The PDPM Ballpark Projections Questionnaire created by HCPro’s postacute regulatory specialist Stefanie Corbett, DHA, allows SNFs to project what the minimum rate component for reimbursement will be under PDPM. The questionnaire lists important items to be considered during admission, such as “how many days does the resident have left in his/her benefit period?” Identifying whether a resident has less than 100 benefit days upon admission will be an important component to identify when projecting revenue under PDPM because reimbursement rates are only going to decrease over the 100-day benefit period. For example, if a resident comes in at day 27 of his or her benefit period, the physical therapy, occupational therapy, and non-ancillary therapy rate has already started to decline.
SNFs also want to consider whether the resident is going to stay long-term, and how close he or she is to exhausting the 100-day benefit period. If SNFs are going to be profitable during that benefit period, it’s important to determine whether the facility can afford to pay for the expenses that will be incurred if that resident has to convert to another payer source, such as Medicaid.
Download the PDPM Ballpark Projections Questionnaire for a step-by-step checklist of important questions to ask upon admission when the new payment model begins October 1, 2019.