Welcome to the HealthPRO Heritage Blog

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. 

On CMS' Technical Page, the agency announced via this post that an error was made in the PDPM Grouper! Six ICD-10 codes (T8484XA, T8389XA, T8321XA, T82399A, T82392A, and T83021A) were excluded. These codes are significant, because they contribute points toward the NTA case mix group when coded on the PPS MDS assessment.

HealthPRO Heritage is eager to share meaningful, optimistic outcomes amidst a critical time.

As we approach the 1-year anniversary of the PDPM implementation, many continue to struggle with COVID-19 related challenges. Despite the circumstances, HealthPRO Heritage is proud to report outcomes that reliably demonstrate What’s Possible: Impressive upward trends in clinical efficacy and business partnership outcomes.

See What’s Possible. Review FIVE key cross-sectional outcome measures that are truly unique only to HealthPRO Heritage.

With our industry’s focus on the COVID-19 public health emergency, this year’s Final Rule addresses essential policies only, while incorporating some impactful PDPM updates. There is a strong theme emphasizing a continued commitment to keeping providers connected through electronic means to promote the exchange and reuse of patient assessment data. The MDS is at the top of that list with discharge information being critical to ensure necessary medical information is shared and transferred among post hospital settings. The MDS will not have the anticipated major over haul until 2 years from the end of the Public Health Emergency, likely October 2022. This is good news for interdisciplinary teams that have been adjusting to many related changes and communication methods. Accuracy and collaboration remain critical for the current environment as well as future changes.

When it comes to clinical reimbursement opportunities, HealthPRO Heritage asks: “Is your clinical team leaving no stone unturned?” As national healthcare consultants with a progressive approach to PDPM, HealthPRO Heritage offers five simple (but not easy*) strategies to compliantly optimize clinical-based reimbursement.

"If it were easy….then everyone would do it!"

To achieve, or maintain high marks on performance outcomes – and ultimately drive census & fiscal upside – HealthPRO Heritage suggests: Supercharge your strategy with on-the-ground support for your Nursing team. 

What's been on your mind? 
More than 90,000 visitors have clicked through HealthPRO Heritage resources to access updates & advice from our subject-matter experts. 

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More than 70% of hospitals outsource at least a portion of coding duties to professional Certified Coders. This fact begs the question: Why shouldn’t skilled nursing operators also seek out the expertise of professional coding experts to optimize coding? After all, accurate, optimal, and timely coding is critical to PDPM success!

We all survived the PDPM transition on October 1. Now what?

As the dust settles, SNFs may be wrestling with an important question: How will the industry define and measure success under PDPM & Beyond?

Gut-Check Survey Results + Feedback from the PDPM Front Line
HealthPRO Heritage launched a survey – “PDPM Gut-Check” – to capture how the industry is feeling about the new reimbursement system.  Here’s what you and your peers had to say.