Patient Driven Payment Model
70th AHCA/NCAL Convention and Expo
The new Medicare skilled nursing facility prospective payment system (SNF PPS) patient-driven payment model (PDPM) is based on resident characteristics reported on SNF PPS minimum data set (MDS) assessments. The presence of depression and cognitive impairments are two characteristics that significantly impact staff direct care time and PDPM payment rates. These characteristics are identified by structured resident interviews, or if the interview cannot be completed, then by staff assessment. Because these items have a significant impact on PDPM payment rates, the centers for Medicare and Medicaid Services (CMS) has indicated that they will be monitoring the coding patterns, accuracy, and supporting documentation of these MDS items. This session will provide a review of the MDS resident assessment instrument (RAI) manual instructions for accurately assessing and coding a resident’s mood and cognitive status.