By: Lisa Chambers, MSCCC, SLP, CHC
Happy Birthday PDPM! We cannot believe you are one ALREADY! We have been through so much together in such a short time and what a crazy year it has been!
Just like with all new things, we have had to learn a few lessons the hard way. A great example is how you really force us to pay close attention to EVERYTHING about our patients. You have really encouraged our PT/OT/SLPs to communicate more than ever. You have shown us that collaboration with nursing and facility staff is essential to make sure nothing it being overlooked. With 50 co-morbidities and services that count toward non-therapy ancillaries, you have put us through quite the challenge to make sure we are crossing all those T’s and dotting all those I’s to account for all the ways we care for our patients and the conditions they present to us.
You have also really driven home just how important our speech therapists are to both the residents and our partners! Their help in identifying cognitive deficits, altered diets, and swallowing disorders have really left a mark on our partners’ PDPM performance. Luckily, at Blue Sky, we have our MIND program and extensive education available for our SLPs to be incredibly well-versed when it comes to treating our patients presenting with dementia and/or swallowing disorders.
Other things we have learned is the critical role the MDS Nurse plays in the interdisciplinary meeting. Continuing to refine the meeting process and the tools utilized to ensure a comprehensive meeting to capture all the detail needed for an accurate patient assessment is ongoing.
Additionally, the accuracy required in Identifying the correct diagnosis, capturing all the applicable NTA’s as well as ensuring accurate depression scores has been a welcome challenge to ensure our approaches are patient driven and reflect the needs of the patient.
We have also learned from a billing and compliance perspective, how important a solid triple check process is as it is critical for accurate billing, a process for monitoring your days in AR, and reconciling what you are paid to what you expect to be paid. A comprehensive audit system to support the coding on the MDS is another critical element needed from accurate HIPPS codes to skilled documentation.
From GG scores, to Case Mix Scores a collaborative therapy partner has been proven to be essential under PDPM. Having a therapy partner that provides educational resources, works collaboratively and regularly reviews utilization patterns and outcomes will ensure your residents are receiving the care they need.
PDPM, you are our first step in preparing us for value based care and as we continue to analyze our data and become more sophisticated in capturing the details we can refine our care with clinical pathways and outcome based objectives. Many Managed Care plans have also adopted the PDPM strategy to support the shift to value based care.
PDPM, it has been an extraordinary year! We thought you would be our biggest challenge and then the Public Health Emergency occurred. These unprecedented times have forced us to reflect and adapt which are skills that serve us well in our quest to provide care to our most vulnerable population. Just when we were getting a grasp on providing group and concurrent therapy as another mode of delivery, we had to shift and focus on 1:1 treatments, working with our facilities to combat isolation and loneliness in our residents, preventing declines in cognition and function and identifying residents at risk for depression due to the restriction of visitors.
We have learned to work in PPE while providing resident centered care and most importantly be a collaborative team to ensure we are mitigating risk and staying focused on our resident’s health and well-being!
And with all that, you still restructured our thinking from a previous system that focused on arbitrary levels of service to a patient driven system that continues to focus us on each patient’s individual needs and characteristics and to provide that care in a collaborative and effective manner. We are excited to celebrate one year of PDPM and are looking forward to many more successful years to come!
About Blue Sky Therapy
Blue Sky Therapy also partners with skilled nursing facilities, assisted living facilities, and home health agencies to provide innovative physical, occupational, and speech therapy services. They also own and operate 6 outpatient clinics throughout Ohio and Florida. LEARN MORE about Blue Sky Therapy.
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