75 days and counting until PDPM arrives on October 1, 2019. Each day inboxes are flooded with articles on PDPM and their messages are consistent and clear. This reimbursement change from CMS is BIG and facilities may be caught off guard by the reality of the changes and the inherent difficulties of requiring so many professionals to do and document more and to do it in a time frame that meets PDPM requirements and does not leave money on the table. A few of the takes away from the articles this week in

  • If you are doing the care it should be documented by all disciplines
  • Medical providers need to be sure to document each active diagnosis
  • Depression scores must be available and accurate – if under 9 it will not impact the PDPM
  • Be sure to complete Section K as the presence of swallowing disorders impacts PDPM
  • GG Function scores impact several categories and their accuracy is vital – learn the impact of your answers
  • Accurate and timely coding is critical and the responsibility of medical providers
  • The “Primary Diagnosis” definition (reason for admission) is new to SNFs – requires clinician verification
  • Inaccurate or incomplete documentation will lead to audits similar to current audits (RACs, HHS, OIG)

Perhaps the old adage still applies: “If it is NOT documented it was NOT done”!