Leah Klusch


After a false start a week earlier, the Centers for Medicare & Medicaid Services has officially posted a draft version of the new RAI training guidance that will help transitioning to the Patient-Drive Payment Model.

Providers and other stakeholders were busy Tuesday digesting the 1,299 manual, which was quietly posted the afternoon before. Of particular interest was a more than 100-page section at the end that tracks changes from last year’s manual.

An there are many changes, though nothing particularly alarming, experts said Tuesday. The main excitement was the fact that, even though it’s officially labeled a “draft” document, trainers now can start preparing providers in earnest for the biggest changes to payment and resident classification processes in more than a generation.

“It’s here, baby!” was how one veteran coding expert confirmed the manual’s issuance Tuesday. “It’s pretty much what we’ve expected. We’ve had plenty of notice on this.”

“It’s very nice to see it in print, and I appreciate the fact that I can see multiple examples that show me what we heard [at training in Kansas City two weeks ago], and that things are consistent,” noted consultant and trainer Leah Klusch, the executive director of The Alliance Training Center. “CMS’s team seems to be working very hard to have the manual be as descriptive and specific as it can be — and it’s clinically sound.”

Jane Belt, a curriculum development specialist for the American Association of Nurse Assessment Coordinators, said the nearly 1,300-page document answers a lot of questions.

“If there was any doubt that PDPM was going to happen October 1, 2019, this draft version should take it away,” she said. “It’s a draft, but it really clarifies some of the items that will be in there.”

Belt independently joined Klusch in observing that the manual should contain “nothing shocking” for anyone who has paid close attention to previous government notices and education efforts.