What are the final things we should do to be ready for PDPM Oct. 1?
With the implementation of the Patient-Driven Payment Model mere weeks away, the final countdown is on. Shore up the facility RAI policies related to PDPM; change verbiage for RUGS to PDPM, and review who is completing the sections of the MDS.
Review the plan for those residents admitted the last week of September. Remember that all residents receiving Part A services on Sept. 30, 2019, will need an MDS done in the current system.
All residents receiving Part A services on Oct. 1, 2019, will need an Interim Payment Assessment completed by Oct. 7, 2019 under PDPM. This ensures the ability to bill for services provided and will avoid default payment or provider liability.
The team needs to carefully coordinate and communicate MDS ARD and due dates during the PDPM conversion or transition process. Verify ICD-10 codes to ensure no “return to provider” codes are used in I0020B of the MDS. Ask your EMR vendor about calculating PDPM levels on current residents so there will be no surprises on Oct. 1.
One area that can enhance your revenue under PDPM is the non-therapy ancillaries. Ensure that everything that can and should be captured on the MDS is captured. The Variable Per Diem day count starts at 1 for all residents as of Oct. 1, 2019. The number of Medicare days used does not reset.
Also remember that there has been no change to coverage criteria and requirements. PDPM does not affect the OBRA requirements.
Finally, remember that knowing your resources is sometimes half the battle. Identify a PDPM resource. This can be someone in your facility, company or a friendly neighboring facility. Reach out to your consultant with questions.
From the September 2019 Issue of McKnight's Long-Term Care News
