presented by Ellen R. Strunk
Financial: Ellen Strunk receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.
Non-Financial: Ellen Strunk has no competing non-financial interests or relationships with regard to the content presented in this course.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
Ellen R. Strunk, PT, MS, GCS, CEEAA, CHC
Ellen R. Strunk, PT, MS, GCS, CEEAA, CHC, has worked in various roles and settings as both a clinician and manager/director: hospital, transitional care, Director of Rehab for a hospital home health agency, Clinical Consultant, Director of a HH staffing division, and Director of Governmental Affairs for a company providing rehab services in long-term care,…Read full bio
1. Components of the PDPM
The Patient Driven Payment Model (PDPM) is the SNF Payment System that correlates payment to the patients’ conditions and care needs rather than volume of services (Cost-Based) provided or resources rendered (PPS RUGs System). This chapter will describe the basis for changing the system and the essential components that calculate the new PDPM.
2. The Clinical Categories for PT, OT, and SLP
The first step in determining the patient’s per diem in the new Patient Driven Payment Model (PDPM) is to classify patients by clinical category. This chapter will define those categories, as well as how the patient is classified into one or another.
3. The Role of Function, Cognition, and Nursing Categories
While the role of function has always been an important part of determining the appropriate frequency and intensity of services to be delivered, the Patient Driven Payment Model (PDPM) elevates its importance by linking it directly to the case-mix index. As a result, it will become an important part of determining how much a skilled nursing provider is paid.
4. The Variable Rate Per Diem (VPDA) and MDS Changes
Tapering of therapy services as a preparatory step to discharge planning is not a new concept. What is new is that the Patient Driven Payment Model (PDPM) incorporates this concept into the payment model beginning on Day 21 of a patient’s stay. This chapter will explain how the calculation will work and why it is being used.
5. Action Steps to Prepare for the Implementation of a Change in Payment
The Centers for Medicare and Medicaid Services (CMS) has openly discussed how the Patient Driven Payment Model (PDPM) will provide patients an opportunity “to choose a skilled nursing facility that offers services tailored to their condition and preferences”. This chapter will explore how the PDPM will do this. The role of quality and value will also be discussed, and the important part the interdisciplinary team, including PT, OT, SLPs, Nursing, Activities, Restorative and Dietary professionals have in their facilities.