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The Centers for Medicare & Medicaid Services (CMS) released final rule CMS-1696-F on July 31, 2018, which outlined the fiscal year (FY) 2019 Medicare Part A payment rates and quality programs for skilled nursing facilities (SNF).

How can SNFs begin preparing for PDPM? Identify the effect of the change in the reimbursement methodology by reviewing the profile of your most common Medicare admissions and calculating how the change to PDPM will affect your Medicare revenue. Begin discussions with ancillary providers about the final rule, including therapy providers and pharmacy services. Talk with MDS personnel also regarding the importance of assessment accuracy, diagnosis coding and inclusion of all pertinent PDPM-required data on each assessment completed. Finally, communicate with nursing administration about clinical competencies and potential specialty niche areas, as well as training for nursing staff.

PDPM is a model that may allow SNFs with clinical expertise to excel and actually see appropriate reimbursement for those patients who may not have been as appealing under the RUG-IV model because they weren’t an ideal therapy candidate.

Register now for one of our upcoming Q&A calls featuring BKD professionals who will be answering questions submitted by registrants.

Want to connect sooner? Contact Sherri or your trusted BKD advisor for additional information or to schedule an assessment of your RUG-IV to PDPM effect.

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