PDPM FAQ: Your critical questions answered!

Ken BellClient News, Skilled Nursing, Training4 Comments

Last month, SimpleLTC, in conjunction with Seagrove Rehab Partners, offered one of our most popular webinar training series ever, with over 2,000 people attending the two training sessions. With barely a year to prepare, providers are hungry for information about PDPM.

Based on the hundreds of questions asked during the webinars, our presenter, Mark McDavid, has prepared this follow-up FAQ document to further aid in preparing for the new Patient-Driven Payment Model (PDPM).

Dozens of answers to your PDPM questions are included, such as:

  • Are we going to continue doing the initial OBRA assessments or just the 5D?
  • Can a patient fall into two categories if appropriate?
  • Are the clinical categories descriptive so we know which category a patient falls into? Who decides the category they fall into, therapy or MDS?
  • Are IPAs for improvements as well as declines?
  • Can Rehab Tech/Rehab Aides be utilized for delivering rehab treatment with PDPM? How about use of students?
  • Can you have more than one Interim payment during the entire SNF admission? Is there a limit?
  • How critical is it for the SNF to use the same ICD-10 codes as the hospital? Will hospitals be mandated to include those codes in the clinical?
  • If a resident goes to the hospital and does not have 3 midnights but stayed for 2 days instead, what is the payment adjusted to?
  • With this new system, regarding long-term residents, do we still do Quarterly MDSs and Significant change MDSs?
  • And many more

Download FAQ now

To download the FAQ and access the PDPM training, click below and complete the form on the registration page. Once you do, you’ll be able to download the FAQ immediately.

Get the PDPM FAQ document

About our PDPM expert

Mark McDavid is an experienced leader within the field of skilled rehabilitation therapy services. His proven track-record of dynamically growing therapy programs makes him a sought-after source for regulatory compliance, MDS, MPPR, manual medical review, functional status coding, and documentation. As the owner of Seagrove Rehab Partners, Mark works to enhance therapy-related operations and Medicare compliance in a wide variety of settings, including long-term care and rehab agencies.

4 Comments on “PDPM FAQ: Your critical questions answered!”

  1. Does a patient have to be made inpatient status when they are readmitted to the hospital in order to start the day 1 assessment period?

    1. Hi Renee, that’s a great question! At the end of our webinars, we do a Q&A with our experts. We have a PDPM webinar coming up Aug 29, so I’ll add this question to our list. Thanks!

  2. Are the patient weeks changing? Or will they stay the same based on the patients admission date? 
     For example: 
    If a resident was admitted on a Tuesday: Would their “patient week” be based on a Tuesday- Monday schedule? Or are we transitioning to a Sunday-Saturday schedule?  
    Thank you for your time. 

    1. Hi Sarah, PDPM will use the actual days of the stay instead of a certain day of the week to calculate the receding adjustments. For example, day 21 would be the first decrease in OT/PT rates regardless of the day of the week.

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