Initiating Conversations Beyond the Facility

Ninety-five days, three months, or one quarter to go until the hard transition from RUG-IV to PDPM. However you prefer to frame it, there’s no denying the next few weeks will demonstrate a shift from theoretical planning of the facility processes to practical application. Within the current planning process Reliant has been privileged to be included in many of your conversations regarding facility education opportunities, interdepartmental communication strategies, and service delivery execution under PDPM.

The preparation and planning strategies have circulated around accurate MDS coding to ensure appropriate resource provision for the patient’s care needs while a resident in our facilities. We are actively educating all levels of nursing staff, therapy staff, administration, and admissions coordinators in expected conversation changes, but have we considered education needs beyond the facility? 

Under PDPM, facilities will be asking more detailed questions of the hospital discharge coordinators and specialists’ offices. We’ll be seeking clarification, coding specificity, and asking probing questions to ensure the patient’s assessment reflects all active comorbidities and conditions. As such, our community partners may begin to ask, “Where is this coming from?” Providing these partners with a big picture snapshot of PDPM and potential conversation changes will help to ease questions and prepare our partners for their own best practice referral strategy.

Team work and collaboration should start before a resident’s admission to the SNF and continue throughout the entire stay.  If you haven’t already, now is the time to reach out to your partners to initiate conversations regarding any process changes required for this transition.  By working together and proactively engaging our referral sources, we can identify education targets now, and avoid pitfalls in the future. 

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