The Patient-Driven Payment Model is the biggest overhaul of nursing home reimbursement in at least a generation, but it is only a temporary fix, cautioned an expert at the recent National Investment Center for Seniors Housing & Care’s spring meeting.
Ultimately, it “will morph into” a unified post-acute care payment system (U-PAC) called for in the IMPACT Act, said Steven Littlehale, a gerontological clinical nurse specialist and long-time data research company executive.
The new system is focused more on nursing and clinical aspects of care, including non-therapy ancillaries. As a result, certain competencies that aren’t therapy-related must be better developed and polished, as well as facility-physician relationships. Among Littlehale’s noted observations:
• While ICD-10 coding becomes a critical tool, the “hospital ICD-10 code is almost irrelevant. The SNF one is important.”
• No extra hiring is required. A facility simply needs someone with ICD-10 expertise — from the SNF’s viewpoint, of course.
• That said, he also endorsed as robust of coding as possible because whenever there’s not stellar coding, “it always bites us on the tuchus” and it can lead to CMS creating new, stricter rules.
• The notions of cutting back on MDS staff or therapy offerings are bad ideas. “Don’t do anything with MDS staff, except give them more education, clinical education,” he added.
• Another myth is the idea that “new patients” might be headed your way. The same type of individuals will need care. What might make a patient population appear different is altered intake criteria adopted by a provider.