Welcome to the HealthPRO® Heritage Blog

Struggling to Define Success Beyond PDPM? Sustaining QMs is the Solution!

Posted on: May 30, 2019

SNFs have been bombarded with changes to many key performance indicators – such as Quality Measures, Five Star Ratings and the Quality Reporting Program – and will be expected to sustain and even grow quality improvements over time.  Read up on all the new changes here. (And have you heard the latest: CMS recently implemented a process whereby the QM thresholds will increase by 50% of the average rate of improvement in QM scores.)  

Based on these obvious smoke signals from CMS, the industry pundits foresee: Quality Measures just might be CMS’s way of monitoring for appropriate levels of skilled rehabilitation services after the October 1 transition to PDPM.   

In light of this prediction, consider your facility’s QM performance in highly monitored areas – such as skin integrity, falls, ADL performance, weight loss, functional mobility, pain, etc. 

Ask:  Are these areas recurrent concerns for your SNF?  

If so, HealthPRO® Heritage advises:

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

Restorative Nursing Under PDPM: Looking for Answers?

Posted on: May 16, 2019

We can all agree: the value of a solid, efficient restorative nursing program for SNFs should not be underestimated!

There’s a lot of BUZZ in the industry about increasing restorative programming in preparation for PDPM. Many SNFs have Restorative Nursing programs. Many do not. Some have a program, but it doesn’t function the way it should.

Here’s the stone cold truth…
Restorative Nursing may (or may not) make sense for your organization. Hear us out. 

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Tags: Patient-Driven Payment Model, PDPM, CMI, Case Mix Index, Restorative Nursing

SNF Proposed Payment Updates

Posted on: April 25, 2019

Today, CMS published the FY 2020 Skilled Nursing Facility Proposed Payment System (SNF PPS) in the federal register. It contains the SNF PPS payment update is 2.5% for FY 2020, which is an increase in payments of $887 million, compared to FY 2019.  This estimated increase is attributable to a 3.0 percent market basket increase factor with a 0.5 percentage point reduction for multi-factor productivity adjustment.

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

Update from CMS Regarding Group/Concurrent Under PDPM • April 19, 2019

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