SNF PDPM Assessments and Grouper Update

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

CMS issued the following statements late afternoon, Friday, October 4, 2019:

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CMS is aware of issues with the latest PDPM DLL Package (V1.0002 FINAL). We are targeting to release an updated version on Monday, October 7, 2019, which corrects the identified grouper discrepancies.

SNF providers should continue to follow the Resident Assessment Instrument (RAI) requirements which include, but are not limited to, establishing assessment reference dates for OBRA or PPS assessments that are required/scheduled, including the PDPM Transitional Interim Payment Assessments, assessing residents, and coding the applicable MDS assessments.

As per the RAI requirements, assessments should be completed within 14 days and recorded in Z0500. Late submission payment penalties do not apply under the SNF PPS.  We will work with providers to ensure that timely payments are made. We will continue to share updates as they become available. In the meantime, providers should not hesitate to contact us.

For questions regarding PDPM please send inquiries to pdpm@cms.hhs.gov and for information technology questions please send emails to MDSTechIssues@cms.hhs.gov.  Please contact your state Medicaid agency for questions related to the Other State Assessment (OSA) and Medicaid payment.

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