Adviser Fall 2018 Vol 1 - Page 13

The PDPM... (Continued from page 11) Frankly, therapy has always been capable of playing a more active role in case management and care coordination. Because PDPM is making this more of a priority, there is an opportunity for a new road for therapy to contribute in different, yet meaningful ways. Long story short: Don’t let the PDPM burden rest on the shoulders of your nursing staff. If responsibilities for care planning and patient management are not SHARED (as with an integrated CINC approach and IDT) the impact on nursing services/staffing, resident care and ultimately fiscal stability could be negative. Instead: focus should be on a truly collaborative effort to capture a truly accurate representation – from all members of the IDT – of care provided to ensure optimal reimbursement for your SNF. Just saying: Therapy services will be an important puzzle piece as everyone clamors to redefine what it means to succeed under PDPM. All that being said, one fundamental tenet will still hold true. Therapy will continue to drive resident satisfaction and ensure functional/performance outcomes in competitive arenas. Remember that SNFs will still be held accountable to maintaining quality outcomes as SNFs in bundled care initiatives, and in regions with high managed care penetration like New York. Don’t lose sight of how therapy is necessary to ultimately fortify fiscal stability by delivering on quality care. Q: What can SNFs do to prepare? The first step to ensure positive patient outcomes, regulatory compliance and financial viability under PDPM is to perform a RUGs-to-PDPM Crosswalk. A RUGs-to-PDPM Crosswalk allows providers to see where patients (and their related patient days) land in the new PDPM groups, and thereby, estimate new Medicare A reimbursement in both aggregate and individual PDPM rate components (nursing, NTA, rehab). This information is critical for both the provider and rehab partner as PDPM care delivery models and pricing proposals are considered. (See The PDPM on page 13) 12