Patient-Driven Payment Model (PDPM)- The Significance of ICD-10 Coding

By Melissa Keiter, RN, RAC-CT, DNS-CT, DON And Melissa Sabo, OTR/L, CDP, CSRS As healthcare providers, we all understand the importance of properly coding diagnoses on the MDS. However, the significance of accurate and appropriate ICD-10 coding plays an even more vital role under PDPM. The diagnosis coding will be the foundation used to classify …

Patient-Driven Payment Model – A Decrease in Administrative Burden for MDS Coordinators

By Melissa Keiter, RN, RAC-CT, DNS-CT, DON And Melissa Sabo, OTR/L, CDP, CSRS RUGS-IV contains intricate rules and regulations along with a significant number of assessments based on the complex scheduling system. From SOTs to COTs and the rarely used EOT-R assessments, as well as the constant potential for assessment throughout the entire skilled stay, …

Section GG to Replace Section G For RUGs: Major Changes Ahead

By Melissa Keiter, RN, RAC-CT, DNS-CT, DON And Melissa Sabo, OTR/L, CDP, CSRS It seems like as far back as I can remember as an MDS Coordinator (this statement seems odd since this white paper is co-authored by two people), one of the main areas of focus and significance was Section G. Reviewing ADLs, especially …

Patient-Driven Payment Model (PDPM) – 6 Keys You Need to Know

By Melissa Keiter, RN, RAC-CT, DNS-CT, DON and Melissa Sabo, OTR/L, CDP, CSRS On April 27, 2018, CMS released an alternative proposed rule for the Prospective Payment System (PPS), called the Patient-Driven Payment Model (PDPM), which would replace the existing RUGs-IV PPS classification system. In CMS’s proposed rule, PDPM is defined as promoting the utilization …

What Characteristics and Qualities Can Predict a Successful Clinical Manager for Home Health Agencies?

The final rule for the Conditions of Participation (CoPs) requires home health agency (HHAs) to have a clinical manager to direct, coordinate, and communicate home health personnel and patient care services.  The clinical manager leadership role requires a health care professional who can coordinate services, collaborate with all disciplines, communicate effectively with residents and caregivers, …

Infectious Disease Prevention and Home Health

Infectious disease prevention contributes significantly to keeping patients and health care providers safe.  The World Health Organization (WHO) estimates that there are 1.4 million health associated infections (HAI) at any given time.  Homecare treatments that have high susceptibility to infection are infusion therapy, urinary tract care, enteral therapy, and wound treatments.  Health care providers are …

Is It Appropriate for Occupational Therapists to Perform the Initial Start of Care for Home Health?

Occupational therapy services are an important component to the overall assessment and functional outcomes associated with home health.  Medicare restricts occupational therapists from performing the initial comprehensive assessment (start of care) for home health. In skilled nursing facilities, long term care, and outpatient therapy settings, occupational therapists are permitted to perform the initial evaluation and …

How Accurate is Documentation When Not Performed at Point of Service?

On day one of physical therapy school, I heard the words “if it’s not documented, then it didn’t happen.” Throughout my career, I have heard this time and time again and used this when I was a Home Health Administrator, SNF Therapy Coordinator, and Outpatient Therapy Coordinator.  This quote is constant throughout the health care …