Welcome to the HealthPRO® Heritage Blog

And the Winner Is... Update from CMS Regarding PDPM

Posted on: April 20, 2019

Late Friday afternoon, April 19, CMS released the FY 2020 SNF PPS Proposed Rule, specifying a few changes for the Patient-Driven Payment Model (PDPM). HealthPRO® Heritage is looking forward to reporting out on all the modifications, but can’t wait to share the following good news…

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Tags: Payment Reform, Patient-Driven Payment Model, PDPM, CMS Update 2019

QRP and QMs are Changing with the Times. Are You?

Posted on: April 18, 2019

As of April, CMS has implemented important modifications for the Quality Reporting Program (QRP) and Quality Measures (QMs) that may have significant fiscal, clinical, and compliance implications as well. Not only will these changes enable CMS to better monitor SNF outcomes, the modifications raise the bar on performance measures and will challenge SNFs to drive care differently. 

What should SNFs know?  HealthPRO® Heritage offers guidance. 

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Tags: Patient-Driven Payment Model, PDPM, CMS Update 2019

Group Therapy Under PDPM: Strength in Numbers

Posted on: April 11, 2019

Think about a task you routinely complete:  yardwork, cooking a meal, or a project at work.  Now imagine asking a friend or co-worker to pick up a rake or join you in the kitchen.  Your results:  being able to complete the same tasks with improved efficiency and even better outcomes.    

Apply this thought-process to providing world-class rehab services for the patients in your care.  Research supports:  There’s strength in numbers!

The post-acute world is looking forward to new rules. Learn more about best practices and potential pitfalls RE: Group Therapy Under PDPM. 

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Tags: Patient-Driven Payment Model, PDPM

Give a Little to Get a Lot: Nursing, PDPM, and Documentation ReDesign

Posted on: April 1, 2019

CEOs, NHAs, and DONs take note!  With the new PDPM paradigm, you’ll be asking your nurses to:

  • Continue to drive quality measures, star ratings, survey results, satisfaction scores, etc.
  • Care for higher acuity patients; and
  • Adopt very different documentation practices.

All of these requisites are vitally important to your facility’s success under PDPM. But perhaps the most challenging change for Nursing teams (who really just want to be patient caretakers, right?) will be #3 on this list. 

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Tags: CMS, CMS policy, Payment Reform, Patient-Driven Payment Model, PDPM, CMS Update 2019

If PDPM is a Relay Race...MDs Carry the Baton First

Posted on: March 14, 2019

It seems everyone’s roles are changing with the onset of PDPM.  Even referring clinicians (MDs, NPs and PAs) who send their patients  to a skilled nursing facility will need to commit to a new more comprehensive, faster-paced process. 

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Tags: Patient-Driven Payment Model, PDPM

Under PDPM, CMS Holds the Line on the Definition of Skilled Requirements

Posted on: January 16, 2019

The more things change the more things stay the same.

CMS has been very clear that in order to receive Medicare Part A reimbursement under PDPM, the following will still hold true:  

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Tags: Patient-Driven Payment Model, PDPM

The New PDPM Paradigm: Nursing in the Limelight

Posted on: December 3, 2018

The tide is turning! Imagine a world where revenue is not based on managing therapy treatment minutes, but will be aligned to care delivery. PDPM will set reimbursement based on patients’ clinical profiles, as captured within various coding and assessment scoring factors from the interdisciplinary team (IDT).

This fundamental change will rely on input from all clinical team members, however, nursing and MDS will be under exponential pressure to understand the nuances of PDPM, document and code accurately, and communicate effectively. In the “Brave New World of PDPM”, there are huge financial implications for anything less than thorough and flawless documentation and coding.

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Tags: Payment Reform, Patient-Driven Payment Model, PDPM

CMS’ Newly Released Fact Sheets for PDPM: What Do You Need to Know?

Posted on: November 21, 2018

While we here at HealthPRO® Heritage are thankful for many things this holiday season, this week we were able to add one more item to our list of “thanks”! We are always so grateful when we come upon new information to share with each of you, but even more thankful when that new information is PDPM clarification that we have anxiously been awaiting. So, while you are enjoying some well-deserved quality time with your loved ones this holiday, here is some light reading for you to digest alongside the turkey and pie!

On November 19, 2018, CMS released nine updated “Fact Sheets” to clarify additional areas and help providers strengthen their understanding of the changes to come on 10/1/19. We have reviewed these thoughtfully-crafted Fact Sheets and here is what you need to know:

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Tags: CMS Update 2018, Patient-Driven Payment Model, PDPM

Nine (Really Important) Reasons Why Therapy Still Matters in PDPM

Posted on: November 1, 2018

Imagine a world where reimbursement isn’t based on managing treatment minutes. Instead, therapists are empowered with the freedom to care for residents and drive outcomes based exclusively on clinical need. Let’s face it: Therapy services and reimbursement under PPS has not always served our industry well.

HealthPRO® Heritage experts agree: CMS’ PDPM system will breathe new life into how, when, and why therapists deliver care. We are, in fact, excited for a new world where our success will be measured by the evidence-based therapy we provide and the outcomes we achieve on behalf of our clients and patients.

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Tags: CMS Update 2018, Patient-Driven Payment Model, PDPM

Which PDPM Therapy Pricing Method is Best?

Posted on: October 22, 2018

Since the RCS-1 Proposed Rule was released in Spring 2017, through the PDPM Final Rule and up to today, we’ve spent hundreds of hours thinking and pressure testing different ideas. We’ve had ongoing conversations with customers, colleagues, and consultants about PDPM therapy pricing. Our goal was simple: Develop a pricing approach which equally addresses and ensures the success of our patients, customers, and employees under PDPM. 

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Tags: CMS Update 2018, Payment Reform, Patient-Driven Payment Model, PDPM