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.
Following are their thoughts:
- “Every day we stop about 2:30-3:00 and use the pdpm-calc.com (PDPM calculator) calculator to figure out the HIPPS code for all the new admits. We are trying to become comfortable with it. It has been a great help! Thank you again!!”
Jen Nalle, Alden Court, Fairhaven, MA
- “Stressing about PDPM? What stress? I’ve been on the count down for literally months now. At our stand-up meetings, the other managers could always count on me to give them the exact date of when the world of MDS is once again turned upside down!
FYI, we are officially at 9 days 10 hours: 34 minutes: 20 something seconds!
I have equated this transition to preparing for the birth of a baby! We spend months preparing, planning, anticipating & after it happens, we discover there were those circumstances or scenarios that were impossible to imagine, much less prepare for!
As you know, we have accessed Harmony Healthcare International’s (HHI) educational resources as well as those offered by AANAC and Florida Healthcare Association (FHCA). We have listened to webinars and attended an ICD-10 instructional course in Orlando. I have printed AANAC informational articles relative to PDPM and distributed them. I sincerely hope it will have been enough.
We are alerting our physicians to the importance of having progress notes uploaded in a timely manner, not thirty days post admission. Our approach is to equate the value of this information as it relates to revenue or more importantly, to the loss of revenue.
Next week, restorative will be implementing a new protocol for assessing and initiating on day one of admission those aspects of restorative nursing that as you have mentioned, we have already been doing. We just need to document, care plan, and take credit for the work.
I will no longer be responsible for long term assessments which will allow focus on our new admissions. I think this will be a huge advantage for us.
Hopefully, this will give us the opportunity to devote more time to ensuring the accuracy of our assessments.
What I am sure of is that some MDS coordinators will drink more and some will pray more to reduce the stress of PDPM, possibly both!
Well, that’s about it for now.
Vivian Pearce, Okeechobee Health Care, Okeechobee, FL
- We have been using the mapping, fact sheet, and the pdpm-calc.com (PDPM calculator) on all new admissions as practice. We set aside time each day and work on the same resident together and leave it open for discussion.
We are also working as close to the Assessment Reference Date (ARD) schedule as possible to clear assessments as the date gets closer.
Kelly Pytel, Alden Court, Fairhaven, MA
- “For us, the key word is Stagger.
- As of 9/17/19 Medicare Admits: No more 14 days, COT's, EOT's, or SOT's, etc.!
- For admits from 9/2 through 9/24: We will combine 5-Day PPS with the Comprehensive if applicable.
- For admits from 9/25-9/30: We plan to do a 5-Day PPS Assessment Reference Date (ARD) of 9/30, then if still here stagger the transitional IPA between 10/2-10/7.
- For admits from 9/25-9/30: If applicable, we will set the Assessment Reference Date (ARD) for the Comprehensive the same as the Assessment Reference Date (ARD) for the transitional Interim Payment Assessment (IPA), so we would have the same observation period for both.
- Then if the patient is still here October 1, I’ll do a transitional Interim Payment Assessment (IPA) with Assessment Reference Date (ARD) of 10/1-10/2.
Through this transition period if need be, we will stagger (walk or move unsteadily, as if about to fall.)
Surely our Administrator and DON will think we are about to stroke out and send us home for some much-needed rest!!
Then for admits of 10/1: PDPM full force.
Yes, you can print my name if I make it through this. Thank you!”
Cathy Toppe, Spartanburg Restorative Hospital, Spartanburg, SC
While the “minutes” wind down, take a few of those minutes left to thank the terrific MDS Nurses Assessment Coordinators for their vision, direction and patience as we head into the world of PDPM.
Just as a note, if you are interested in a PDPM Transition Calendar, please click on the following link for Harmony Healthcare International’s (HHI) PDPM Transition Calendar.clicking here. Looking to train your staff? Join us in person at one of our our upcoming Competency/Certification Courses. Click here to see the dates and locations.