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Phone: 330-821-7616
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TATCI CE Credits

Join us at The Alliance Training Center for this NEW program!

Key Components in Understanding P.D.P.M.

This fast paced program will discuss the 5 key components that Skilled Facilities and their staff need to understand to be successful as we move from P.P.S to the P.D.P.M. payment process in October, 2019. Operational and Clinical professionals need to begin working now to focus their teams on the key issues that will impact the payment process. This is a total change and needs to have a new and very interdisciplinary approach with significant communication between Nursing and Therapy as plans of care are formulated and monitored during the stay. MDS data is a vital part of this process and accuracy of coding needs to be addressed in many areas that have not contributed to payment in the past.

The Key Components discussed in this program are: The realization that this change in the payment process is a total change and must be viewed with significant operational and clinical focus. The new payment process has a complex structure that includes large amounts of MDS data and calculations of functional performance that are much more detailed than the PPS process. Combined with the new focus on person centered care and specific outcome documentation in the new survey process this is a significant task.

Facilities must know their data formulation, reporting and review process. This involves all departments. Training and competency documentation must be established now and documentation of competency must be specific. Resident records must substantiate the MDS data set with reproducible information specific to the data collection process. Therapy data and outcome documentation must be consistent with the entire resident record.

The entire interdisciplinary team has responsibility for data collection and formulation into the MDS with many new or additional coding guidelines and instructions in the October 2018 RAI Manual update. Errors in coding or a lack of training on the new process will produce payment loss or negative regulatory outcomes.

The facility must monitor and be aware of the therapy delivery and documentation process including policies, protocols and compliance with Medicare coverage guidelines in the Medicare Benefit Policy Manual. The resident specific plan, interventions and outcomes must be consistent with other resident specific documentation with a focus on proper diagnostic coding primarily at the time of admission.

Once the data is formulated then the facility must know the specifics of their data to manage the process. This requires an operational focus on outcomes, patterns of care delivery, length of stay, diagnostic codes and services delivered. The flow of data from the MDS and claims into 5 Star, Nursing Home Compare and Quality Measures must be monitored constantly for accuracy and quality reporting.

Each facility needs to assess the training, and competency of the staff managing the MDS process as well as the knowledge of the significant updated coding and documentation guidelines in the update October ,2018. There will be many additional items in 2019 and more coding guidance before the October 2019 implementation date

Objectives: • Identify the specific changes in the P.D.P.M payment process that require operational and clinical focus and process changes. • Describe the data formulation process changes that are necessary to provide the new payment system with adequate information for payment rate formulation. • Review the requirements for the reproducibility of data on the MDS data set in the medical record and approaches to evaluate the quality of resident specific data in the medical record. • Discuss the steps to develop a truly interdisciplinary data collection process using the current policy and process detailed in the updated RAI Manual. • Distinguish the best patterns for outcome documentation from therapy and nursing interventions as well as the operational and clinical leadership needed to produce this data. • Review the components of effective training and competency measurements that satisfy the updated regulatory requirements in the new payment system and regulatory tags.

When: March 28, 2019 9:00am - 4:30pm

Where: The Alliance Training Center, 1930 S. Freedom Ave Alliance Oh

Cost: $125.00

Instructor: Leah Klusch, RN, BSN, FACHCA

NAB approved: 6 hrs

Call today to register! (330) 821-7616

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