Access SLP Health Care

Issue Focus: 2019 SNF Payment Changes November 2018
Access SLP Health Care addresses the specific needs of speech-language pathologists working in health care.

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Headlines Clinical Resource

Cognitive-Communication Referral Guidelines for Adults: Want a checklist to trigger appropriate referrals for individuals with cognitive-communication disorders? Customize the information on this page to provide to physicians, nurses and other facility staff to initiate appropriate referrals.

Featured Question

What are the advantages of the Patient Driven payment Model (PDPM) over the existing Skilled Nursing Facility Prospective Payment System (SNF PPS)?

Per the report available at the Centers for Medicare and Medicaid services (CMS), the advantages for PDPM are:

  • “Removes therapy minutes as the basis for therapy payment
  • Establishes separate case-mix-adjusted component for NTA [non-therapy ancillary] services, thereby improving targeting of resources to medically complex beneficiaries and increasing payment accuracy for these services
  • Enhances payment accuracy for nursing services by making nursing payment dependent on a wide range of clinical characteristics (as originally considered for RUG-IV) rather than being primarily a function of therapy minutes and functional status
  • Improves targeting of resources to beneficiaries with diverse therapy needs by dividing single therapy component into three separate case-mix-adjusted components: PT, OT, and SLP
  • Provides additional resources to facilities for treating potentially vulnerable populations, including beneficiaries with the following characteristics: high NTA utilization, extensive services (ventilator, respirator, or infection isolation), dual enrollment in Medicare and Medicaid, end-stage renal disease (ESRD), longer prior inpatient stays, diabetes, wound infections, IV medication, bleeding disorders, behavioral issues, chronic neurological conditions, and bariatric care
  • Enhances payment accuracy for all SNF services by: (1) basing payment for each component on predicted resource utilization associated with clinically-relevant resident characteristics and (2) introducing variable per-diem payment adjustments to track changes in resource use over a stay
  • Promotes consistency with other Medicare and post-acute payment settings by basing resident classification on objective clinical information while minimizing the role of service provision in determination of payment.”
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Related Resources
The next issue of Access SLP Health Care is coming January 2019! Address comments and suggestions for future topics, information or resources to Monica Sampson at

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