Patient Driven Payment Model (PDPM) Boot Camp PDPM is Coming: Are You Ready? What You Need to Know by October 1, 2019 -- (LIVE STREAM DATE) April 8, 2019

The new Medicare Patient Driven Payment Model (PDPM) begins October 1, 2019. For Skilled Nursing Facility (SNF) providers, this will warrant not only significant operational changes but also a change of thinking as the new PDPM removes therapy minutes as a determinant of payment and strengthens the relationship between payment and clinical characteristics to promote payment accuracy and provide the resources necessary for SNFs to meet the care needs of a diverse range of residents. Key components of this payment accuracy rely upon the understanding of how the six components (PT, OT, ST, NTA, Nursing, Non-Case Mix) of the PDPM impact reimbursement. Additionally, PDPM requires a greater understanding of how to identify the medical complexity of our residents and ensure that complexity has been captured within the Minimum Data Set (MDS). The identification of medical complexity will require SNFs to have a keen understanding of the ICD-10 codes and how the ICD-10 codes determine how the resident is classified into the PDPM clinical categories.

TARGET AUDIENCE

1. Interdisciplinary team members including Administrators, Nurses, Business Office, MDS Coordinators, Therapy Staff, ICD-10 Coders and other team members involved in managing a Medicare A census, and corporate consultants and business office team members who’d like to understand the new payment system.

CEU-  6.0

1. Administrator

Objective: 

Understand how payment will be assigned under PDPM for SNF PPS.

Agenda

1. Obtain working knowledge of ICD-10CM coding guidelines to correctly assign ICD-10CM codes for diagnoses
2. Learn how categories of ICD-10CM codes are used in case mix adjusted components of the PDPM per diem rate
3. Become familiar with MDS items used to set component CMI rates for PDPM
4. Understand the PT/OT and Nursing function score and implications for payment
5. Learn how MDS items are used in case mix adjusted components of the PDPM per diem rate
6. Understand the variable per diem adjustment schedule
7. Understand the ‘interrupted stay’ policy and how it impacts payment for SNF PPS
8. Become familiar with current rules for using the Interim Payment Assessment to change a per diem rate under PDPM
9. Understand ‘presumption of coverage’ under PDPM
10. Step by step calculation of the per diem rate under PDPM
11. Receive ICD-10 coding guidance to correctly assign ICD-10CM codes and to understand financial implications of each of the 10 clinical categories of ICD-10CM codes used to develop the PT and OT component of PDPM
12. Become familiar with the current CMS ICD-10CM clinical category mapping tool
13. Learn the MDS items that make up the PT/OT and Nursing function score and payment implication
14. Understand how the SLP component CMI is generated though understanding ICD-10CM coding for the ‘acute neurologic’ diagnosis category, MDS coding for cognitive impairment, ICD-10CM coding for speech related co-morbidities, MDS coding for swallowing problem and mechanically altered diet
15. Become familiar with the NTA CMI scoring system to include ICD-10CM and MDS coding to obtain the appropriate NTA component CM
16. Review nursing component categories
17. Understand PPS policies under PDPM to include:  variable payment adjustment schedule, interrupted stay policy, use of the interim payment assessment, and presumption of coverage

This program is sponsored by The Beacon Institute and approved for 6.0 continuing education credits / contact hours.

Administrator
This program is approved by the National Continuing Education Review Service (NCERS) of the National Association of Boards of Examiners of Long Term Care Administrators. 

Cancellation Policy

Refunds, minus a $100 processing fee per registrant, will be honored if requested in writing SEVEN (7) business days prior to the date of the seminar. In the event of emergency, attendees may send substitutions in their places without prior notification. Additional fees may apply