PDPM For Skilled Nursing Success

Patient Driven Payment Method (PDPM) Overview

PDPM For Skilled Nursing Success

Patient Driven Payment Method (PDPM) Overview

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PDPM Concepts I & II – Program Overview

This interactive training provides an introductory overview of the new Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) payment model implemented on October, 1, 2019
The training is designed for clinicians newer to SNF reimbursement & seeking a step by step breakdown of the old reimbursement to make it easier to learn the new system.


Intended Audience: 

This training is great for all SNF Team members including MDS Nurses, DONs, ADON, Rehab, Social Service, Admissions, Restorative Nurse, Nurse Managers, Business Office, Nurse Practitioners ect


Learning Objectives:   

  • Intro to PDPM Concepts
  • PDPM vs RUGS V
  • Dissecting Payment Components
  • IPA  Management & Strategy
  • The Pre-Post Admission process
  • The updated Medicare A Schedules & Management
  • Documentation requirements

Live Virtual Workshops:

  • July 1 & July 8, 2020 (Wed) 7:00pm-8:30pm cst
  • More dates to come

** Live virtual course workshops questions are welcomed, no webcam needed.

REGISTER HERE

Self Paced Modules – 2 Module Video Course

  • Designed for busy clinicians unable to meet scheduling requirements
  • Recorded course in same format as live sessions
  • Allow 24-48 hours for email access to learning platform
  • Hard copy of books and materials shipped to personal address or facility (please specify if shipping to facility)
  • Up to 30 days to complete program requirements (May complete when all requirements are met)

Cost: $199.00  

 REGISTER HERE

To register by check:

All checks should be made payable to:

MDS Training Institute
5700 Tennyson Parkway Suite 350
Plano, TX 75024

Related Courses:

             

Figure 2.  PDPM Component and Patient Characteristics Used for Case-Mix Group (CMG) Assignment

Component Patient
Characteristics
Per Diem
Structure
# of Case Mix
Groups
PT – Primary reason for SNF Care ICD-10
– Functional Status – MDS Section GG Early and Late Loss
Payment Decreases
After Day 20
16
OT – Primary reason for SNF Care ICD-10
– Functional Status – MDS Section GG Early and Late Loss
Payment Decreases
After Day 20
16
SLP – Primary Reason for SNF care  ICD-10
– Cognitive Status
– Presence of swallowing disorder or mechanically altered diet
– Other SLP related comorbidities
Average Daily Payment
No Variable Payment
12
Nursing – Clinical information from SNF Stay
– Functional Status – MDS Section GG Early and Late Loss
– Extensive Services Received
– Presence of depression
– Restorative nursing services received
Average Daily Payment
No Variable Payment
25
NTAS – Comorbidities present
– Extensive services used
Payment Decreases
After Day 3
6

While considerable analysis is needed to understand how SNFs may optimally deliver quality care under PDPM, five key elements of the payment system are critical to understand when considering preparations for the transition from RUGs to PDPM.  See Figure 3., below.

Figure 3.  PDPM is a New Medicare Part A Fee-For-Service Payment System: Key Elements to Understand

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