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The CY 2018 HH PPS proposed rule (82 FR 35320) and the technical report from December 2016, posted on the Home Health PPS Archive web page located at: provides a more detailed explanation as to the construction of these functional impairment levels using the OASIS items

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doi: 10.1163/156856208784909435

PHAs can biodegrade effectively without specific temperature requirements, similar to other biopolymers, in landfills and in environments unfavorable to degradation, such as freshwater and marine ecosystems [61,62]

Plaque rupture exposes pro-thrombotic material to the bloodstream, triggering the formation of blood clots that can occlude arteries and lead to acute cardiovascular events such as myocardial infarction and stroke [74]