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Pam Duchene

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[ICYMI] PDPM Transition Tips: MDS Nurse Assessment Coordinators

Posted by Pam Duchene on Tue, Oct 08, 2019


C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


As the saying goes, “Change is inevitable, except from a vending machine!” 

The transition to the Patient Driven Payment Model (PDPM) certainly exemplifies the constancy of change.  With the transition date nearing, it seems most appropriate to hear from those who are most impacted by the change ~ the MDS Nurse Assessment Coordinators.  So, I reached out to some of the brilliant Nurses with whom I am privileged to know and asked them for their last-minute preparation strategies.

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Topics: PDPM

PDPM Transition Tips From the Field: MDS Nurse Assessment Coordinators

Posted by Pam Duchene on Tue, Sep 24, 2019


C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


As the saying goes, “Change is inevitable, except from a vending machine!” 

The transition to the Patient Driven Payment Model (PDPM) certainly exemplifies the constancy of change.  With the transition date nearing, it seems most appropriate to hear from those who are most impacted by the change ~ the MDS Nurse Assessment Coordinators.  So, I reached out to some of the brilliant Nurses with whom I am privileged to know and asked them for their last-minute preparation strategies.

Read More

Topics: PDPM

PDPM Q & A: Respiratory, Diagnoses Codes, Shortness of Breath and More

Posted by Pam Duchene on Thu, Sep 12, 2019


C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


  1. Regarding nursing performing respiratory therapy. Assuming they have their competencies, can an LPN provide respiratory therapy or does it need to be an RN? Does the nurse need to present with the resident the entire 15 minutes?

    A licensed nurse (either RN or LPN) can provide respiratory therapy as long as they have demonstrated/documented competence.  However, you need to check the state practice act because some states are more stringent (New York) in that the LPN cannot perform assessments.
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Topics: PDPM

Top 5 Strategies: ICD-10 Coding and Skilled Diagnosis

Posted by Pam Duchene on Thu, Aug 22, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


As the name states, the Patient Driven Payment Model (PDPM) compensates by patient characteristics and the associated ICD-10 Codes.  Hence, it is imperative to identify and properly document the ICD-10 Codes that best reflect the patient’s reason for Skilled Medicare Coverage upon admission to the SNF.

There are 3 outcomes when selecting patient ICD-10 Codes:

  • Return to Provider
  • Resolved in Hospital
  • Reason for Skilled Care
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Topics: ICD-10

Top 10 Things To Know About Triple Check PDPM Style

Posted by Pam Duchene on Tue, Aug 20, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency



The triple check process is a long-standing system used at Skilled Nursing Facilities (SNFs) across the country to ensure compliance in Medicare billing.   Specifically, to assure that the RUG Level accurately billed for therapy minutes and that everything matches between the UB-04, the MDS and therapy logs.

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Topics: PDPM, Triple Check

ICYMI: PDPM: Admission Screening

Posted by Pam Duchene on Fri, Aug 09, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


At Harmony Healthcare International (HHI), we are fielding massive amounts of questions on how and if the new PDPM reimbursement system will change the patient profile in a nursing home.

Some inquiries include:

  • Does the advent of PDPM change the SNF admissions criterion for patient admission?
  • Are there characteristics that define the ideal referral for skilled care in the Patient Driven Payment Model (PDPM)?
Read More

Topics: PDPM

ICYMI: Restorative Nursing: Crucial for Patient Quality, Critical for PDPM

Posted by Pam Duchene on Thu, Aug 01, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


What patients can do today and what they will be able to do tomorrow may be the result of Restorative Nursing Programs.  That’s been the conclusion of multiple research studies, including a study from Johns Hopkins in which 31% of patients improved their ADL self-performance at 6 months with 15 minutes of Restorative Nursing daily. 

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Topics: Patient-Driven Payment Model

PDPM: Admission Screening

Posted by Pam Duchene on Tue, Jul 09, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


At Harmony Healthcare International (HHI), we are fielding massive amounts of questions on how and if the new PDPM reimbursement system will change the patient profile in a nursing home.

Some inquiries include:

  • Does the advent of PDPM change the SNF admissions criterion for patient admission?
  • Are there characteristics that define the ideal referral for skilled care in the Patient Driven Payment Model (PDPM)?
Read More

Topics: PDPM

PDPM: Top 3 Areas for Systems Implementation

Posted by Pam Duchene on Tue, Jul 02, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


The Patient Driven Payment Model incorporates a multitude of changes into the current Medicare Part A SNF payment model.  Some of the criteria that require immediate application include:

  1. Interruptions in Stay;
  2. Interim Payment Assessments; and
  3. Administrative Level of Care Presumption.
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Topics: PDPM

Immunization: What does “up to date” mean?

Posted by Pam Duchene on Fri, Jun 14, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


The World Health Organization identifies Vaccine hesitancy as one of the top threats to global health.  While the target of education is largely centered around education for parents of young children, vaccinations for preventable disease is an important concept for all individuals.  Older adults, in particular, are at risk for communicable disease since immune systems weaken with age.  The Centers for Disease Control and Prevention (CDC) recommends the Shingles vaccine for individuals over 50 years of age, and Pneumococcal vaccines for adults over 65 and for those under 65 with certain chronic health conditions. 

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Topics: Immunizations

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