Residents who are frail are more clinically complex and have increased nursing care needs. Those whose frailty has increased as the result of functional or cognitive declines need the most nursing care time and this impacts the per diem rate under PDPM. Assessing frailty is key to capturing revenue and accurately predicting costs of care in the world of the Patient-Driven Payment Model (PDPM). Understanding frailty can help us identify the risks associated with patients’ costs, as these are higher for frail patients with similar diagnoses than for their non-frail counterparts. In other words, the trajectory of care for two patients with similar diagnoses but different levels of frailty are drastically different. Capturing all this information is necessary to optimize PDPM reimbursement and to be paid for the increased nursing time you will be providing to the frail resident.
For more on this topic click on this link to the most recent Provider Magazine article.
8.8.2019 by Joanne Kaldy