Expected Discharge Score

CMS looks at large groups of residents with the same diagnosis and similar admission function and identifies where those residents typically end up by discharge. That typical outcome becomes the starting estimated discharge score.

James's admission score combined with his primary diagnosis of Stroke sets his starting estimated discharge score.

This is lower because stroke recovery often follows a different trajectory, with more variability and typically smaller functional gains.

• Model Intercept (+29.08 pts)
• Baseline Admission Lift (+13.00 pts)
• Diminishing Returns (-1.37 pts)
• Stroke (-8.62 pts)
• Admission × Diagnosis Interaction (+2.40 pts)

Before the event that led to hospitalization, a resident's level of independence helps shape what recovery is realistically expected. Even if the starting estimate is moderate, prior limitations can significantly lower the expected outcome.

James's pre-admission factors meaningfully reduce the expectation. Prior dependence in self-care, mobility, and cognition combined with wheelchair use all pull the expectation down; only prior stair dependence offsets that with a small positive contribution.

• Age: 65–74 years (reference) (+0.00 pts)
• Prior Self-Care: Dependent (-4.03 pts)
• Prior Indoor Mobility: Dependent (-1.72 pts)
• Prior Stairs: Dependent (+0.32 pts)
• Prior Functional Cognition: Limited (-0.93 pts)
• Mobility Device: Manual/Motorized Wheelchair or Scooter (-2.57 pts)

CMS looks at large groups of residents with the same diagnosis and similar admission function and identifies where those residents typically end up by discharge. That typical outcome becomes the starting estimated discharge score.

Ruth's admission score combined with her primary diagnosis of Debility & Cardiorespiratory sets her starting estimated discharge score.

This reflects a more limited recovery trajectory compared to more predictable rehab pathways.

• Model Intercept (+29.08 pts)
• Baseline Admission Lift (+15.17 pts)
• Diminishing Returns (-1.86 pts)
• Debility & Cardiorespiratory (-6.24 pts)
• Admission × Diagnosis Interaction (+1.85 pts)

Before the event that led to hospitalization, a resident's level of independence helps shape what recovery is realistically expected. When prior function shows high dependence, the expected outcome is lowered further.

Ruth's pre-admission factors meaningfully reduce the expectation. Mechanical lift use, dependent self-care and mobility, cognitive limitations, and advanced age all pull the score down; prior stair dependence offsets that slightly with a small positive contribution.

• Age: 85–90 years (-0.78 pts)
• Prior Self-Care: Dependent (-4.03 pts)
• Prior Indoor Mobility: Dependent (-1.72 pts)
• Prior Stairs: Dependent (+0.32 pts)
• Prior Functional Cognition: Limited (-0.93 pts)
• Mobility Device: Mechanical Lift (-2.82 pts)

CMS looks at large groups of residents with the same diagnosis and similar admission function and identifies where those residents typically end up by discharge. That typical outcome becomes the starting estimated discharge score.

Robert's admission score combined with his primary diagnosis of Fractures & Multiple Trauma sets his starting estimated discharge score.

This reflects a recovery path where higher functional gains are commonly expected.

• Model Intercept (+29.08 pts)
• Baseline Admission Lift (+21.67 pts)
• Diminishing Returns (-3.80 pts)
• Fractures & Multiple Trauma (-1.80 pts)
• Admission × Diagnosis Interaction (+0.40 pts)

Before the event that led to hospitalization, a resident's level of independence helps shape what recovery is realistically expected. When limitations are present but not severe, they create modest adjustments.

Robert's pre-admission factors create modest adjustments in both directions. Prior assistance with self-care and mobility, plus age, pull the expectation down; prior surgery and walker use offset that with small positive contributions, leaving only a small net reduction.

• Age: 75–84 years (-0.31 pts)
• Prior Surgery (+0.65 pts)
• Prior Indoor Mobility: Some Help (-1.08 pts)
• Mobility Device: Walker (+0.11 pts)

CMS looks at large groups of residents with the same diagnosis and similar admission function and identifies where those residents typically end up by discharge. That typical outcome becomes the starting estimated discharge score.

Before the event that led to hospitalization, a resident's level of independence helps shape what recovery is realistically expected. Residents who needed significant help with mobility or relied on assistive devices are unlikely to become fully independent during a short SNF stay, while those who were more independent may have greater recovery potential depending on diagnosis.