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PDPM Part 3: Nursing Case Mix Groups

PDPM Part 3: Nursing Case Mix Groups 

On October 1, 2019 CMS will implement the Patient Driven Payment Method (PDPM), a new payment system for Skilled Nursing Facility (SNF) providers. The new payment system significantly changes how SNF Per Diem rates for Medicare beneficiaries in a Medicare Part A stay will be determined. SNF providers need to have a solid understanding of this new system prior to October 1! 

In Part 3 of our 6 Part PDPM webinar series we will begin to look at the nursing component and the corresponding 25 case mix groups. This course will identify each of the 6 main Nursing Categories and the MDS items that impact each category. We will also discuss the role of the PHQ-9® and restorative nursing in the assignment of nursing CMGs.



$15.00

Hours: 0.75
REL-PAC-0-PDPMNG

Certificates

Certificates provided by accrediting body (6 Match)

American Nurses Credentialing Center

0.75 HOURS


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 0.75 contact hours for participating in this course.

District of Columbia Board of Nursing

0.7 HOURS


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 0.70 contact hours for participating in this course.

Georgia Board of Nursing

0.75 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 0.75 contact hours for participating in this course.

South Carolina Board of Nursing

0.75 HOURS


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

New Mexico Board of Nursing

0.75 HOURS


New Mexico Board of Nursing (CEBroker Provider # 50-290)

This course awards 0.75 contact hours upon successful completion.

Arkansas State Board of Nursing

0.75 HOURS


Course Details

Course Code: REL-PAC-0-PDPMNG
Hours: 0.75
Type: Online Course
Content Expiration Date: 6/30/2022
Learning Objectives:
Identify how the Function Score is calculated for the Nursing case mix groups.
List the 6 main case mix group Nursing Categories for the nursing component of the PDPM.
Explain how the PHQ-9© and restorative nursing programs are used in the calculation of the nursing CMG.

Outline:

Nursing CMGs Overview

Hierarchical Method

Nursing CMG Summary

Nursing Function Score

Nursing Function Score Table

Nursing Function Score - Example

Extensive Services

Depression

Depression – Financial Impact

Special Care High

Special Care Low

Tube Feeding Requirements/Skin Treatments

Special Care Low

Clinically Complex

Restorative Nursing

Restorative Nursing – Financial Impact

Behavior Symptoms/Cognitive Performance

Reduced Physical Function

Nursing Case Study: Meet Mrs. Juneau

Nursing Case Study: Rate Difference

References

Resources

Course Contributor



 


Instructor: Ron Orth RN, CHC, CMAC, AHIMA-Approved ICD-10-CM Trainer
Ronald Orth, RN, CMAC, CHC  obtained a nursing degree from Milwaukee Area Technical College in 1985 and a B. A. in Health Care Administration from Concordia University in 1996. Mr. Orth possesses over 30 years of nursing experience with over 20 of those in the Skilled Nursing industry. Mr. Orth has extensive experience in teaching Medicare regulations to healthcare providers both in the US and internationally. Mr. Orth is currently the Post-acute Care Curriculum Designer and is certified in Healthcare Compliance through the Compliance Certification Board (CCB). Ron has also successfully completed the Infection Control Officer training through the AHCA and is an AHIMA approved ICD-10-CM trainer. Disclosure: Ron Orth RN, CHC, CMAC, AHIMA-Approved ICD-10-CM Trainer has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Administrators; Nurses; in the following settings: Acute Care Facility.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.

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