Get ready for the October implementation date of the Patient Driven Payment Model (PDPM) with our informative series of articles authored by Leah Klusch, RN, BSN, FACHCA, founder and director of The Alliance Training Center. We’ll prepare you for the new reimbursement model with detailed insights in a step-by-step guide to PDPM success. You’ll learn about everything from building staff competencies and improving your coding practices to the value of partners and how to enhance efficiencies. The series will conclude with a checklist to help you gauge your readiness.
The soon-to-be-launched Patient Driven Payment Model (PDPM) is designed to capture the individual needs and characteristics of each patient to better represent the care they need and the reimbursement the facility requires to take care of them. When the shift to PDPM goes live on October 1, initial patient assessment may be the primary focus, but there will also be a new emphasis on total diagnosis documentation. The new regulations require that all of the MDS data must be reproducible in a resident’s medical record. How do you meet the reproducibility threshold?
The two most critical resources for getting documentation right are the latest version of the RAI manual and the MDS itself. Using these materials as guides, the resident record must not only be substantiated but speak the same language. That means that if an elder has a condition, the record has to read exactly the same – with the same definitions – as the MDS. To support this exacting documentation standard, a facility should have a process in place to support the level of thoroughness and consistency required at the following three stages.
Leah Klusch, RN, BSN, FACHCA,
founder and director of The
Alliance Training Center
The heart of the PDPM process is documentation that can be interpreted on the MDS to meet patient needs and ultimately determine the facility’s level of payment.
Be sure to look at the documentation requirements and arm your staff with tools – paper-based or electronic – to meet the standards.Download PDF