Journey to PDPM, Stage 3: Analyze

May 13, 2019 Stephanie Mancini

Now that your processes and care content have been standardized and your staff have had time to adjust to the new tools, workflows, content, and approaches in Stage 2, you are now ready to begin Stage 3: Analyze. In this stage of your journey, you will examine the changes you’ve made thus far in the process and determine what’s working and what needs more attention going forward.

This is a good time to look for any potential gaps in your processes and discover the impact the standardization from stage 2 has on your outcomes. To do this, you will need to review how these changes have impacted potential revenue for PDPM. If shifts have been designed to optimize revenue under PDPM, how has this impacted targets and outcomes?

Guidelines to direct you throughout this stage are as follows:

Review your new protocols and workflows

Look for areas of improvement, outcomes that did not change or indications that problems continue to exist. This is also the time to review processes with staff and get their feedback.

Re-examine your MDS accuracy

A comprehensive picture of the residents on the single payment five-day assessment is the only way to optimize reimbursement and capture the clinical characteristics of the resident needed to create the best care plan. Ensure gaps have been closed between the five-day and 14-day RUGs assessments.

Evaluate your revenue and quality mix

Your quality mix is constantly changing and PDPM only affects a portion of your revenue this year. You will need a clear understanding of how this change impacts the bigger picture to ensure the best decisions are made to achieve financial success now and in coming years

Validate your revenue projections

Understanding the impact this will have in 2020 will help you be successful in fiscal 2021 and beyond. This picture needs to be looked at holistically — taking into account all payers and shifts in the industry towards advantage plans.

Want to learn more about Stage 3? Check out our recorded webinar “Your Journey Through PDPM”.

Register now for Stage 4 of this webinar, taking place on June 13.

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