The PPS PDPM methodology is categorized and calculated based on the individual patient. Knowing and capturing categorized information is important to assess outcomes and will drive reimbursement. When completed correctly it is rewarding however even one mistake can have a negative impact, not only financially but also clinically and in quality measurements. The Minimum Data Set (MDS v3.0) assessment is the required assessment of the CMS. This 48-page document requires staff to abstract from the patient’s medical record and interviews the data to support the accuracy of the assessment while adhering to required timeframes and submission guidelines. Errors, submission delays, and lack of adherence to the rules can cause serious problems for the facility.

Learning Objectives:-

• State a clear understanding of the PPS PDPM categories
• Demonstrate through calculation-based PDPM methodology an outcome for HIPPS code determination

Areas Covered:-

• The PDPM Methodology and Calculation
• The MDS Section Items with Relationship to the PDPM HIPPS Outcome
• Guidelines and Timeframes
• Governing Rules and Regulations

Background:-

The Centers for Medicare and Medicaid Services (CMS) implemented the PPS PDPM model to replace the RUG-IV reimbursement system for Skilled Nursing Facilities in FY2019 and is used to classify skilled patients in a covered Part A stay. Annually the CMS updates the PPS PDPM model. Providers and assessors must stay apprised of these ongoing updates along with knowing the basic intricacies of this complex system.

Why Should You Attend:-

If you are a facility or corporate representative and are expected to know the PDPM reimbursement program utilizing the MDS assessment (MDS Assessors, Interdisciplinary Team Members, Biller, Medical Record Coders, Directors of Nursing, Administrators or work in the Business Office) in your job. This program will provide you with updated information and insightful tools to perform successfully.

Who Should Attend:-

• MDS Assessors
• Nurse Directors and Skilled Unit Managers
• Case Managers and Admission Coordinators
• Administrative Officers (CFO, CEO, Regional Directors, etc.)
• Interdisciplinary Team Members (RN, SW, RD, LPN, CDM, AD,)