What SNFs need to know about CMS’s Patient Driven Payment Model

What SNFs need to know about CMS’s Patient Driven Payment Model

Last July, The Centers for Medicare and Medicaid (CMS) announced a new case-mix classification model, the Patient Driven Payment Model (PDPM). PDPM will take effect beginning October 1, which will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay.

How will PDPM work?

The PDPM system will effectively overhaul the Resource Utilization Group (RUG-IV) system. While the RUG-IV compensation was driven by volume, PDPM will be based on patients’ care needs. PDPM will utilize six payment components to determine payment:

  • Physical Therapy
  • Occupational Therapy
  • Speech-Language Pathology
  • Non-therapy Ancillary
  • Nursing
  • Non-Case Mix

Patients will be assigned to a Case-Mix Group (CMGs) for each component. For more information on the calculation of reimbursement, you can visit CMS’s PDPM FAQ page.

What will be different?

Payment will now be determined by clinically relevant patient characteristics rather than volume-based measurements, like therapy hours. So rather than relying hevily on therapists to drive reimbursements and, in turn, the patient’s overall care plan, the responsibility will be more in the hands of the nurses, who, as you know, are the front lines of patient care.

This will make payments more specific to the patient – which will more accurately reimburse you for the care you provide to each patient.

What does this mean for my facility?

Your facility will need to do some heavy lifting so that you can benefit from this new system, as the accurate capturing of information will be crucial to your SNF’s success.

Under the RUG-IV, only 20 fields were expected to be filled, but now Minimum Data Set (MDS) coordinators will be asked to fill 161 fields using precise ICD-10 codes for patient diagnoses.

Even if you have already participated in an initial 5-day MDS assessment, patient characteristics can change over time. Experts suggest that an Interim Payment Assessment (IPA), which is performed after an initial assessment, can be the best way to capture a change in patient characteristics when a patient’s condition has changed so that you can maximize your reimbursement potential.

Some instances where an IPA may be helpful:

  •  Non-Therapy Ancillary (NTA)
  • Physical Therapy
  • Occupational Therapy
  • Speech Therapy
  • Nursing

Here is a helpful article that summarizes the strategies for implementing an IPA.

PDPM is swiftly approaching. What to remember as you prepare for October 1.

Coding will be a key skill moving forward. CMS has not specified a required coding program, but facilities should consider taking steps to ensure providers have some ICD-10 code expertise, and perhaps even offer incentive to providers to earn some professional coding credentials. Experts suggest a Certified Inpatient Coder credential through the American Academy of Professional Coders (AAPC.)

Nurses will now quarterback reimbursements. Therapy hours are no longer the key driver of reimbursements, so therapists, in turn, will no longer dictate a resident’s overall care plan. Your nurses may also take on the additional reimbursement paperwork – as an accurate record of resident diagnoses will be vital to accurate Medicare compensation. Make sure you are properly supporting your nursing staff through safe staffing practices.

We are here for you. While CMS’s ultimate goal with this transition from RUG-IV to PDPM is meant to improve patient care, increase the accuracy of reimbursements, and remove some of the administrative burdens on SNF providers, we know that implementing radical changes to your facility’s processes will significantly impact your day-to-day. Remember that you have a resource in us – if you’d like to have a conversation about how we can best suit your needs in light of these changes, let us know.

 

Does your facility need help with your staffing needs? Request a demo with a member of our sales team for a walk-through of our intelligent solution.

IntelyCare was created by nurses, for nurses. We’re here to take care of those who take care of everyone else; our staffing solution gives nurses the opportunity for a better, more flexible schedule to help reduce nurse stress. Apply today to join the future of nursing.

Striving Toward Nurse Safety

Striving Toward Nurse Safety

How evolving the culture and fixing the superhuman mindset can improve the lives of nurses and their patients.

Nursing is consistently voted the nation’s most trusted profession – and yet, it can be one of the nation’s most ‘at-risk’ professions as well. According to the U.S. Bureau of Labor Statistics, nursing has the highest rate of nonfatal occupational injuries.

Dr. Danielle Ofri, the author of a recent op-ed in the New York Times, blames the culture of self-sacrifice encouraged by the healthcare industry. She writes that despite the detrimental experiences thrown a healthcare provider’s way, “an overwhelming majority do the right thing for their patients, even at a high personal cost.” Ofri explains that the code of ethics healthcare workers keep drives them to out-stretch themselves, rather than to complain, or better yet, ask for help.

Chris Caulfield, our co-founder, and Chief Nursing Officer, weighed in on his time working bedside. “Unsafe environments tend to be the norm – they happen on every shift. It should be unacceptable – but that’s the culture nurses come to accept.”

In honor of National Safety Month, we’d like to shine a light on the dangers nursing professionals grapple with every shift – in the hopes that at most, the culture of self-sacrifice changes, and at the very least, nurses can be more mindful of their health as their care for the health of others.

Injury on the Job

Nurses who assist in lifting or re-positioning patients often endure repetitive back pain injuries. Caulfield noted that even when facilities have no-lift policies in place, nurses will be asked to forego policy in the interest of time. “As a male nurse, especially, I was asked to lift patients and heavy objects, even when it was unsafe to do so.”

Needle sticks also are a regular threat to nurses – according to the CDC, an average of 385,000 sharps-related injuries occurs among healthcare workers. This puts nurses at-risk of several diseases, namely Hepatitis B, C, and HIV.

Accidents do happen, but Chris posits that some of these injuries can be avoided. “In the past, I worked at facilities that had no-lift policies, and others that used safer, retractable needles. The only barrier for each of those is price. The price of time saved by rushing and lifting a patient, and the higher price of better, more-advanced needles.”

In cases where the administration doesn’t spring for safer policies and safer equipment, nurses pay the price.

Violence against nurses

While healthcare workers make up only 9% of the workforce, studies indicate that there are nearly as many violent injuries in the healthcare industry as there are in all other industries combined. And the number of violent injuries will only continue to skyrocket as time has gone on; over the past decade, there has been a 110% spike in the rate of violent incidents reported against healthcare workers.

Incidents are incredibly common for nurses who care for patients with dementia. 76% of nurses surveyed in one study noted that they had experienced physical or verbal abuse in the last 12 months. But it’s not something always reported, dealt with, or taken seriously.

Some measures are being taken by individual facilities; hospitals will host self-defense classes or training exercises that walk nurses through specific violent scenarios, which is a start, but until there are nationwide safety standards, violence against nurses will be an inevitable reality.

Burnout

Ask any nurse, and they will tell you that stress is par for the course, caused by a stressful work environment in general, and exacerbated by inadequate staffing levels.

In a 2016 study, 92% of nurses surveyed reported moderate to very high levels of stress. And that stress carries over into the rest of their lives. The same study also found that 78% of nurses reported sleeping less than 8 hours a night, 69% did not exercise regularly, and 22% of nurses’ relationship with alcohol would be characterized as binge drinking.

This chronic stress and lack of self-care all contribute to nurse burnout – an occupational phenomenon the World Health Organization characterizes as “feelings of energy depletion,” “increased mental distance from one’s job,” and “reduced professional efficacy.”

When nurses sacrifice their own well-being, it not only impacts their own health but their ability to provide the best care to the very patients they are aiming to protect. It can also be the catalyst for nurses leaving the field – which will only exacerbate the severe nurse staffing shortage.

So – what’s the solution to an environment where injury, abuse, and burnout are the norm?

For our part, IntelyCare is trying to improve the nursing experience. We allow nurses to choose their own schedule and take control of their lives. We offer a care team ready to advocate on their behalf, and we are a company co-founded by a nurse who understands what it’s like to be on the front lines of patient care. While we hope that our ability to fill the gaps in care will reduce stress on facility floors, we know that our efforts won’t even remotely come close to solving a pervasive, industry-wide issue.

Associate professor Linsey Steege, who studies the health and safety of nursing professionals, sums up the “supernurse” phenomenon perfectly: “That need and culture to be super creates a stigma around asking for help. It creates a stigma around showing signs of weakness and it creates, in some ways, some internal cultures within nursing that you’re not a real nurse if you haven’t worked 12 hours without peeing or taking a break, or if you haven’t worked five shifts in a row.”

Something has got to give – namely eradicating the mindset of self-sacrifice. This mindset that makes nurses so admirable is also the one that is their downfall. If nurses can start recognizing dangerous situations and abuse and advocate for themselves, that’s a great place to start. But ultimately, we also need a shift in the nursing culture.

As healthcare continues to evolve as a result of technological innovation and government policy, let’s hope that these shifts are made not only in the interest of saving money, simplifying and expediting administrative processes, or winning awards, but also a shift in culture in the interest of the people on the front lines taking care of us and the ones we love.

 

IntelyCare was created by nurses, for nurses. We’re here to take care of those who take care of everyone else; our staffing solution gives nurses the opportunity for a better, more flexible schedule to help reduce nurse stress. At IntelyCare, we’re driven to offer nurses and CNAs healthcare’s best working experience. Apply today.

Why Skilled Nursing Facilities Love IntelyCare’s Book Me Feature

Why Skilled Nursing Facilities Love IntelyCare’s Book Me Feature

Finding the right nursing professional for your skilled nursing facility’s shifts can be tough. So, when you connect with a nursing professional who shows up to work your per-diem shift and they are the perfect fit, it’s only natural to want to bring them back next time you need to fill a shift.

Well, lucky for you, IntelyCare’s got your back.

With our super simple Book Me feature, you can hand pick those nursing professionals you wish to continue staffing from our network of IntelyPros!

What is Book Me?

Our Book Me feature gives you the flexibility to choose who will staff your needs making it easier than ever to control the credentials and quality of care you want in your per-diem workers.

It’s so important to have a positive and happy work environment, especially given the stressful nature of nursing. So, if you and your staff love working with one of our IntelyPros and you have an ongoing staffing need, Book Me allows you to book them for multiple shifts at a time. Who knows – you may like the IntelyPro so much you might decide to hire them!

Why Schedulers and Directors of Nursing use Book Me:

  • Consistency: When you book a preferred IntelyPro through our Book Me feature, you provide consistency to your patients and your staff. Book Me also provides the opportunity to build relationships between your staff and patients, which we know is integral to quality care; a 2017 study by the Council of Accountable Physician Practices found that patients believe that positive patient-provider relationships is the key element of quality healthcare.
  • Confidence: Feel confident that you have the right person on the floor. Hand-pick your favorite IntelyPros who meet the exact credentials and experience your facility needs.
  • Comfort: Rest Easy. Book Me lets you book your IntelyPros in advance, so you can ditch the worrying about whether your shift will get filled or not.

Whether it’s in response to the nurse staffing shortage, to cover for your staff on vacation, or to fill the gaps in between hires, Book Me is the perfect tool to augment your nursing staff.

Want to learn more about the Book Me feature? Download our infographic here.

Does your facility need help with your staffing needs? Request a demo with a member of our sales team for a walk-through of our intelligent solution.

IntelyCare Celebrates National Skilled Nursing Care Week!

IntelyCare Celebrates National Skilled Nursing Care Week!

Happy National Skilled Nursing Care Week!

National Skilled Nursing Care Week is sponsored by the American Health Care Association (AHCA) to recognize the challenging, important work that every team member of a skilled nursing facility does day in and day out.

This year’s National Skilled Nursing Care Week (NSNCW) theme is “Live Soulfully” – this week, we celebrate how skilled nursing facilities like yours help our most vulnerable populations continue to live happy, healthy lives. Your residents’ lives don’t simply move on to the next chapter once they come to your facility – they flourish. You ensure that they continue to live soulfully through activities like gardening, cooking and eating good food, singing to music, encouraging them to express themselves through art, reading and discussing good books, but among all that, you make sure they feel cared for, physically, mentally, and emotionally.

All week long, many of you have told us about the awesome ways you have chosen to celebrate your residents and staff – and we’re so happy to hear you have been embracing the theme of living well. As National Skilled Nursing Week comes to a close, we want to make sure we share a heartfelt thank you to you for all you do.

Thank you to the schedulers for juggling schedules to keep your shifts safely staffed.

Thank you to administrators for balancing everything from patient care to food vendor decisions.

Thank you to directors of nursing for ensuring safe, diligent, above and beyond patient care.

Thank you to the secretaries who greet every visitor with a smile.

Thank you to the accountants for balancing the books.

Thank you to the maintenance employees, custodians, and groundskeepers that keep the lights working, halls clean, and lawns trimmed.

Thank you to the activity coordinators for sparking joy and keeping spirits high.

Thank you to physical and occupational therapists that help residents gain back their independence.

Thank you to food service workers that keeps plates and stomachs full, and the dieticians that keep residents eating well.

And thank you to volunteers for giving up your free hours to make a difference.

No matter your role, your impact is a substantial one.

Thank you for making sure that our senior and disabled communities continue to live enjoyable and meaningful lives. We know the job you do is one of the hardest out there and can sometimes feel like a thankless endeavor. We want you to know that your dedication to your residents and your staff does not go unnoticed; we hear it in your voices on every call, and we see it first hand on every visit. While you take time this week to acknowledge your staff and your residents, make sure to take some time to celebrate yourself, too.

Thanks for all you do!

 

Does your facility need help with your staffing needs? Request a demo with a member of our sales team for a walk-through of our intelligent solution.

Meet IntelyCare’s Nurses

IntelyCare was built by nurses, for nurses. We know, we say that a lot, but we think it’s an important distinction.

We care deeply about the happiness, safety, and overall well-being of our nursing professionals (IntelyPros), and the quality and level of training each of them. To achieve that, we believe it’s essential to have nurses on our team that both understand what it’s like to work in a skilled nursing facility, and more importantly, understand how hard it is to be a nurse. So, we wanted to introduce you to two of the most integral members of our team, Chris and Janiene, who check both of those boxes.

Chris, our Co-Founder and Chief Nursing Officer, brings a diverse nursing background and an extensive tenure educating his fellow nurses. He and our co-founder, Ike Nnah, were inspired to create IntelyCare after they witnessed unsafe, inefficient staffing practices that put both nurses and patients at risk.  From design and development of the app to the continued education and training of nurses, Chris has a hand in almost every facet of the business. He also works to build personal relationships and meaningful interactions with our IntelyPros.

Our Quality Assurance Education Nurse Manager, Janiene, is also a Registered Nurse. She works both with our partner facilities and with our nurses to uphold the quality of care and clinical competence of our team. As a nurse with agency experience, Janiene plays the vital role of both advocate and educator for our nursing professionals.

Our internal nursing team is vital to what we do – they are committed to establishing a culture of IntelyPro excellence, which includes making sure our IntelyPros are fully prepared to work when they step into their first facility, having their back if there’s ever an issue, and making sure they have all the tools necessary to deliver the best possible care to their patients.

We could not think of two better people to work with our nurses on a daily basis. So, we’d like you to get to know them as well as we do. Below are excerpts from our two spotlight blogs on Janiene and Chris.

An excerpt from Janiene’s spotlight:

“I’ve always loved being there for people, but what I really fell in love with was patient care. I saw how my presence and personal touch affected my patients. I found that I had a knack for bringing peace to my patients and I could easily put them at ease when they became anxious about a procedure or diagnosis. I made them feel comfortable and cared for and I advocated for their needs. I also had a way with ‘difficult’ patients’. I soon realized that it was my ‘way’ with my patients that made them feel cared for.

Nursing is so much more than ‘a good paying job’. You need to have compassion, empathy, and be willing to go the extra mile for your patient.

Those are the qualities of a truly good, dedicated nurse.”

Read the rest of Janiene’s spotlight here. 

An excerpt from Chris’s spotlight:

“I’m consistently amazed and proud of our IntelyCare Nurses & Nursing Assistants. Nursing is not an easy job by any stretch of the imagination, but our nursing professionals continue to complete shifts while providing amazing care to patients at our facilities. I really do love getting to come into work every day knowing that we are helping Schedulers safely staff their facilities, Directors of Nursing get the coverage they need on each floor, and Administrators meet their required staffing ratios.

As if that isn’t cool enough, we are helping nurses take charge of their lives. Now, nurses have the flexibility to be in complete control of their schedules. Ultimately, we are also helping patients receive better, more compassionate, quality care because our nurses don’t suffer from as much burn out.”

Read the rest of Chris’s spotlight here.

We have been celebrating nurses all week long! You can read our thank you to nurses here.

IntelyCare was created by nurses, for nurses. We’re here to take care of those who take care of everyone else; our staffing solution gives nurses the opportunity for a better, more flexible schedule to help reduce nurse stress. At IntelyCare, we’re driven to offer nurses and CNAs healthcare’s best working experience. Apply today.