RoPs 3:

• Webinar

Date: February 27^th, 2019, 2:00pm – 3:00pm EST

Topic: Get Ready for Phase 3 RoPs: Elements of a successful QAPI program

Speakers:  Maureen McCarthy, President & CEO, Celtic Consulting, Jillian Martin, Senior Health Consultant, CliftonLarsonAllen

• Tools and Resources to be posted on the LeadingAge website

Date: Week of February 25^th, 2019

Topic: Implementing Trauma-Informed Care:  A Guidebook

Date: Mid-February 2019 to May 2019

Topic: Competency Toolkits:  Knowledge, Skills and Assessments (25 in total)

• In-Person presentation at Leadership Summit, Washington, D.C.

Date: Tuesday, March 19, 2019 at 3:45 – 5:15 p.m.

Topic: Skilled Nursing Regulatory Update

Speaker: Bonnie Reed, Centers for Medicare and Medicaid, will discuss the nursing home regulatory environment impact.

• Webinar

Date: April 3^rd, 2019, 2:00pm – 3:00pm EST

Topic: Compliance and Ethics:  What Every Nursing Facility Needs to Know About Mandatory Compliance Programs

Speaker:  Aric Martin, ESQ, Managing Partner, Rolf, Gottman, Martin & Lang

Patient-Driven Payment Model (PDPM) Medicare Payment System, effective October 1, 2019

LeadingAge will offer an array of education, resources, and tools that enable members to succeed under the new PDPM payment system. We are developing a variety of opportunities, including many that will be available for on-demand consumption with sensitivity for clinical staff who might not always be able to attend time specific or day long trainings. Clinical staff will be among the key drivers of success under the model. In addition to the below topical areas that will be rolling out through the remainder of the year, many LeadingAge state partners are offering valuable education and training opportunities to take advantage of. We anticipate announcing details in early March.

Case Mix Components: Assessment and Coding

• Understand the role of the primary reason for skilled nursing facility (SNF) admission and function score in determining case mix group for PDPM
• Learn the operational considerations for obtaining necessary documentation to support coding for the case mix groups
• Comprehend the connection between primary diagnosis category, nursing category, and related non-therapy ancillary items to ensure appropriate reimbursement under PDPM
• Recognize how the ICD-10 code for primary reason for SNF care and non-therapy ancillaries affect PDPM case mix groups
• Discuss the importance of interdisciplinary team collaboration in determining all diagnoses that are appropriate for a Medicare Part A resident under PDPM

Therapy and Nursing Together Under PDPM

• Appreciate the increased level of interdependence between physical therapy, occupational therapy, speech therapy, and nursing in determining a resident’s payment group
• Recognize how changes in payment groups can impact your therapy provision whether in-house or contracted
• Understand the increased importance of looking at the hospital record to guide SNF resident admission to ensure a holistic patient-centered care plan and appropriate coding for medical complexities
• Discern the new normal of daily life in the building including a retooling of the Medicare meeting and roles and responsibilities of all members of the interdisciplinary team

Financial Considerations and Implications

• Identify potential operational changes that might be necessary to sustain your organization during the transition to PDPM
• Understand the aspects of the variable per diem payment rate and the connection to resource use
• Recognize the financial drivers that will determine reimbursement under PDPM as compared to RUGs and the implication for your organization and its unique resident case mix
• Learn about modeling tools and calculators that enable organizational specific projections

Ask the Experts Interview Series

We are developing an opportunity to have your specific questions answered from a panel of national experts and recorded for on demand listening. In the near future, we will share instructions on how you can call or email your questions to LeadingAge so they can be discussed by experts and available as podcast style recordings.

In-Person presentation at Leadership Summit, Washington, D.C.

Date: Tuesday, March 19, 2019 at 3:45 – 5:15 p.m.

Topic: Skilled Nursing Regulatory Update

Speaker: John Kane, the SNF team lead for the CMS Chronic Care Policy Group, will discuss the PDPM payment system alongside a CMS colleague focused on regulatory issues and the requirements of participation.