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Key Components in Understanding The Transition to 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 transition from P.P.S to the P.D.P.M. payment process on October 1, 2019. Operational and
Clinical professionals need to begin working 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. The transition process will
be discussed.
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.
- 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. 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. The specifics of the transition documentation and the CMS process directives will be
discussed.
Objectives:
- Identify the specific changes in the P.D.P.M payment process that require operational and clinical focus
and process changes for the transition from PPS to P.D.P.M.
- 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 as well as the rate transition process after October 1, 2019.
- Distinguish the best patterns for outcome documentation from therapy and nursing interventions as well
as the operational and clinical leadership needed to produce the proper documentation during the
transition.
- Review the components of effective training and competency measurements that satisfy the updated
regulatory requirements in the new payment system and regulatory tags
When: September 20, 2019 9:00 a.m. - 4:30 p.m.
Where: The Alliance Training Center
Cost: $125.00
Instructor: Leah Klusch, RN, BSN, FACHCA
NAB approved: 6 hours
Call today to register! (330) 821-7616
www.tatci.com