Contact Celtic today for your individualized training agenda.
Overview of PDPM Payment System (Session Length: 2 Hours)
- All aspects of the new program
- For Nursing, MDS, Rehab, Billing, Admission (or hospital liaisons), Administration, Social Services, Dietician, and any other IDT members
ICD-10 Diagnosis Coding Concepts (Session Length: 2-3 hours)
- Review of intermediate ICD-10 principles for MDS, Admissions, Rehab
- Chapter specific guidelines pertinent to the Skilled Nursing Facility setting
- ‘Real World’ Coding Examples & Coding Practice
- The role of Medication Reconciliation, Drug Regimen Review, and Capturing Conditions
PDPM Training Competencies (Three Sessions)
- Session 1: Effective Capture of Diagnoses & Condition Categories (Session Length: 1.5 hours)
- For MDS, Rehab, Admission, Dietician
- Explain condition category assignment importance
- Educate on primary code assignment in current (2018) I Section
- Communicating amongst Providers: Using discharge summaries, provider documentation, & the medical record to capture conditions
- Session 2: Collaborating to Determine Functional Performance and Outcomes (Session Length: 1 hour)
- For MDS, Nursing, Rehab
- Maximize reimbursement
- Manage outcomes
- Session Three: Refresher in MDS Coding of Cognition and Mood & Relationship to PDPM (Session Length: 1 hour)
- For MDS, Social Services, SLP
Concepts for Managing Costs and Reimbursement (Three Sessions)
- Session 1: Restorative Nursing Programs- MDS, Nursing, Management, Rehab (Session Length: 1.5 hours)
- Benefits (Clinical and Financial), etc.
- Program requirements
- Skilled Care/Medicare coverage
- Session 2: Group/Concurrent Therapy Limitations- Management, Rehab, MDS (Session Length: 1.5 hours)
- Benefits (Cost Center vs. Revenue Center)
- Regulations for each type of therapy
- Developing treatment schedules for each type
- Practice with Managed Care
- Session 3: Link to Medicare Spending Per Beneficiary QRP Measure- Management, Billing (Session Length: 30 minutes)
- Therapy spending
- Use of restorative nursing vs. therapy for some cases
- Managing ‘downstream’ costs
- Evaluating ‘in-house’ care programs, equipment and exploring program development
Use of IPA to Reset Case Mix Grouping Category (Session Length: 1 hour)
- Daily case management & tracking
- Communication and interviewing for success
- Monitor consults, notes, etc. for clues on additional conditions
- Setting ARD for the IPA Assessments
Transition Planning for September – October 2019
Nursing Fundamentals for Skilled Patients (Session Length: 1 Hour)
- Practices nursing should implement to skill patients
- Skilled Nursing Documentation Competencies
- Review of Medicare Coverage Guidelines
- Skilled Nursing and Skilled Rehab criteria
PDPM and Triple Check (Session Length: 1 hour)
- For MDS, Nursing, Admission, Finance, Rehab
- New practices to implement
- How will IDT’s Roles change to accommodate PDPM
- New Triple Check Checklist reviewed
What Happens after Day 8? Revised MDS Coordinator Duties (Session Length: 30 Minutes)
- Case Managing Skilled Patients
- Monitoring criteria for IPA assessments
- New diagnosis/conditions capture
Rehab under PDPM (Session Length: 1.5 Hours)
- Therapy contract review
- Use of group and concurrent therapy
- Determining clinical appropriateness
- Skilled therapy diagnoses
- Reporting rehab services for Medicare meeting
PDPM, VBP and QRP: How It All Pulls Together (Session Length: 3+ hours)
- Participants will learn how to determine their final per diem rate including VBP penalties, for FY 2019 and beyond under SNF VBP.
- Attendees will learn the difference between performance and outcome measures and how each type effects reimbursement under the SNF QRP.
- The audience will come away with best practice ideas for monitoring compliance and reporting in the CMS program.
- Participants will understand how spending, or the cost of care, will be monitored and how the new PDPM system will encourage cost savings.
- Presenter will review the various CMS reporting structures.
- Presenter will demonstrate the use of CMS reports to improve quality rankings and maintain QAPI.
PDPM for the Interdisciplinary Team (Session Length: 3+ hours)
- Review of new case mix methodology under PDPM
- Practices to prepare your staff for the changes, and how the IDT needs to shift focus to be successful under PDPM
- Review how new ADL scoring, clinical classification categories and groupings called “condition categories” will affect payment levels and how “Add-on” point system is derived and what competencies will need to be honed in order to optimize opportunities in relation.
- Present sample timeline for nursing leadership to utilize when developing their educational programs for building PDPM competencies