In the months leading up to October 1, 2019, providers across the long-term post-acute care (LTPAC) spectrum have been very busy preparing for PDPM for Medicare A residents. We at Richter have as well, as we’ve been training, updating software, adjusting processes and planning our strategy for the biggest change in reimbursement in over 20 years. The good news: It’s finally here! The bad news: There is no real direction on what to do about Medicare Advantage plans.
As we all know, no matter how hard we try, payer information can be wrong. If you think that a resident is on a Medicare Advantage Plan upon admission and a month down the road, you find out they are classified under Traditional Medicare A, you will be in a world of hurt if you did not complete the Medicare A assessments. This is why we recommend that you complete the PDPM 5-day assessment on all Medicare and Medicare Advantage skilled residents. Although this will be a PDPM 5-day assessment, you will still be able to see the RUG-IV at the top of each assessment if needed by the Medicare Advantage Plan. If you are not using PointClickCare®, call your software vendor to see if you have this option available.