Solutions
PDPM Check In: Understanding reimbursement differences
People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support.
PDPM Check In: Understanding reimbursement differences
Written by Melissa Tabor, LPN & Carrie O'Connell, RN
In October 2019, the long-term care world was completely changed by the introduction of the Patient-Driven Payment Model (PDPM). The new reimbursement system was intended to shift focus away from therapy volume, and towards treating the patient's condition. In doing so, the Center for Medicare & Medicaid Services (CMS) predicted there would not be a shift in reimbursement - instead, facilities would see reimbursements remain budget-neutral. After four months of data, CMS is finding that this isn't necessarily the case.
Experts predict that corrections will be made to bring the payment system back to intended budget-neutral levels. Until this shift comes, long-term care facilities must pay careful attention to documentation, specifically the MDS.
This tip sheet outlines three areas that your care team must focus on to protect reimbursement today, tomorrow, and throughout anticipated changes from CMS.
In this tip sheet, you'll learn best practices for
Recorded Oct 23, 2018
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Melissa Tabor LPN, has nearly 12 years of experience working in health care, primarily in long-term care. Melissa has devoted her nursing career to educating and training nurses to use evidence-based practice. Melissa currently holds a multi-state license, and is a CPR instructor, level-one Medication Aid Instructor, and has certifications in diabetic/nutrition, Intravenous (IV) therapy, and wound care.
As a product manager for WellSky, Melissa provides clinician-based knowledge to the product development team to ensure WellSky Long-Term Care products adhere to industry best-practices, ensuring the best possible outcomes for residents.
Carrie O'Connell, RN, is the Director, Clinical Product Manager for WellSky. Carrie's wealth of knowledge and expertise in health care informatics spans more than 20 years. Carrie's focus includes the strategic design and direction of clinical products, regulatory guidance, educational services, customer training, and implementation success. Currently, Carrie serves as a board member and is involved with the National Association for the Support of Long-Term Care (NASL), which represents rehabilitation- therapy companies, IT developers, and other ancillary services providers. Carrie is actively involved with NASL's IT and Medical Services Committees and its IMPACT Act Workgroup. Carrie was recently named to participate in CMS's LTACH Function Quality Measure Development Technical Expert Panel (TEP).
Melissa Tabor LPN, has nearly 12 years of experience working in health care, primarily in long-term care. Melissa has devoted her nursing career to educating and training nurses to use evidence-based practice. Melissa currently holds a multi-state license, and is a CPR instructor, level-one Medication Aid Instructor, and has certifications in diabetic/nutrition, Intravenous (IV) therapy, and wound care.
As a product manager for WellSky, Melissa provides clinician-based knowledge to the product development team to ensure WellSky Long-Term Care products adhere to industry best-practices, ensuring the best possible outcomes for residents.
People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.
WellSky is a technology company advancing human wellness worldwide. Our software and professional services address the continuum of health and social care — helping businesses, organizations, and communities solve tough challenges, improve collaboration for growth, and achieve better outcomes through predictive insights. People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care. Informed by more than 30 years of providing software and expertise, our purpose is to empower care heroes with technology for good, so that together, we can realize care’s potential and maintain a healthy, flourishing world.
People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.
People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.
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