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PDPM Switch Could be a Rough Road for Some SNFs

By Caralyn Davis, Staff Writer - December 20, 2018

On Oct. 1, 2019, the new Patient-Driven Payment Model (PDPM) will replace RUG-IV as the case-mix classification system for Part A beneficiaries under the Skilled Nursing Facility Prospective Payment System (SNF PPS). “There is no transition period between RUG-IV and PDPM, but rather a hard switch from one system to the other,” said officials with the Centers for Medicare & Medicaid Services (CMS) during the Dec. 11 SNF PPS: PDPM National Provider Call. “This is due to the immense potential for significant administrative burden, and the confusion that would arise from trying to run the RUG-IV and PDPM systems concurrently.” Note: Access the call slides, as well as a transcript and recording when available, here.


The two most critical points that nurse assessment coordinators (NACs) need to know about this hard switch are: