Welcome to the HealthPRO® Heritage Blog

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

Coding for Success in PDGM

Posted on: May 14, 2019

Coding will be instrumental to your agency’s success under PDGM. Performing an audit of your coding practices now will provide the opportunity to educate your staff on accurate and cohesive coding guidelines and targeted aspects of the OASIS to ensure you are prioritizing both patient needs and accurate reimbursement. 

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Tags: PDGM, CMS Update 2019, Patient-Driven Grouping Model

PDPM: Outcomes, Outcomes, Outcomes

Posted on: May 2, 2019

Success under PDPM – and beyond!  in large part, boils down to this: A SNF’s ability to build positive, sustainable outcomes. As such, HealthPRO® Heritage advises providers to focus on the strategies, processes, and initiatives that will support consistent delivery on exceptional clinical and performance outcomes.  

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Tags: Rules of Participation, PDPM, CMS Update 2019

Ticket to Ride: OASIS Will Drive Success Under PDGM

Posted on: April 30, 2019

Accurate OASIS coding has always been important, but with PDGM on the horizon, our ability to master the OASIS will be imperative! After all, accurate OASIS coding will directly impact an agency’s ability to achieve optimal outcomes and support reimbursement in today’s and tomorrow’s world.

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Tags: Home Health, PDGM, CMS Update 2019, Patient-Driven Grouping Model, PrepareExecuteSucceed, OASIS

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

Get Ready for PDGM

Posted on: April 25, 2019

Implementation of the new case-mix classification model, the Patient Driven Grouping Model (PDGM), on January 1, 2020 will bring BIG changes to the home health profession! HealthPRO® Heritage at Home is ready to help you start preparing TODAY for the most dramatic Medicare reimbursement change since PPS.

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Tags: Home Health, PDGM, CMS Update 2019, Revenue, Patient-Driven Grouping Model, PrepareExecuteSucceed, OASIS

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

Under PDGM: Revenue Cycle Matters

Posted on: April 15, 2019

PDGM implementation is a mere 38 weeks away, bringing significant changes in episode length (60 to 30 days), resultant billing processes, revenue cycle, and ultimately, cash flow. While certification periods will continue to be 60 days in duration, reimbursement will be broken into 30-day payment periods. As such, billing will have to be processed for each 30-day payment period including Requests for Anticipated Payment (RAPs) and final claims. This will likely result in a substantial increase in claims volume in addition to an interruption in cash flow. Specifically, agencies will experience a cash flow “crunch” during the first few months of implementation as the conversion from 60-day to 30-day payments is realized with a leveling off after the initial impact and conversion.

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Tags: Home Health, PDGM, Revenue, Patient-Driven Grouping Model, PrepareExecuteSucceed, Episode Length of Stay, ELOS

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