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VIEW THE FULL WEBINAR BROCHURE HERE.

COURSE OVERVIEW

PDPM began October 1, 2019, followed closely by the onset of the COVID-19 public health emergency. SNFs did not have time to become fluent with the new payment system due to the onset of the PHE.

This presentation will focus on the therapy components of PDPM (PT, OT and SLP).  The Medicare teams are still confused by the fact that the therapy payment is no longer dependent upon therapy days and minutes provided during the MDS look-back. Instead, the PT and OT components are based solely upon the Section GG functional score and the primary diagnosis coded in MDS item I0020B.

The second half of the presentation will focus on the Speech Language Pathology (SLP) component. We will discuss the 5 areas that impact payment:  primary diagnosis coded in I0020B, SLP comorbid diagnoses (late effects of CVAs, cancers of the oral cavity, ventilator use, tracheostomy care, or diagnosis of ALS) and cognitive impairment (BIMS interview or CPS).  The end splits affecting payment are the presence of a potential swallowing problem coded in K0100 and/or a mechanically altered diet. The SLP component is frequently found to have errors on Medicare review.

SPEAKER

Carol Maher is a Board Certified Gerontological Registered Nurse with over 30 years’ long term care experience and has worked in long term care in many roles. She worked as the MDS Coordinator in a 300 bed SNF in Pennsylvania for eight years before moving to California to become the MDS Coordinator/Director for a 1200 bed SNF in San Francisco. She has also worked as the MDS Coordinator in a SNF that typically had 60-75 residents on Medicare in addition to 160 long-term care residents. More recently she was the Senior VP of Utilization Services and Director of Reimbursement for large multi-facility organizations. Presently, Ms. Maher is the Director of Education for Hansen Hunter & Co., providing MDS, Medicare, and regulatory and clinical educational classes and webinars for HHC clients nationwide. Carol has worked as one of the Gold Standard nurses for MDS 3.0, serving on the RAP workgroup to prepare the way for the CAAs for MDS 3.0, and participating on several Technical Expert Panels related to MDS, Quality Measures and care planning. A sought-after speaker, Carol has given presentations at AANAC, AHCA and LeadingAge national conferences as well as many state organization presentations. She is presently serving as the chair of the AANAC Expert Advisory Panel and as an AANAC Master Teacher of the RAC-CT and RAC-CTA certification courses. Ms. Maher provides MDS and Medicare classes across the country, presenting monthly educational webinars and completing compliance audits. She is the author of Long-Term Care MDS Coordinator’s Field Guide (HCPRO 2016).

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