Simplify Success
PDPM is a complex system of reimbursement. Of the 5 payment categories, the NTA category requires significant clinical skill and awareness to be sure the NTA HIPPS fully represents the unique characteristics of each resident. Over 40% of the points at stake within this category represent ICD-10 coding at MDS item I8000. With some states…...
PDPM is complex and mastering the 5 payment categories in this grouper is a must. The nursing category contains an array of clinical data that identifies the resident’s unique needs from a reimbursement and quality perspective. Getting this category right will ensure proper payment for both Medicare and, in many states, Medicaid, proper representation of…...
Traditionally, the PDPM nursing category has been underutilized in its representation of resident unique characteristics. With the elimination of section G in MDS 3.0 v1.18.11 in October 2023, states are moving away from RUG based case mix index rate adjustments to PDPM based systems that generally incorporate only the PDPM nursing category in that calculation.…...
We’ve been hard at work doing a complete refresh of PDPM Navigator® and we’re excited to show it to you. So excited in fact that we’re going to give you a sneak preview right now. First of all, we’d like to sincerely thank everyone who has downloaded and use PDPM Navigator®! We are incredibly humbled… Continue reading PDPM Navigator® – Version 2 is here!
The Speech Language Pathology Component in PDPM can be can be challenging to understand. With so many moving parts it can be difficult to be sure you have captured everything necessary to accurately represent your resident population accurately in the facility PDPM rate. This presentation will unlock the SLP component of PDPM so providers can…...
CMS has made changes to the MDS item set that will take effect in the next two fiscal years. Some changes are minor while some of the changes have been designed to align data capture in the SNF with the health equity initiatives embedded in the National Quality strategy. SNFs will be gathering more Social…...
Understanding how your PPS rate is constructed is a critical skill. This presentation will break apart the PPPS rate and discover ways to ensure that your team is identifying and capturing resident specific information necessary for a PPS rate that reflects the acuity of your patient population. Download course materials here. Download PDPM Rate Calculator…...
It, still the season for giving right? So… we thought we would provide you with some post Christmas, pre new year reading courtesy of CMS As you may be aware, CMS promised a full set of MDS 3.0 v1.18.11 item sets before the end of the year. Well, CMS has gone and done it again.… Continue reading All 9 MDS 3.0 v1.18.11 DRAFT Item Sets Released!
Hello Insiders! In this presentation you will learn drivers of your FY 2023 rate. You can download the materials here. To apply for NAB and/or ANCC credit, please fill out this form....
Hello there Insiders! Today, we’re going to look at some of the latest data from RESDAC. We’ve just received data for quarter 4 of 2021 and want to share some observations with you. PDPM and Two States Minnesota McKnights recently published an article about skilled nursing and Minnesota. You can read it here. The short…...
