Answered: ) Define describe and explain the PDPM…

Understanding Business

12th Edition

ISBN:9781259929434

Author:William Nickels

Publisher:William Nickels

Chapter1: Taking Risks And Making Profits Within The Dynamic Business Environment

Section: Chapter Questions

Problem 1CE

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Question

1) Define describe and explain the PDPM reimbursement system? 2) Define and describe how PDPM impacts nursing homes considered who is admitted ,how does this creat a opportunity or a threat to the facility and how does these impact the operations? 3) Identify the importance between PDPM and RUGs4

Expert Solution

Introduction

PDPM Model:-

Full form of PDPM model is Patient Driven Payment Model.

The Journey to PDPM:-

Advance Notice of Proposed Rule making (ANPR)-may 2017- called Resident classification system (RCS-1), there were three main points:-

-More accurately compensate SNFs. (Skilled nursing facilities)

-Reduce incentives for SNFs to deliver therapy based on financial considerations rather than resident need.

-Maintain Simplicity.

Lots of industry comments and feedback contributed to prolonged decision making process by CMS about changes to the reimbursement process.
During an open door forum in march 8,2018, CMS indicates that it had not proposed or finalized any policy for assessment with RCS-1.