Capturing all the appropriate MDS data in support of care improves the quality of care as well as assists facilities in maximizing the Nursing category for Medicaid reimbursement under a PDPM model. Open communication between interdisciplinary team members is an integral part of ensuring accurate data to provide comprehensive quality patient care. Communication must occur among the interdisciplinary team, including patients, family members, and physicians. The importance of communication is critical with PDPM to capture the ‘true’ picture of the patient.
With the removal of Section G from the MDS, numerous states with CMI are utilizing or converting to a PDPM Medicaid reimbursement model which encompasses the Nursing component of PDPM plus incentive measures. While labelled as the Nursing component, the information captured often requires a comprehensive interdisciplinary team approach. Information must support services related to:
Depression must also be assessed and coded accurately to properly classify Special Care High and Low and the Clinically Complex categories.
The therapy department should be an integrated part of the interdisciplinary team in the provision of patient care. Therapy can assist with capturing data and providing care for various areas related to function, swallowing, weight loss, wound care, cognition, communication, behaviors, and restorative nursing needs, and so on.
Through teamwork and open communication within our facilities, we can continually advance accurate coding to assist with comprehensive quality patient care and appropriately maximized reimbursement.