Therapy Management & Consulting Services Blog

Overwhelmed By the Newly Proposed CMS Payment System?

Unaware that CMS has proposed a new payment system for our fee for service residents ?  Don’t worry, we read the entire proposed rule and have everything ready for you.  If you haven’t seen our most recent Advisor for a quick “what’s this PDPM all about?”, click here.  We were swift with putting together all of the details in a webinar for our current and potential partners – you can watch the recording here if you missed it. 

So what’s the big deal, you ask?  Everything.  It’s not just a name change. CMS has proposed changing how skilled nursing facilities are reimbursed for Medicare Fee For Service residents taking away therapy minutes as the driver and using resident classification or characteristics.  The MDS will be the driver of payment based on the resident’s clinical needs, including ICD-10 coding, Section GG functional status, cognitive status, nursing skilled and extensive services among other items. 

If you are thinking, oh boy!, you are right.  There are a lot of ways to begin preparing to stay ahead of this proposed October 1, 2019 change.

  1. Get educated on PDPM.  We already put this together for you – watch the recording
  2. Start looking at your coding practices – who does it? how soon is it done?
  3. Let’s talk about triple check – do you do it?  If not, start. 

That’s enough for today.  We are working on the therapy piece trust us:  clinical and care pathways, documentation changes, education and certification on CARE Tool item sets/Section GG, work flow for daily PDPM reviews between the IDT. 

Tags: skilled nursing facility, snf, RCS-1, Patient-Driven Payment Model, PDPM