Tag Archives: PDPM

CMS Announces SNF PPS and PDPM Final Rule. Here are the Changes…

July 31st, 2018, the Centers for Medicare & Medicaid Services (CMS) announced the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) – including – Patient-Driven Payment Model (PDPM). There were no significant changes in the final rule as compared to the proposed rule.   We have highlighted key takeaways below. There will be a market basket increase of 2.4% ($820 million) – Effective October 1, 2018. Patient-Driven Payment Model (PDPM) – Effective October 1, 2019 PDPM will be a major shift away from volume-based services (RUG-IV) with the new focus being value-based services and is designed to treat the needs of … Continue reading

Patient-Driven Payment Model (PDPM) Update

Patient-Driven Care Under PDPM (via cms.gov)

In May 2018, a new value-based reimbursement proposal, Patient-Driven Payment Model (PDPM), was introduced by CMS. CMS believes PDPM is an improvement over the RUG-IV and Resident Classification System (RCS-1) models because it better accounts for resident comorbidities and patient-specific care needs while reducing the emphasis of therapy minutes. PDPM is also designed to decrease administrative complexities (paper work!) through an overhaul of required MDS schedules. PDPM is budget-neutral and classifies each resident into five categories (PT, OT, SLP, Non-Therapy Ancillaries, and Nursing) and provides a single payment based on the sum of these individual classifications. The new model is on … Continue reading