PDPM Resource Center - available to all SNF AHCA Members


On October 1, 2019, skilled nursing facility (SNF) providers will submit claims for Medicare Part A services under an entirely new per-diem SNF prospective payment system (PPS) model called the Patient Driven Payment Model (PDPM).  Payments under the RUG-IV SNF PPS model will end on September 30, 2019. 

The PDPM case-mix payment model relies on resident clinical characteristics reported on the minimum data set resident assessment instrument (MDS-RAI) and claim form and includes significant changes in the assessment process and schedules, clinical information used to determine case-mix payment rates, and how therapy services are reported.  These changes will impact all aspects of SNF operations including front office, billing, resident assessment, and care planning and delivery processes.  These changes will also interact with other SNF policies that are not changing including:

  • Need for Daily Skilled Care
  • Requirements of Participation and Related Survey & Certification
  • SNF Quality Programs (SNF QRP and SNF VBP)
  • Annual Payment Rate Update
  • Consolidated Billing

The PDPM payment model may also interact with other payers that rely on RUG-based payment methodologies including; Medicaid, Medicare Advantage, and the VA, as well as other alternative payment models and demonstrations including ACOs and bundled payments.

The AHCA Patient Driven Payment Model (PDPM) Academy provides AHCA provider members with a suite of original content, tools, and training options and resources to assist providers in how to be successful in preparing for and implementing the new Medicare Part A PDPM SNF PPS in October 2019. 

Basic versions of many AHCA PDPM Academy copyrighted document resources and webinars will be available to all AHCA provider members at no additional cost at the AHCA PDPM Resources page (see below).  AHCA will also be providing PDPM educational resources customized to the needs of ABM partners at no additional cost (see link at left side of this page).    

For a reasonable fee, AHCA provider members may enroll in the AHCA PDPM Academy to obtain access to more extensive educational opportunities and resources (see link at left side of this page) including:

  • AHCA PDPM Academy 1-day Hands-on Workshop (most states and online)
  • Monthly AHCA PDPM Academy Update Webinars
  • “How-to” Webinars, Instructions, and Case-Examples for AHCA developed PDPM tools

  Additionally, AHCA now offers two online customized SNF PDPM ICD-10-CM diagnosis coding training programs for a separate reasonable fee, including one where registrants can earn coding certification in a 16-hour program (see link at left side of this page).    

Upcoming & On-demand Webinars

  • PDPM Status Updates - for AHCA SNF Members

    Contains 8 Component(s) Includes Multiple Live Events. The next is on 11/21/2019 at 3:00 PM (EST) Recorded On: 10/31/2019

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The webinars will be recorded and available within 24 hrs after the live date. After registering, you will be notified of the recordings availability. Please note we anticipate large participant numbers. If we are unable to respond to your question due to the number of participants, please direct questions to the pdpm@ahca.org email address. We incorporate questions submitted at the email address into our FAQ documents.

    If you are unable to hear the streaming audio, please check your sound settings and press F5 to refresh your connection. 

  • PDPM- One Week Out

    Contains 1 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    As providers approach the imminent October 1 implementation of the SNF PPS transition from the RUG-IV to PDPM, the Centers for Medicare and Medicaid Services (CMS) continues to issue last-minute updates including  corrections to policies, software, billing guidance, and educational resources.  During this 90- minute live webinar, the presenters will discuss key resources that CMS has updated recently that providers should pay attention to.  In addition, the presentation will cover several frequently asked questions associated with the payment model transition that members have submitted to the pdpm@ahca.org helpdesk.  After the presentation, webinar participants will also have the opportunity to submit questions to be responded to during the webinar.  AHCA will also post an on-demand recording of the live webinar as well as written Q&A responses to all questions submitted shortly after the live webinar.      

  • PDPM – Two Weeks Out

    Contains 1 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    As providers approach the imminent October 1 implementation of the SNF PPS transition from the RUG-IV to PDPM, the Centers for Medicare and Medicaid Services (CMS) continues to issue last-minute updates including  corrections to policies, software, billing guidance, and educational resources.  During this 90- minute live webinar, the presenters will discuss key resources that CMS has updated recently that providers should pay attention to.  In addition, the presentation will cover several frequently asked questions associated with the payment model transition that members have submitted to the pdpm@ahca.org helpdesk.  After the presentation, webinar participants will also have the opportunity to submit questions to be responded to during the webinar.  AHCA will also post an on-demand recording of the live webinar as well as written Q&A responses to all questions submitted shortly after the live webinar.

  • 11th hour PDPM Transition Guide

    Contains 1 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    During this 90- minute live webinar, the presenters will discuss how providers can use a concise and downloadable 11th hour PDPM Transition Guide tool we developed to help providers answer these questions over the remaining days leading up to October 1.  In addition, the presenters will share important recent PDPM implementation updates from the Centers for Medicare and Medicaid Services (CMS) including: 1) Policy changes and clarifications discussed in the recently published SNF PPS FY 2020 Final Rule, 2) FAQs from the CMS August 8 SNF Open Door Forum call, and 3) Key PDPM-related MDS updates/clarifications discussed in the CMS August 13-14 SNF QRP/MDS/PDPM two-day provider training, and  any other billing guidance issued by CMS prior to the webinar.  There will be a Q&A period of approximately 30 minutes following the presentation.  In addition to the downloadable 11th hour PDPM Transition Guide tool and webinar slides, AHCA will also post an on-demand recording of the live webinar as well as written Q&A responses to all questions submitted shortly after the live webinar.

    Recommended Participants:  SNF Administrators, Directors or Nursing, MDS Coordinators, Rehabilitation Directors, Billers, and other staff responsible for assessment of Medicare Part A SNF PPS residents. 

    Presenters: 

    Mike Cheek, Senior Vice President, Reimbursement Policy, AHCA and 

    Robin Hillier, Robin Hillier Consulting, LLC



  • Understanding the critical role of malnutrition in the Patient Driven Payment Model (PDPM) for Success

    Contains 1 Component(s) Recorded On: 02/26/2019

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    Efficiency and cost-effective positive nutritional outcomes are critical for success in today’s healthcare environment. CMS will be replacing the current SNF PPS Resource Utilization Group (RUGs) payment model with a new per-diem payment system called the Patient-Driven Payment Model (PDPM) beginning on October 1, 2019. It is critical for success that providers understand where key nutrition related diagnoses are included in the PDPM. This session will discuss collaboration with appropriate healthcare professionals to incorporate systems, processes and documentation for successful financial reimbursement of nutrition related services.

    Objectives:

    After attending this session attendees will be able to:

    • Identify key components for sustainable success with the CMS Patient Driven Payment Model (PDPM).
    • Present key Non-Therapy Ancillary (NTA) Components Diagnostic Criteria and SLP   - Component of Presence of swallowing disorder or mechanically altered diet related to Nutrition.
    • Discuss critical collaborative steps for successful integration of nutrition services into PDPM.

    Presented by:

    Brenda Richardson, MA, RDN, LD, CD, FAND

AHCA PDPM Grouper Version 2 (9/19/2019)

AHCA is releasing an improved PDPM Grouper Version 2.0 with clearer “how to use instructions” as well as a simplified workbook. The AHCA Grouper Tool (“Tool”) was developed to help AHCA members with PDPM implementation and to directionally understand the financial impact of PDPM. Please note the AHCA Grouper tool is not a substitute for the forthcoming CMS GROUPER tool.  Rather, it is intended to help members simulate PDPM payments and probable PDPM performance The user guide explains how to use the grouper tool, along with important model and data considerations. The tool allows the user to input patient-level data and derive estimated PDPM payments for non-interrupted patient stays. The user will be able to use this tool to understand the difference between reimbursement under RUG-IV and PDPM at a patient and facility level.

  • AHCA PDPM Grouper Tool How to Use Webinar
  • AHCA PDPM Grouper Tool Guide
  • AHCA PDPM Grouper Tool 

AHCA Education and Training Available Now

  • Veterans Administration (VA) SNF Payment Policies Impacted by PDPM

    Contains 10 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.  Community providers are a vital part of VA’s high-performing health care network; making sure Veterans who have served our country and their families get the timely, high-quality health care they need.  With community care, Veterans and their family members (dependents) can receive care from a local provider in their community depending on specific eligibility requirements, their medical needs and circumstances, care available at VA, and other factors.  

    Community-based skilled nursing providers may furnish short-term and long-term care to veterans under VA benefits under one of the three programs identified below:   

    • 1.Patient-Centered Community Care (PC3) is a nation-wide network of community providers VA uses to refer Veterans to community care under specific circumstances. PC3 is intended to provide eligible Veterans with access to medical care when services are not readily available or accessible at their local VA medical facility.
    • 2.Community Care Network (CCN):  In an effort to streamline VA’s community care programs, the president signed the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, referred to as the “MISSION Act,” into legislation on June 6, 2018, providing more choices and robust care coordination for Veterans using one consolidated program instead of multiple programs. A significant component of having one method for Veterans to receive care from community providers, although not dependent on the legislation, are the Community Care Network (CCN) contracts to be awarded to as many as four contractors covering an established set of regional boundaries to ensure health care services and resources are available to our diverse Veteran population.  To establish the new CCN, VA released a request for proposal for private sector companies to develop and administer regional networks of high-performing licensed health care providers who will work together with VA providers and practitioners to provide medical, dental, and pharmacy services to Veterans who are unable to receive care at local VA medical centers. The CCN contracts were developed with a focus on transparency, accountability, quality, and increased communications between VA and Veterans.
    • 3.Veterans Care Agreements (VCA):  VA may enter into agreements with certain community providers to care for Veterans when they are not part of VA’s contracted community care network. These agreements are known as Veterans Care Agreements (VCA), which are intended to be used in limited situations where contracted services through VA’s community care network are either not provided or not sufficient to ensure Veterans can get the care they need. VA may only purchase care for Veterans through these contract vehicles such as the Patient-Centered Community Care (PC3) network or the Community Care Network (CCN), or by establishing a VCA.  Providers interested in establishing a VCA should contact their closest VA medical facility.  In some cases, VA medical facilities may reach out to community providers to request they establish a VCA where there is a need for services not adequately covered through VA’s contracted network.

     

    VA Relationship with PDPM:  Historically, the VA program payments to SNFs have varied regionally, with many locations having based payments on the Medicare SNF PPS RUGs payment model.  While certain parts of the VA system are transitioning to PDPM on October 1, 2019, other parts appear to be continuing to base payments to SNFs under the RUGs model, or under other previously established contracted rates with individual providers, for at least a short period.  This toolkit contains the most current available information related to the VA SNF payment policies.      

  • CMS PDPM-Related PDPM/MDS/SNF QRP Resources

    Contains 63 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    On May 7-8, 2019 and again (with minor updates) on August 13-14, 2019 the Centers for Medicare and Medicaid Services (CMS) conducted a two-day train-the-trainer session on the October 1, 2019 updates to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP).  Examples of agenda items directly relevant to PDPM include: discussions on how to properly code Section GG of the MDS, Changes in Sections A, I, J, and O of the MDS, PDPM: What is changing and what is not, and Integrated coding & PDPM Case Study.  This PDPM Academy toolkit includes all available CMS agenda, slides, and video resources related to these training dates.

    Additionally, this toolkit contains a direct link to the CMS PDPM-Related MDS-RAI Resources webpage containing the most current minimum data set resident assessment instrument (MDS-RAI) manual.  Scroll to the bottom of the page and download the file under “Related Links” labeled MDS 3.0 RAI Manual v1.17 October 2019.

    • Chapter 2 contains a significant rewrite due to the elimination of the RUG-IV scheduled and unscheduled assessment types, and the introduction of the new SNF PPS Interim Payment Assessment (IPA) as well as the new Optional State Assessment (OSA).
    • Chapter 3 contains instructions for completion of new or revised MDS items that impact PDPM and SNF QRP, including new Sectikon J2100-J5000 surgery items and I0020B primary reason for the SNF stay ICD-10 diagnosis code.
    • Chapter 6 is a complete rewrite of the SNF PPS resident classification process and other policies including the new IPA, interrupted stay, and late assessment/default payment policies.
  • CMS MDS Section GG Training Resources

    Contains 6 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The SNF PPS Patient Driven Payment Model (PDPM) relies on accurate coding of several MDS Section GG mobility and self-care items that impact the PT, OT, and Nursing component per-diem case-mix payment rates.  This toolkit contains a collection of Section CC training materials that the Centers for Medicare and Medicaid Services (CMS) has provided on their website that may be useful for provider PDPM training of nurses, certified nursing assistants, and therapists. 

  • CMS PDPM Program Manual Updates

    Contains 4 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The Centers for Medicare and Medicaid Services (CMS) has issued sub-regulatory guidance related to the Skilled Nursing Facility Medicare Part A Prospective Payment System (SNF PPS) Patient Driven Payment Model (PDPM) in recent Progrram Manual update transmittals.  The most current updates and related resources are provided in this folder. 

    • Medicare General Information, Eligibility, and Entitlement Manual PDPM Updates (October 4, 2019)  (Bobbie – use the R126GI file)
    • Medicare Benefit Policy Manual PDPM Updates (October 4, 2019)  (Bobbie – use the R261BP file)
    • Medicare Claims Processing Manual PDPM Updates (October 4, 2019)  (Bobbie – use the R261CP file)
  • TRICARE SNF Payment Policies Impacted by PDPM

    Contains 3 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    TRICARE provides health care benefits to active military personnel and their families.  TRICARE has three regions: East, West, and Overseas.  Each TRICARE region has its own managed care support contractor (MCSC) who is responsible for administering the TRICARE program in each region. The MCSCs establish the provider networks and conduct provider education.  At a minimum, all TRICARE providers must be authorized/certified under TRICARE Regulation and must have their authorization/certification status verified by the managed care support contractors (MCSCs) in each region.  There are two types of TRICARE-authorized providers: Network and Non-Network Providers 

    Network Providers:  To become a network provider, a SNF will sign a contractual agreement with the MCSC in the applicable region. In the contract the SNF will: 1) Agree to provide care to TRICARE beneficiaries at a negotiated rate, 2) Accept the beneficiaries' copayment or cost share as payment in full, and 3) File claims with TRICARE for the remaining amount.

    Non-Network Providers:   If a SNF doesn’t want to sign a contract, the center can be a non-network provider, but the SNF must be certified by the MCSC.  As a non-network provider the SNF can decide to be a "participating provider" or a "non-participating provider".  Participating providers agree to file claims for beneficiaries, to accept payment directly from TRICARE and to accept the TRICARE allowable charge as payment in full for their services.  Non-participating providers do not agree to accept the TRICARE allowable charge or file beneficiary claims. Non-network providers can choose to participate on a claim-by-claim basis. A SNF doesn’t have to be participating or non-participating all of the time.

    TRICARE Relationship with PDPM:  Historically, the TRICARE coverage and payments to SNFs have mirrored the Medicare SNF PPS payment model, however it appears that TRICARE is not converting to PDPM at this time.  This toolkit contains the most current available information related to the TRICARE SNF payment policies.

  • PDPM and Medicare Advantage Toolkit

    Contains 6 Component(s)

    Because SNF providers contract directly with MA plans, it is essential that both parties understand any changes in resident assessment and claims processing that may be necessary to assure that beneficiary access and provider cash flow are not interrupted. To assist, AHCA has added new resources to the PDPM and Medicare Advantage Toolkit that providers can use to help prepare for discussions with Medicare Advantage (MA) plans prior to October 1 to help assure a seamless transition as the SNF PPS transitions to PDPM. The Toolkit includes:

    • For Providers – PDPM Impact on Medicare Advantage - PDPM Impact on Medicare Advantage, containing an overview of the impact that PDPM may have on your existing MA contracts and out of network payments, as well as suggested questions for health plans to ease the transition.
    • Sample PDPM Survey for Medicare Advantage Health Plans - with sample questions to ask plans to better understand what operational and billing procedures regarding MA residents you may have to change on 10/1.
    • PDPM in Medicare Advantage Contracts Readiness Checklist - to ensure you are fully prepared under your existing MA contracts and for out of network payments.
    • PDPM Impact on Medicare Advantage Webinar - which reviews the recommendations and resources above.
  • LTC Trend Tracker – PDPM Top Line Reports

    Contains 1 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

  • CMS PDPM HIPPS Coding Web Page Resources (posted 9/20/19)

    Contains 1 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    This web page contains information related to the use and maintenance of the Health Insurance Prospective Payment System (HIPPS) codeset. The Centers for Medicare and Medicaid Services (CMS) are named in the ASC X12 837 Institutional Claim Implementation Guide as the code source for HIPPS codes.  The following files contain specific details regarding the SNF PPS PDPM HIPPS code construction as well as a master list of all valid HIPPS codes applicable to PDPM.

    • Definition and Uses of HIPPS Codes (see file below)
    • HIPPS Code Master List (see file below) - an Excel spreadsheet that provides a complete list of all valid HIPPS codes, with their effective dates, payment settings and code definitions.

     

  • CMS Allowable ICD-10 Codes for the MDS Item I0020B Primary Reason for SNF Stay Field

    Contains 2 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    PDPM requires an acceptable ICD-10 diagnosis code to be entered into MDS item field I0020B top represent the primary reason for the SNF stay.  ICD-10 codes not on the list of allowable codes, often referred to as “return-to-provider” codes will not classify into a PDPM clinical category.  CMS publishes a list ICD-10 codes that are approved for use in MDS Item field I0020B for PDPM classification purposes.  The file includes the following information: 1) Alphanumeric ICD-10 code; 2) Code Description; 3) Default Clinical Category; 4) Whether a MDS Section J Surgery Code Indicating That the Resident Had a Prior Major Surgical Procedure is Needed to Refine the Default Clinical Category; 5) PT and OT Component Clinical Category; and 6) SLP Component Clinical Category.  If a code is not listed in this file, it cannot be used in the MDS I0020B item field.  CMS provides this file in a Microsoft Access Format.  AHCA converted the CMS file into Microsoft Excel for providers that are not familiar with Microsoft Access. 

  • SNF PDPM Basics and Impacts in Care Delivery Partners Toolkit

    Contains 1 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    Because CMS has provided limited to no guidance to SNF care delivery partners impacted by the PDPM implementation on October 1, AHCA members have asked if we could create a webinar about PDPM that providers could share with referring hospitals, physicians, Medicare Advantage plans, Accountable Care Organizations, and Bundled Payment program partners.

    To help facilitate AHCA member discussions with care delivery partners about PDPM, we have prepared a one page document that includes links to the following five pre-recorded webinars and slides that are intended to be viewed by SNF care delivery partner to get a better understanding about what PDPM is, and how PDPM may impact their relationships with SNF providers. No password is necessary to access this content. 

    Each webinar recording (approximately 30 minutes each) contains the following content:

    • An overview of the PDPM payment model
    • Key clinical characteristics impacting PDPM
    • Specific PDPM considerations for SNF partners, and (each recording has partner-specific content)
    • Where SNF care delivery partners can go for more information

    Each recording is identical except for the third item that includes content that is customized to the specific type of SNF care delivery partner.  AHCA Members are encouraged to open a dialogue with their care delivery partners as part of their PDPM transition preparations.  We also encourage SNFs to consider sharing the respective links below with these partners as a supplement to your discussions. 

    Please submit questions related to these webinar resources to pdpm@ahca.org.

  • PDPM Basics for AHCA Provider and Associate Business Members webinar

    Contains 1 Component(s)

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    Members have asked AHCA to update the PDPM Basics webinar to include updates announced by CMS since January as well as highlight the importance of collaborating with care delivery partners including hospitals and physicians as well as with vendors including therapy contractors and pharmacies.  This 40 minute webinar is designed for introductory in-services and individual learning for individuals that have limited knowledge about PDPM.  The webinar discusses the basic design of the PDPM payment model as well as discusses changes in operations and clinical processes that will be occurring with the introduction of the PDPM payment model.  After viewing the webinar the participant will understand:      

    1. Key features of the new Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) Patient-Driven Payment Model (PDPM) case-mix payment model that the Centers for Medicare and Medicaid Services (CMS) will be implementing on October 1, 2019.
    2. How and why PDPM will require SNFs to transform their operational and clinical processes in order to be successful in achieving optimal resident care outcomes in a financially viable manner.
    3. How and why it is critical for SNFs to consider “Win-Win” approaches when approaching care delivery partners to improve communications and service delivery.
  • AHCA PDPM Therapy Staffing/Contracting Considerations Under PDPM Toolkit

    Contains 9 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    COPYRIGHT STATEMENT

    AHCA PDPM Academy publications, tools, workshops, webinars or other resources have been developed and paid for as a part of your AHCA provider membership  and/or PDPM Academy registration.  These resources are for your facility use only and copyrighted resources should not be distributed outside your organization without AHCA permission.  Please respect the copyright.

    Questions about the contents of AHCA PDPM Academy publications, tools, workshops, webinars or other resources may be directed to pdpm@ahca.org.

    For additional information about AHCA visit www.ahcancal.org.

    Copyright 2019 American Health Care Association, 1201 L Street NW Washington, DC  20005. All Rights Reserved.  Permission to use, copy and/or distribute any documentation and/or related images from AHCA PDPM Academy publications, tools, workshops, webinars or other resources shall be expressly obtained from AHCA

  • PDPM Frequently Asked Questions (FAQs)

    Contains 2 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    Click here to access CMS PDPM FAQs. Updates to the resources will be included as needed.

  • TeamSTEPPS 2.0 for Long-Term Care

    Contains 2 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The Agency for Healthcare Research and Quality (AHRQ) developed TeamSTEPPS 2.0. TeamSTEPPS was developed by AHRQ and the Department of Defense (DoD) as a teamwork system that offers a powerful solution to improving collaboration and communication within your institution. Teamwork has been found to be one of the key initiatives within patient safety that can transform the culture within health care. Patient safety experts agree that communication and other teamwork skills are essential for the provision of quality health care and for the prevention and mitigation of medical errors and patient injury and harm. 

    Provided as a flexible training kit, TeamSTEPPS 2.0 is an evidence-based program aimed at optimizing performance among teams of health care professionals, enabling them to respond quickly and effectively to whatever situations arise. This curriculum incorporates more than 30 years of scientific research that has been conducted on teams and team performance.

    This curriculum is a customized version of TeamSTEPPS 2.0 for use in long-term care settings. The TeamSTEPPS 2.0 for Long-Term Care Instructor Manual is designed to help you develop and deploy a customized plan to train your staff in teamwork skills and lead a medical teamwork improvement initiative in your nursing home from initial concept development through sustainment of positive changes. Contained within the materials are comprehensive presentations and instructional guides, including short case studies and videos illustrating teamwork opportunities and successes.

    The AHRQ TeamSTEPPS is a resource available in the public domain that aligns with and can help providers address several areas of the AHCA PDPM Academy Core Competencies

    The web address to access the TeamSTEPPS 2.0 for Long-Term Care curriculum is: https://www.ahrq.gov/teamstepps/longtermcare/index.html

     

  • CMS PDPM Reference Resources and Crosswalk Tables

    Contains 4 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    Click here to access the following resources and crosswalk tables provided by CMS:

    • CMS Provider-Specific RUG-IV to PDPM Revenue Impact Estimate File
    • CMS PDPM Resident Classification Step-by-Step Walkthrough Document
    • CMS PDPM ICD-10-CM PT/OT/SLP Component Clinical Category Mapping Crosswalk
    • CMS PDPM NTA Component Comorbidity Mapping Crosswalk

  • AHCA PDPM MDS Accuracy Toolkit – Resident Classification

    Contains 3 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The AHCA PDPM MDS Accuracy Toolkit – Resident Classification was designed to furnish tools to providers during preparations leading up to PDPM implementation to better understand the specific MDS items and claim information that determine how the five case-mix adjusted component classifications and per-diem payment rates are determined.  All members can access template PDPM MDS worksheets (including ~40 new items providers will report on October 1, 2019), template PDPM workbooks that enable manual determination of resident case mix classifications and rates, and a PT, OT, and NTA variable per-diem and RUG-IV rate tables.  These tools will permit members to compare the relative impacts of PDPM rates versus RUG-IV rates on current residents, which can help in planning changes in operational and clinical processes prior to PDPM implementation.  PDPM Academy Registrants can also access example resident MDS and resident classification workbooks to facilitate team training efforts.  Additional tools and resources to be added as developed.

  • AHCA PDPM Hospital Discharge Toolkit

    Contains 3 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The AHCA PDPM Hospital Discharge Toolkit was designed to facilitate the collection of clinical information from the referring hospital prior to admission to better assure that information related to a residents SNF care needs upon admission, and appropriate PDPM case-mix group classification, is obtained and documented prior the end of the residents SNF PPS 5-day assessment reference date.  The tools can also be used to help facilitate discussions with referring hospitals regarding how to better coordinate the transfer of health information relevant to PDPM resident classification.  All members can access a SNF pre-admission checklist tool and a reference document identifying all MDS item fields that apply to PDPM case-mix adjusted components.  PDPM Academy Registrants can also access an additional “High-Impact” MDS items reference document.  Additional tools and resources to be added as developed.

  • AHCA PDPM Compliance Guide and Best Practice Model Policies Toolkit

    Contains 1 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The AHCA PDPM Compliance Guide and Best Practice Model Policies Toolkit will include several tools and resources to help providers prepare for successful transition to PDPM.  These include ideas and tools on how to address compliance risk areas identified by the Centers for Medicare and Medicaid Services, The Office of Inspector General, and other government agencies.  All members can access the Compliance Policies and Procedures Checklist Tool.  Best practice policies be added for PDPM Academy Registrants as developed.

  • PDPM Core Competencies Toolkit

    Contains 3 Component(s)

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    The PDPM Core Competencies Toolkit was designed to facilitate discussions among Skilled Nursing Facility (SNF) management and front-line clinical and support personnel as you begin your journey in preparing your administrative and clinical operations to be successful in the change of the per-diem SNF prospective payment system (PPS) from the current Resource Utilization Groups, Version 4 (RUG-IV) case-mix model to the Patient-Driven Payment Model (PDPM) starting on October 1, 2019.  These files should be shared and reviewed by SNF administrative and clinical staff as part of training efforts.  Additionally, these tools should be used in identifying your baseline readiness status, and conducting gap-analysis as part of planning to implement those changes necessary to be successful under PDPM.   The first file is a 31 slide packet with a cover slide title of “Patient Driven Payment Model (PDPM) Readiness Planning: Background and Methodology”.  This file provides an overview of PDPM and what it means for SNFs, and why and how AHCA identified the need for and developed a PDPM training approach revolving around four Core Competencies for success.  The second file is a more comprehensive 49 slide packet with a cover slide title of “Patient Driven Payment Model (PDPM) Readiness Planning: Core Competencies for Success”.   This file provides more detailed information related to each of the four identified Core Competencies.  The third file is an eight page PDPM readiness considerations checklist document with the title “Core Competencies for Success under PDPM”.  This file identifies very specific questions your administrative and clinical staff should ask and answer within each of the four Core Competencies so that you can identify items where your organization may need to focus efforts prior to October 1, 2019, so that you are best prepared to be successful under PDPM.  

    Learning Objectives:

    1. The document users will understand the importance of beginning the process of a formal Readiness Review in preparation for the October 1, 2019 implementation of the per-diem SNF PPS PDPM payment model to replace RUG-IV.
    2. The document users will be able to describe the four PDPM Core Components for success identified by AHCA through interviews with a diverse array of large and small and for-profit and non-profit member organizations.
    3. The document users will be able to successfully use the “Core Competencies for Success under PDPM” checklists within their organizations to perform gap-analyses to identify operational and clinical areas that will need to be addressed to be successful under PDPM.    

    Who is this for?

    These materials were designed to be useful to all AHCA members that furnish Medicare Part A services under the SNF PPS per-diem payment model, regardless of size or business structure. They were designed to facilitate discussions between administrative and front-line clinical personnel as part of staff education as well as strategic baseline readiness assessment and strategic planning meetings. 

  • Comprehensive Person-Centered Care Planning §483.21

    Contains 1 Component(s)

    Purpose & Intent: To develop a baseline care plan within 48 hours of admission to direct the care team while a comprehensive care plan is developed that incorporates the resident's goals, preferences, and services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being.

Resources for AHCA Associate Business Members

  • PDPM Basics for AHCA Provider and Associate Business Members webinar- for ABMs

    Contains 1 Component(s)

    AHCA Associate Business Members have asked AHCA to offer a PDPM Basics webinar to provide an overview of the new SNF PPS Patient-Driven Payment Model (PDPM) as well as highlight the importance of SNFs collaborating with care delivery partners including hospitals and physicians as well as with vendors including therapy contractors and pharmacies. This 40 minute webinar is designed for individuals that have limited knowledge about PDPM. The webinar discusses the basic design of the PDPM payment model as well as discusses changes in operations and clinical processes that will be occurring with the introduction of the PDPM payment model.

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    AHCA Associate Business Members have asked AHCA to offer a PDPM Basics webinar to provide an overview of the new SNF PPS Patient-Driven Payment Model (PDPM) as well as highlight the importance of SNFs collaborating with care delivery partners including hospitals and physicians as well as with vendors including therapy contractors and pharmacies.  This 40 minute webinar is designed for individuals that have limited knowledge about PDPM.  The webinar discusses the basic design of the PDPM payment model as well as discusses changes in operations and clinical processes that will be occurring with the introduction of the PDPM payment model.  After viewing the webinar the participant will understand:     

    1. Key features of the new Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) Patient-Driven Payment Model (PDPM) case-mix payment model that the Centers for Medicare and Medicaid Services (CMS) will be implementing on October 1, 2019.
    2. How and why PDPM will require SNFs to transform their operational and clinical processes in order to be successful in achieving optimal resident care outcomes in a financially viable manner.
    3. How and why it is critical for SNFs to consider “Win-Win” approaches when approaching care delivery partners to improve communications and service delivery.

Coming Soon- More General PDPM Resources Available to All Provider Members

  • AHCA PDPM Model Job Descriptions Tool
  • AHCA PDPM Therapy Staffing/Contracting Considerations Toolkit 
  • AHCA PDPM Toolkit Updates (as needed) based on CMS FY 2020 SNF PPS PDPM Proposed Rule 
  • AHCA PDPM Toolkit Updates (as needed) based on CMS FY 2020 SNF PPS PDPM Final Rule (estimate Sep 2019 release)    

COPYRIGHT STATEMENT

AHCA PDPM Academy publications, tools, workshops, webinars or other resources have been developed and paid for as a part of your AHCA provider membership  and/or PDPM Academy registration.  These resources are for your facility use only and copyrighted resources should not be distributed outside your organization without AHCA permission.  Please respect the copyright. 

Questions about the contents of AHCA PDPM Academy publications, tools, workshops, webinars or other resources may be directed to pdpm@ahca.org.

For additional information about AHCA visit www.ahcancal.org.

Copyright 2019 American Health Care Association, 1201 L Street NW Washington, DC  20005. All Rights Reserved.  Permission to use, copy and/or distribute any documentation and/or related images from AHCA PDPM Academy publications, tools, workshops, webinars or other resources shall be expressly obtained from AHCA

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