care5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
8Periodic Health Assessment5%85%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
9CDP - Diabetes Mellitus4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
10CDP - Chronic Kidney Disease2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
11CDP - HIV1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
12CDP - Cirrhosis4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
13Oral Care2%85%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
14TB Screening & Treatment2%98%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
15Vaccination Program3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
16Pregnant Residents4%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0167500ERROR:#DIV/0!
17Long-Term Care3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
18Acute Infirmary Care3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
1923 Hour Observation1%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
20Hepatitis C Tracking5%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
21Transfer Screening1%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0047500ERROR:#DIV/0!
22Diagnostics3%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!
23Infection Control & CQI Meetings2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
24Sentinel & Adverse Events5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
25Patient Education5%90%ERROR:#DIV/0!ERROR:#DIV/0!$0.0207500ERROR:#DIV/0!
26Continuous Quality Improvement*Required per NCCHC standards. Not evaluated or audited per contract.ERROR:#DIV/0!
MENTAL HEALTH CRITERIA1Mental Health Screening6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
2Restrictive Housing2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
3Mental Health Units3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!ERROR:#DIV/0!
4Outpatient Needs2%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0087500ERROR:#DIV/0!
5Psychiatric Medication Services6%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0237500ERROR:#DIV/0!
6Multidisciplinary Team Meeting (MDT)3%95%ERROR:#DIV/0!ERROR:#DIV/0!$0.0127500ERROR:#DIV/0!ERROR:#DIV/0!
QUARTERLY BASE PER DIEM INCENTIVE INVOICE ADJUSTMENTERROR:#DIV/0!
Please leave information here and hidden. Thank you, Patrick
Contacts & Groups12
Assessment-Tx Planning12
Health Services Requests12
Psychiatric Encounters12
Current WtThresholdProposed Wt
1Credentialing / Training2%95%2%
2Transfer DC Meds3%90%3%
3RDU Screen10%95%10%
4Sick Call GP Chart Review9%95%8%
4aSick Call GP Offered95%1%
5SC Segregation Chart Review9%95%8%
5aSick Call Segregation Offered95%1%
6Sick Call RDU Chart Review9%95%8%
6aSick Call RDU Offered95%1%
7Continuity of Care8%90%8%
8Periodic Health Assessment2%85%2%
9Chronic Disease10%95%8%
9aTreatment Plans95%2%
10Oral Care3%85%3%
11Annual TB10%100%8%
12Segregation2%85%2%
13Pregnant Resident3%95%3%
14LTC - Inpatient2%95%2%
15Acute Infirmary Care2%95%2%
1623HR Observation3%95%3%
17HEP C Tracking2%95%2%
18Transfer Screen (RCV)3%95%3%
19LTBI2%100%2%
20MAR2%95%2%
21Diagnostics2%90%2%
22Pharmacy Operations100%2%
23Annual Tool2%90%2%
100%

File details come from the government source that posted it. Updated .