SNF Medical Directors and Clinicians in PDPM Have Vital Role

On October 1, 2019, the Patient Driven Payment Model (PDPM) will change how skilled nursing facilities (SNFs) are reimbursed for post-acute care provided to Medicare A recipients. The major change from the existing Resource Utilization Group (RUG IV) system is the shift in focus from therapy to patients’ clinical characteristics and services rendered. This is a natural transition because the role of SNFs has evolved over time, from rehabilitation to subacute care for medically complex patients. PDPM separates therapy and nursing as distinct payment drivers and further distinguishes physical therapy, occupational therapy, and speech-language pathology services by creating their own respective categories.