AAPACN is dedicated to supporting post-acute care nurses provide quality care.

PDPM Game Plan

PDPM Game Plan

Members: $61 |  Non-members: $122

PDPM Game Plan: A Compilation of Information, Tools, Resources, and Audits

The Patient-Driven Payment Model (PDPM) is used for Medicare reimbursement and has been adapted for some state Medicaid reimbursement models. This complex payment model requires a comprehensive assessment of the resident’s conditions, comorbidities, functional status, cognition, swallowing problems, and more. To help nurse assessment coordinators and facility staff improve their confidence in managing PDPM, AAPACN’s PDPM Game Plan delivers 80+ pages of interactive, downloadable tools, checklists, and resources all in one convenient PDF resource. See the Table of Contents.

PDPM Game Plan provide a NAC with tools and information

PDPM Training Tools Included in the Game Plan  

  • PDPM Calculation Worksheet to guide you in the determination of HIPPS codes 
  • Interrupted Stay Policy Tracking tool to help you and your team track interrupted stays and ensure correct billing for days not covered by Medicare  
  • PDPM Case-Mix Group Conversion to HIPPS Characters Tool to help you gather the HIPPS characters under each payment group for the HIPPS code you’ll need to identify a SNF resident’s payment classification 
  • Tools and considerations for when to complete an interim payment assessment (IPA)
  • Top five mistakes made when assigning ICD-10-CM codes in the SNF so you can avoid them 
  • PDPM Admission Checklist Tool to help you collect information needed at the time of admission 
  • Tools to help you audit billing and reimbursement 
  • Detailed review of the risk of payment penalty for late or missed assessments under PDPM

*Updated November 2023.