August 2, 2023

Patient-Driven Groupings Model (PDGM) -Primary Diagnosis

The Patient-Driven Groupings Model (PDGM) is the Home Health Prospective Payment System (HH PPS) used for reimbursement that went into effect on January 1, 2020. Before PDGM, the HH PPS was based on the therapy volume as a threshold for reimbursement. With PDGM, the reported diagnoses (ICD-10-CM), and specific items coded on the Outcome and Assessment Information Set (OASIS) represent the patient characteristics to determine reimbursement. PDGM uses 30-day periods as the basis for reimbursement,…

New Nursing Home Survey Process Triggers SNF Beneficiary Protection Notification Reviews

The new survey process for nursing homes went into effect November 28, 2017.  The surveyors will be conducting a Beneficiary Protection Notices Review. The survey team coordinator (TC) will make offsite unit assignments and mandatory facility task assignments for the surveyors. There are nine mandatory facility tasks which include the Beneficiary Protection Notification Review. The objective of the Beneficiary Protection Notices Review is to determine if the facility issued the Notice of Medicare Non-Coverage as required…

Understanding the Pros and Cons of an Interim Assignment vs. Employment

Have you ever wondered what working as an interim professional would be like? Do you think this type of job would be what you need? Admittedly, contract, gig, or interim work is not for everyone. This approach to filling critical positions has existed in healthcare for quite some time and contract nursing positions have been around for many years. Employers reach out to agencies providing contract nurses to fill open positions due to a variety…