Rehabilitation Therapy Day
70th AHCA/NCAL Convention and Expo
Garry Pezzano, EMBA, MS/CCC-SLP, NAP
Senior Vice President of Clinical Practice
Genesis Health Care/Genesis Rehabilitation Services
Disclosure: Genesis Health Care () : Employee, Ownership Interest (stocks, stock options, or other ownership interest excluding diversified mutual funds)
On October 1, 2019, providers entered a new era with the implementation of the Medicare Part A SNF prospective payment system (PPS) patient driven payment model (PDPM). While the prior resource utilization groups model linked payments to the volume of therapy services furnished, the PDPM is value-based and aligns payment with a wide range of resident clinical characteristics associated with care needs. In short, under the PDPM, SNFs are being asked to shift their focus from constantly tracking therapy service delivery to monitor and adjust payment rates, to a more holistic, interdisciplinary, person-centered care model. While basic skilled care coverage requirements remain unchanged, providers now have more flexibility in addressing a resident’s clinical needs. Opportunities for interdisciplinary collaboration will increase in order to support patient-centered care. The success of an SNFs rehabilitation program under the PDPM (and to some extent for long-stay residents) will be monitored closely by the Centers for Medicare and Medicaid Services through the amount and type of therapy provided and outcomes associated with function and other quality and per-beneficiary spend measures . This four-hour program will include presentations and panel discussions by representatives from the interdisciplinary professions that have been actively “imagineering” changes in SNF rehabilitation operations and clinical practice during preparations for the implementation of the PDPM. The presenters will share their experiences, lessons learned, and recommendations for best practices based on these efforts.
8:00 AM -10:00 AM - Session 1: ‘How Much Is the Right Amount of Therapy?’
Expert panelists will each present a perspective on rehabilitation care management. This section will cover how rehabilitation therapy utilization could change under PDPM and how it can be managed to insure we are delivering necessary medical rehabilitation services while being responsible stewards of Medicare resources. We will explore rehabilitation care management that includes defining comprehensive rehabilitation services, effective population health management approaches and how the evidence in research informs our practice. Participants will develop strategies for delivering value to their patients, achieving positive clinical outcomes and quality measures while running a successful operation.
10:15 AM – 12:15 PM - Session 2: ‘Managing Compliance Risk under PDPM’
The expert panelists will each present a perspective on Compliance Risk and Management especially in areas related to rehabilitation therapy. In this section we will cover current and future standards and measures of compliance as stated in CMS’ education on PDPM. Participants will be able to define aspects of compliance in coding, MDS assessment, clinical documentation and Quality Measure Reporting. We will explore compliance risk areas and how they may be mitigated through internal audit processes, education and what it means to establish a culture of compliance. We will also strategize on how we may leverage this aspect of evolution to a value-based system in promoting a positive image of COMPLIANCE FIRST in our industry.