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PDGM Training Essentials Library

Product Code: XHHPDGM

Quick Overview

This library is designed to ensure your entire team from intake to clinicians to coders are operating as efficiently as possible to ensure success in the new world of PDGM. They will make certain that you’re providing the highest quality patient care while ensuring correct reimbursements under this new payment model.

Price: $599.00

PDGM Training Essentials Library

After completing this training, learners will be able to:

  • Get a breakdown of how PDGM will impact every area of your agency
  • Increase efficiencies in your intake department and ensure all necessary details are captured
  • Identify therapy utilization best practices and strategies
  • Understand the importance of detailed documentation and in PDGM
  • Evaluate how to correctly use comorbidities and avoid unacceptable codes to get paid correctly
  • Leverage key activities for case conferencing and care coordination under PDGM

Who should participate?

  • Administrators
  • Quality Managers
  • Directors of Nursing
  • Clinical Supervisors
  • Compliance Officers
  • Clinicians

Courses Include:

PDGM Breakdown: An Overview of the Changes

The 2020 payment rule provides updates on the Patient-Driven Groupings Model (PDGM)—the new payment system launching for the home health industry. This course will explain how the changes CMS is making to PDGM will affect your agency and will detail the steps you’ll need to take to adapt.

The rule also contains several other major items that will affect agencies’ payments in the coming years. Those items include proposed changes to Requests for Anticipated Payments (RAP), the Home Health Quality Reporting Program and OASIS, value-based purchasing, and more.

At the conclusion of this program, participants will be able to:

  • Describe how PDGM will affect the home health industry beginning in 2020
  • Detail changes to payment outlined within the new payment rule
  • Explain how the Home Health Quality Reporting Program will impact their agency


Understand the Impact of PDGM on Coding and Case-Mix Calculations

The Patient-Driven Groupings Model (PDGM), the new payment system for the home health industry beginning January 1, 2020, comes with heighted specificity requirements and a need to document all the relevant diagnoses for a patient. This course will explain how this payment system will affect coding and what agencies and coders should do to prepare.

This course will cover which diagnosis codes will no longer be acceptable under PDGM, how comorbidity adjustments will work, and why it’s vital to have a sound query process when further specificity in documentation is needed.

At the conclusion of this program, participants will be able to:

  • Understand the overview of the PDGM
  • Understand the overview of the PDGM
  • Understand PDGM coding and how to avoid RTP codes
  • Understand comorbidities in PDGM
  • Understand industry movement related to PDGM
  • Understand the query process, and
  • Evaluate existing team members related to implementation of PDGM


Learn How to Handle Therapy in a PDGM World

The Patient-Driven Groupings Model (PDGM) removes therapy thresholds for payment, but what does that mean for your patients and your business? If you currently generate a large percentage of your Medicare dollars through therapy, how will you need to adjust? In this course, you will learn about the new payment model, best practices to prepare, and options for therapy staffing moving forward.

At the conclusion of this program, participants will be able to:

  • Identify how therapy fits into PDGM
  • Explain PDGM’s functional impairment structure
  • Underline the importance of accurate OASIS
  • Compare the pros and cons of salary vs. pay-per-visit
  • Describe the impact of 30-day periods on therapy staffing
  • Explain the role of the clinical manager in PDGM
  • Identify therapy utilization best practices and strategies


Intake Strategies for Success

The Patient-Driven Groupings Model (PDGM) dramatically affects the way home health agencies are paid. It also has a significant impact on agencies’ operations, from intake through discharge. This course will walk agencies through the significant home health changes under PDGM and detail how agencies should adapt their intake process as a result. If agencies don’t make improvements at intake, they will likely be affected downstream.

At the conclusion of this program, participants will be able to:

  • Understand details about PDGM and how it differs from PPS
  • Understand the need for detailed documentation for coding under PDGM
  • Understand how to improve efficiencies within the intake department
  • Learn about scripting that agencies can utilize when educating referral sources about need for additional documentation


Improve Clinical Documentation Strategies (Part 1): Understanding the New Expectations

This course will outline ways agencies can start to improve their documentation right away in order to achieve accurate coding, protect payments, avoid ADRs, and ensure a smooth transition to PDGM.

At the conclusion of this program, participants will be able to:

  • Identify key elements of clinical documentation integrity, or CDI, in home health
  • Explain the importance of proper documentation under PDGM
  • List three best practices for concurrent documentation review


Improve Clinical Documentation Strategies (Part 2): Concurrent Review Process

This course will outline ways agencies can start to improve their documentation right away in order to achieve accurate coding, protect payments, avoid ADRs, and ensure a smooth transition to PDGM.

At the conclusion of this program, participants will be able to:

  • Identify key elements of clinical documentation integrity, or CDI, in home health
  • Explain the importance of proper documentation under PDGM
  • List three best practices for concurrent documentation review


Refine Care Coordination Process

Many agencies will suffer devastating financial losses once the Patient-Driven Groupings Model (PDGM) launches. To survive and thrive, agencies must improve their monitoring of visits, making every visit count while still ensuring patients get all the care and services they need.

This course will show how PDGM is set to affect agencies’ payments—and how agencies can ensure they aren’t caught unprepared. This course will explain how clinical and case managers will need to shift their roles under PDGM. This course will also cover benchmarks that clinical managers should monitor and the ways case conferences will need to change.

At the conclusion of this program, participants will be able to:

  • Explain the basic reimbursement structure of PDGM
  • Describe the role of clinical managers under PDGM
  • Identify key performance indicators for clinical managers, and
  • Apply key activities for case conferencing and coordination of care under PDGM

Jennifer Sandel, MPT, HCS-O, is a home health consultant and co-owner of Home Care Services Solutions in Battle Creek, Michigan. She has a background in physical therapy, working in acute care skilled nursing facility and home health settings. She has served as a field clinician and physical therapy team supervisor. Her company provides outsourcing to home health agencies in ICD-10 coding and reviews, OASIS reviews, clinical chart audits, and on-site consulting for staff development, efficiency, and documentation compliance.

Sue Payne, MBA, RN, CHCE, is vice president and chief clinical officer for The Corridor Group. She is responsible for clinical quality and business review to ensure client satisfaction. She also serves as the corporate compliance officer. Payne joined Corridor in December 2016 after the company acquired Transpirus, LLC. At Transpirus, she was senior vice president of clinical services. Payne has spent more than 25 years working in homecare operations and strategic leadership, including serving as vice president of home health at multistate providers Advanced Home Care and Life Care at Home.

Sharon Litwin, RN, BSHS, MHA, HCS-D, is principal and founder at 5 Star Consultants, LLC in Camdenton, Missouri. Litwin has been in healthcare management and administration for 30 years. For the past 25 years, she has been actively involved in the home health industry, serving in roles from field nurse to executive director to senior managing partner/healthcare consultant.

Sherri Parson, RN, HCS-D, HCS-O, COS-C, BCHH-C, HSC-H, brings more than 25 years of healthcare experience to her role as vice president of education and control standards with Quality in Real Time (QIRT) in Floral Park, New York. Earning her RN license in 1994, Parson started her career providing direct care in hospital settings, including medical surgical, ICU, and interventional radiology, before transitioning to home health. She has been an in-home provider of skilled nursing services, as well as developing expertise in quality assurance, diagnosis coding, OASIS review, and regulatory compliance. She has also served as a therapy manager and staff education and development expert. At QIRT, Parson hires, trains, and monitors coding and OASIS review staff and managers, as well as establishes the metrics for key performance indicators to ensure continuous staff improvement in coding and OASIS accuracy.

Diane Link, RN, MHA, is president of Link Healthcare Advantage in Littlestown, Pennsylvania. Her company offers personalized home health and hospice clinical consulting focused on improving HHCAHPS, Home Health Compare, FEHC, and patient experience of care surveys; operational efficiencies using Lean Six Sigma tools; medical records review; and quality assurance/performance improvement planning and corporate compliance programs. Link has more than 23 years of home health experience, having served as a nurse and performance improvement management director. She is president of the Maryland National Capital Homecare Association.

Robert Markette is an attorney with Hall, Render, Killian, Heath & Lyman. His primary areas of practice are health law, Medicare/Medicaid compliance, fraud and abuse, and employment law and litigation. He is certified in healthcare compliance by the Health Care Compliance Board. Markette assists clients including county health departments, home health agencies, private duty agencies, hospices, and physicians with a wide range of healthcare compliance and litigation issues.

Board of Medical Speciality Coding & Compliance (BMSC)
Pre-approved by the Board of Medical Specialty Coding & Compliance for 1 CEU.