Reimbursement

70th AHCA/NCAL Convention and Expo

RMB-4 - PDPM: Establishing the Reason for SNF Care

Panelist(s)

• 

  Alex Bardakh, MPP

  Director, Public Policy and Advocacy
  AMDA - The Society for Post-Acute and Long-Term Care Medicine

  Disclosure: Nothing to Disclose
• 

  Rajeev Kumar, MD, CMD, FACP

  Chief Medical Officer
  Symbria

  Disclosure: Symbria: Employee (Status: Ongoing), Ownership Interest (stocks, stock options, or other ownership interest excluding diversified mutual funds) (Status: Ongoing)
• 

  Bill Ulrich, CHC

  President / CEO
  Consolidated Billing Services, Inc

Moderator(s)

• 

  Mike Cheek

  Senior Vice President, Reimbursement & Legal Affairs
  AHCA/NCAL

  Disclosure: Nothing to Disclose

For each Medicare Part A admission, the SNF should determine the primary reason for skilled care. While the new SNF patient driven payment model (PDPM) that took effect October 1, 2019, places additional emphasis on the reason for SNF care, this is not a new concept. SNFs should take the first step toward PDPM readiness by properly training key staff and refining systems so that documentation and care are centered on this point, because the reason for SNF care, driven by a physician diagnosis, must receive an ICD-10 code that is appropriate for the patient’s condition and map to the PDPM.

Learning Objectives:

• Explain how attending physicians must assign a diagnosis for their care and how that diagnosis relates to the SNF PDPM diagnosis.
• Discuss how Hospital Discharge Planners are communicating with SNF admissions staff.
• Relay findings from preliminary discussions about how 5-Day Assessments are working.