The PDPM...
(Continued from page 11)
Frankly, therapy has always been capable of playing a more active role in case
management and care coordination. Because PDPM is making this more of
a priority, there is an opportunity for a new road for therapy to contribute in
different, yet meaningful ways.
Long story short: Don’t let the PDPM burden rest on the shoulders of your
nursing staff. If responsibilities for care planning and patient management are not
SHARED (as with an integrated CINC approach and IDT) the impact on nursing
services/staffing, resident care and ultimately fiscal stability could be negative.
Instead: focus should be on a truly collaborative effort to capture a truly accurate
representation – from all members of the IDT – of care provided to ensure
optimal reimbursement for your SNF. Just saying: Therapy services will be an
important puzzle piece as everyone clamors to redefine what it means to succeed
under PDPM.
All that being said, one fundamental tenet will still hold true. Therapy will continue
to drive resident satisfaction and ensure functional/performance outcomes
in competitive arenas. Remember that SNFs will still be held accountable to
maintaining quality outcomes as SNFs in bundled care initiatives, and in regions
with high managed care penetration like New York. Don’t lose sight of how therapy
is necessary to ultimately fortify fiscal stability by delivering on quality care.
Q: What can SNFs do to prepare?
The first step to ensure positive patient outcomes, regulatory compliance and
financial viability under PDPM is to perform a RUGs-to-PDPM Crosswalk.
A RUGs-to-PDPM Crosswalk allows providers to see where patients (and
their related patient days) land in the new PDPM groups, and thereby, estimate
new Medicare A reimbursement in both aggregate and individual PDPM rate
components (nursing, NTA, rehab). This information is critical for both the
provider and rehab partner as PDPM care delivery models and pricing proposals
are considered.
(See The PDPM on page 13)
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