Welcome to PDPM: Thoughts from the trenches two weeks in

Welcome to PDPM!

“Less than two weeks in and it feels like we are speaking a new language.  CMGs, BIM scores, and NTA comorbidities have already become familiar terms.  Now that we are into the new payment system, one thing I can say for sure is that there certainly is no sign of a decreased dependence on therapy.  Our management team has spent countless hours educating and now reconciling both therapy and nursing CMGs.  While I cannot attach a dollar figure to it at this point, I know that therapy has been essential in assessing cognition, identifying moods and behaviors not supported by nursing documentation, and identifying issues in the coding of Section K… all which now have a direct impact on reimbursement.

Therapy Center’s management team and therapists have worked tirelessly to look for opportunities to maximize not only therapy reimbursement but also nursing reimbursement.  Our therapists have been trained to document on the entire patient, which has allowed for capturing of reimbursement that would not have been substantiated by nursing alone.  We are busy learning the MDS and working with the entire interdisciplinary team to insure that all patient deficits are identified and coded.

While we have worked with our customers in advance to prepare,  daily conversations are necessary to make the best decisions and move forward with plans and programs that will best benefit our patients and our customers.

Has your therapy team been readily available and present in morning meeting?  Are they identifying depression indicators not otherwise charted by nursing?  Are they working with dietary and MDS to address deficits in Section K?  Have they talked with you about GG and analyzed best course of action when GG coding is borderline?  While many of these sections and processes have been part of the MDS for some time, accurate coding in a single section can translate into big dollars.”


Rachel Manuel, Regional Director for SNF Operations


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