As October 1 is growing closer, what should my facility now be doing to prepare for the Patient-Driven Payment Model?
This month, review your MDS coding. In addition to closely consulting the RAI manual that was released at the end of May, review MDS coding accuracy. Here is a guideline of sections to review: Section C- Cognitive Pattern is an interview section. This section will impact the CMI (Case Mix Index) of speech therapy as well as nursing. Does your staff know when to complete the staff interview or appropriate use of dashes? Are they comfortable with the interview process?
Ask the same questions about Section D, Mood, as this can also impact the nursing CMI. Behaviors captured in Section E could classify residents in the behavioral symptoms case mix group.
Section GG is now the section used for nursing and therapy CMI placement. Discuss as a team the most appropriate discipline, or combination of disciplines, to complete this section.
Section I will drive your payment categories for PT, OT, speech, some nursing categories and definitely your non-therapy ancillaries (NTAs). A solid understanding of ICD-10 coding is crucial. Staff should be cleaning up Section I and using the appropriate diagnoses now.
Section K also is an area that can have a huge impact on the speech CMI. Discuss as a team the most appropriate discipline to complete section K. Speech therapists are able to assess swallowing disorders as well.
Sections H, J and M also should be looked at for accuracy impacting the nursing CMI. Section O impacts NTAs and nursing, but note that while minutes do not count toward reimbursement, CMS is still monitoring their numbers in various situations.
