Subscribe to Judy's Mailing List

Judy Wilhide Brandt is offering a free  webinar to discuss the volume of questions she has been responding to since new guidance was issued on 6/26/20 on required documentation for waiver cases and new billing guidance.  This recorded webinar is free.  It is about 23 minutes long.

Register and watch here

6/29/20 new guidance from CMS on  1135 Waiver and COVID-19 Issues


PDPM Explained for SNF MDS Coordinators or others who manage a Part A Census in a SNF

Recorded Live 05/06/2020

1hr 40 min


Target audience:  SNF interdisciplinary team members involved in managing a Medicare A census; corporate consultants and business office team members who’d like to understand the PDPM payment system

Key Results:

  • •Become familiar with MDS items used to set component CMI rates for PDPM

  • •Become familiar with the current CMS ICD-10CM clinical category mapping tool 

  • •Understand the role of ICD 10 coding in PDPM

  • •Understand the PT/OT and Nursing function score and implications for payment

  • •Learn how MDS items are used in case mix adjusted components of the PDPM per diem rate

  • •Understand the variable per diem adjustment schedule

  • •Understand the scheduling rules for a PPS 5 day and Interim Payment Assessment

  • •Understand the ‘interrupted stay’ policy and how it impacts payment for SNF PPS

  • •Discuss what PDPM components qualify for the presumption of coverage

New Beginners:  Eight Part Recorded Webinar Series:

Pandemic Pricing:  Normally $125 now $60.00 per webinar, for 7 with 8th webinar free. 

New Beginners:  Eight Part Recorded Webinar Series:

Pandemic Pricing:  Normally $125 now $60.00 per webinar, for 7 with 8th webinar free. 

Part 1:  Introduction to the RAI Process, Section A coding, OBRA and PPS Scheduling

Target Audience:  MDS Coordinators

Length:  1:24


  • Introduce the RAI process 

  • Understand the importance of using the RAI Manual for MDS scheduling and coding 

  • Become familiar with the contents of the RAI manual 

  • Know resources available at QTSO.CMS.GOV 

  • Discuss regulatory requirements for the MDS 

  • Identify key items and common coding issues in Section A. Identification Information

  • Delineate the Types of Assessments including: Federal OBRA Assessments, PPS Assessments, Other Medicare Required Assessments and Entry/Discharge reporting. 

  • Explain required time frames for assessment completion and submission.

Part 2: Sections C,D,E & Q

Target Audience: MDS Coordinators and Social Workers

Length:  1:17


  • Discuss coding accuracy for:

    • Section C: Cognitive Patterns

    • Section D: Mood

    • Section E: Behaviors

    • Section Q: Participation in Assessment and Goal Setting

  • Understand the importance of using the RAI Manual as a reference for coding these sections and conducting the interviews 

  • Delineate components of interview for Mental Status (BIMS) and Signs / Symptoms of Delirium 

  • Identify critical components of Resident Mood Interview (PHQ-9). 

  • Explain how to appropriately code Behaviors (Section E). 

  • Explain regulatory reason Section Q is on the MDS 

  • Discuss PDPM implications of these sections 

  • Discuss QM implications of these sections

Part 3: : Sections B, G, & GG: 

Target Audience: MDS Coordinators

Length:  1:18


  • Describe correct coding for Section B Hearing Speech and Vision

  • Understand coding rules for Section G Functional Status:

  • Activities of daily living (ADLs), 

    • Altered gait

    • Balance,

    • Decreased range of motion.

  • Understand coding rules and unique lookback periods for Section GG Functional Abilities and Goals:  

    • Prior functioning and device use

    • Functional Abilities and Goals

  • Discuss PDPM and QM implications of these sections

Part 4: Section H, I & J

Target Audience: MDS Coordinators

Length:  1:25


  • Discuss coding accuracy for

    • •Discuss coding instructions for 

    • •Section H:  Bowel and Bladder

      • Appliances

      • Toileting programs

      • Bladder/Bowel Incontinence

      • Constipation

    • •Section I:  Active Diagnoses

      • 0020 for PPS Assessments

      • I0100 – I8000 coding instructions

    • •Section J:  Health Conditions

      • Pain and Pain Interview

      • Other health conditions

      • Tobacco use

      • Prognosis

      • Problem Conditions

      • Falls

      • Surgical procedures

Part 5: Section F, K & L

Target Audience: MDS Coordinators, Activities & Dietary

Length:  1:02 


Identify Coding Instructions for:

  • Section F:  Preferences for Customary Routine and Activities

    • Explain required interview techniques and rules

    • Discuss staff assessment of preferences

  • Section K: Nutritional Approaches

    • Signs and symptoms of possible swallowing problem: Accurate coding

      • PDPM implications

    • Height and weight, loss and gain: 

      • Understanding the lookback periods

      • Rules for “MD prescribed”

      • Weight loss implication for PDPM & QM

    • Nutritional approaches

      • Accurate coding for ”While” and “While Not” a resident

      • When IV fluids can be coded and when they count for PDPM

      • Feeding tube implications for PDPM

      • Mechanically altered diet:  Definition and PDPM implications

      • Therapeutic diet accurate coding

    • Calculating percent intake by artificial route, ‘while a resident’ and ‘during entire 7 days’ PDPM implications

  • Section L: Oral/Dental Status

    • Accurate coding

Part 6: Section M & N

Target Audience: MDS Coordinators, Wound Nurses 

Length:  1:05


Identify Correct Coding for:

  • Section M:  Skin Conditions

    • Risk of Pressure ulcers

    • Unhealed pressure ulcers/injuries

    • Present on admission

    • Venous/Arterial Ulcers

    • Other Ulcers, wounds and skin problems

    • Skin and ulcer/injury treatments

    • PDPM and QM implications of Section M

  • Section N: Medications

    • Injections

    • Insulin

    • Medications Received

    • Antipsychotic Medication Review

    • Drug Regimen review

    • PDPM and QM Implications

Part 7: Section O & P

Target Audience: MDS Coordinators 

Length:  1:04


  • Discuss proper coding for 

  • Section 0: Special Treatments, Procedures and Programs

    • O0100:  Special treatments, procedures and programs

    • O0250: Influenza vaccine

    • O0300: Pneumococcal vaccine

    • O0400:  Therapies

    • O0420: Distinct calendar days of therapy

    • O0425: Part A Therapies (Part A Discharge)

    • O0500:  Restorative Programs

    • O0600:  Physician Examinations

    • O0700:  Physician Orders

  • Section P:  Restraints and Alarms

    • P0100:  Physical Restraints

    • P0200:  Alarms

Part 8: Section V, Z and Care Area Assessments (CAA)

Target Audience: MDS Coordinators, IDT participating in the CAA process

Length:  46:00

Price:  Free bonus webinar


  • Identify the 20 Care Assessment Areas and the triggering process.

  • Describe the Care Assessment Area review process and documentation requirements.

  • Explain coding instructions and timing requirements for Section V0200:  Care Area Assessment Summary

  • Discuss Coding for Section Z:

    • Z0100:  Medicare Part A Billing

    • Z0200:  State Medicaid Billing

    • Z0250:  Alternate State Medicaid Billing

    • Z0300:  Insurance Billing

    • Z0400: Signature of Persons Completing the Assessment or Entry/Death Reporting

    • Z0500: Signature of RN Assessment Coordinator VerifyingAssessment Completion