A continual challenge for many long-term post-acute care (LTPAC) organizations is knowing what to skill residents for under Medicare A, and what the criteria is. While therapists have borne much of the documentation burden for this under previous PPS payer rules, nursing now shares that responsibility under the new Patient Driven Payment Model (PDPM).
Once a resident’s primary diagnosis has been made, the determination for skilling that resident falls under at least one of five main skilled areas. While each resident must fall into at least one of these, up to five may apply as well. Richter developed this guide as an easy-to-use reference for each area. It includes the area category, qualification as skilled services and criteria for determining resident applicability based on directives from the Centers for Medicare and Medicaid Services (CMS).
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