The October switch to the new Patient Driven Payment Model (PDPM) is going to take a lot of preparation. With so much to prepare for and so many other things going on in your skilled nursing facility, you’ll need to work smarter, not harder when it comes to preparation. We’ve created a calendar for you to do just this! Our PDPM Planning Calendar takes your team from April to the big shift in October.
In April, your business office and administrative staff needs time to plan and then to communicate to the rest of the employees. Early communication will play in your favor as this will be a big change for staff given that there hasn’t been this big of a Medicare reimbursement shake up in more than twenty years. Communicate your plans for training, for transition, for technology, for everything PDPM. April should also be when you begin ICD-10 Code training for clinical staff. ICD-10 Codes will be an adjustment and must be entered properly to receive Medicare reimbursement.
In May, clinical staff will need training on wound care, neurologic conditions, and cognition. Identifying these conditions and coding them properly will be commonplace for clinical staff under PDPM.
For June, take a moment to focus on your MDS Coordinator as their role is going to evolve, perhaps more than any others. Bring them into the conversation and get their take on where things will need to shift and what needs the most focus. On the administrative side, take a look at your plan for comprehensive discharges to reduce readmissions. The new interrupted stay policy under PDPM has been established to determine how payments will be made when residents are discharged and re-admitted during a benefit period. This policy is due to the tapering of payment rates under PDPM. It’s always best for any SNF to have a plan in place for comprehensive discharges to reduce readmissions and PDPM will be no exception.
July is an ideal time to check your technologies, both electronic health records (EHR) and financials, to ensure your platforms will be ready for PDPM. Check in with your tech vendors and see how their product can help ease the transition. For your clinical training, pay attention to infection control. Ensure staff can identify, treat, and document infections as there’s going to be an increased focus in the Non-Therapy Ancillary (NTA) component of PDPM.
When August rolls around, it’s time to really hone in on the updates to the Minimum Data Set (MDS) for both clinical and administrative staff. Under PDPM there will be new forms and schedule requirements. The changes are to Sections GG, N, C, I, J, M, and O.
September is your last month before the shift! Use this last month to check in with your staff and gauge where any anxiety or hesitation lies. Revisiting the ICD-10 codes and ensuring staff has a full understanding of them, while also making sure there are resources around to aid in the transition will be very helpful. Business office should review the need for daily skilled documentation and supporting documentation of services and conditions.
On October first, it’s time for more communication – remind everyone that PDPM is officially the new reimbursement model for Medicare. The entire month will need close monitoring completeness of assessments and billing closely.
After October, the transition isn’t really complete, it’s going to take time for everyone to adjust. In November and December, your business office and clinical staff should review processes to see what is working and what isn’t with implementation. Review what is trending for the patient population and identify possible gaps in documentation and collaboration between team members. And there’s always opportunity to review and identify coding.
We hope this planning and training schedule is helpful for you and your team. There will always be more topics to tackle, but we hope that this is a good jumping off point and will ease your mind during the transition.