As you define your month-by-month plan to transition to PDPM, here are questions to answer with your interdisciplinary team (IDT) to ensure effective collaboration, knowledge sharing, and success.
LEADERSHIP / ADMINISTRATION
1. As we cross-walk current patients (using the CMS Grouper Tool) do we see shifts in revenue? If so, how will they be remedied?
2. How might patient inflow and referrals change?
3. Which previously denied patients might we target &prepare for under PDPM? (E.g. CHF, bariatric, behavioral, cognitive diseases, etc.)
4. What hiring or reorganization needs to happen to meet new priorities, clinically complex patients, and/or expected demand?
5. How will roles be delineated for nursing, CNAs, therapy, & MDS?
6. What additional education is needed per team role?
7. How must team workflows change to ensure accuracy, compliance, and quality?
8. What is our team’s expertise with the conditions, co-morbidities, and extensive services that contribute to NTA?
9. As we assess our current patients, how accurate is our ability to capture their levels of depression?
10. How will our MDS coordinator’s role change?
11. How accurate are our primary diagnosis codes now?
12. What improvements must be made in communications with IDT to determine primary diagnoses?
13. What additional ICD-10 training is needed?
14. How will we assess staff competencies and provide ongoing diagnosis coding training?
15. What systems need to be implemented or improved (e.g. triple check) to ensure that billing is supported by appropriate documentation?
NURSING & CNAs
16. What clinical pathways are we strategically targeting and how will our approach change?
17. How might staffing ratios change to account for acuity under PDPM?
18. What education is necessary for our nurses & CNAs?
19. What training & collaboration is needed between therapy and CNAs for ADLs, restorative, and proper documentation & coding?
20. What other resources will clinicians need to make quick, appropriate, data-driven decisions?
21. What clinical pathways are we strategically targeting and how might our therapy approach change?
22. How is the therapy team using care pathways and data/models to determine the amount of therapy necessary to move each patient to the next level of care?
23. Which diagnoses / patients will be most responsive to concurrent and/or group therapies?
24. What changes with SLP may need to happen to identify and treat neurologic conditions, swallowing disorders, and cognitive issues?
25. How will referral sources need to be educated to ensure complete and accurate patient information before admission?
26. How can communication be improved before, during, and after patient transitions?
27. How will we show referral sources our better outcomes with certain diagnoses?
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We are helping our customers and senior communities across Michigan understand the PDPM transition process and the steps necessary for success on October 1, 2019 and beyond. Call us toll free at 877-TMI-8171 or email us today.