Wednesday, October 23 | Legislative/Policy, Thought Leadership, Post-Acute Care, Care Coordination

Why Treating Depression Under PDPM Is More Important Than Ever 

By Netsmart

The circumstances that bring most elders to nursing homes often include loss of function and mobility at home. Those issues combined with chronic pain, loss of loved ones and the stigma associated with depression heighten the need to screen for and treat depression among residents in nursing homes.
 
Consider these statistics: 
 
Approximately 40% of residents in nursing homes have symptoms of depression.
 
Elderly individuals who suffer from chronic pain are between 2.5 and 4.1 times more likely to experience depression.2
 
Approximately 68% of adults aged 65 and over know little or almost nothing about depression.3
 
What’s more, 15% of persons aged 65 years or older are readmitted to the hospital with depression-related symptoms. Those with high depressive symptoms are more likely to be readmitted than those with low depressive symptoms.4
 
However, for a variety of reasons, skilled nursing facilities (SNFs) haven’t always been proactive about identifying depression in residents. Historically, SNFs have often under-diagnosed and undertreated depression. They’ve often also under-documented or miscoded for signs of depression. Studies show depression management is correlated with lower rehospitalization and lower length of stay.  
 
With the launch of Medicare’s new Patient-Driven Payment Model (PDPM) – aimed to drive the best outcomes for individuals and reward providers based on outcomes – it becomes more important than ever for SNFs to properly identify and care for people with depressive symptoms.  
 
Caring for people with depression costs more and is reimbursed more under PDPM. When SNFs properly identify and treat depression as part of a resident’s overall care plan, reimbursements can increase up to 17% in the nursing component, according to The Centers for Medicare and Medicaid Services (CMS) final rule for the SNF prospective payment system. 
 
The question becomes: How can you ensure you have the right staff to conduct depression assessments, particularly in elderly residents with multiple complex conditions? What steps can you take now to successfully manage depression among your residents? 
 
Below are some suggestions from McBee Clinical Consulting Manager Peter von Mechow.

Invest in training and education 
 
Make sure frontline caregivers, especially your social workers, are trained in recognizing depression. Ask your medical director, psychologist or psychiatrist to consult with staff on how to spot depression. Equally important is helping staff overcome the barriers of being afraid to discuss depression with residents. 
 
Once depression is recognized in a resident, the chart should be reviewed by the physician so it can be properly diagnosed and treated. Depression should be in every clinician’s assessment with some type of review process to determine whether a resident verbalizes depression or shows signs of depression. Furthermore, it needs to be documented in all disciplines. 
 
Conduct quality chart reviews 
 
After education and training, it’s important to conduct quality chart reviews to see if there is any indication of depression. In the review, ask, was depression recognized? Was it treated? If depression was documented appropriately and diagnosed by the primary physician, did staff appropriately capture it on the Minimum Data Set (MDS)? 
 
Do a live chart review with the interdisciplinary team within five days of an admission to see if all data, including depression, is properly documented and coded before the 5-day MDS is complete.    
 
Keep focused on care planning
 
Everything you are diagnosing or capturing in the notes as a problem needs to be included in the care plan. Because care plans help assign the correct and most qualified staff to provide the care outlined in the plan, it’s critical that you document accurately and completely. 
 
With recent CMS updates on regulations, care planning is a new focus for compliance. The significance of depression adds to the clinical complexity score of the nursing component, creating an even greater importance in proper care planning.
 
PDPM offers a huge opportunity, both clinically and financially, for SNFs who can properly capture, identify and treat depression. But the most important beneficiaries of this new patient-focused care model are the elderly who are served.   
 
 
To learn more about how Netsmart and McBee can help you succeed with PDPM, click here.
 
 
Sources
 
 


Meet the Author

Netsmart - color - PNG
Netsmart ·

From the CareThreads Blog

Webinar Recap: What’s Next for MCOs After EVV Compliance

Wednesday, September 28 | Value-based Care,Thought Leadership

As the upcoming EVV compliance timeline is quickly approaching, we thought it would be interesting to discover how the initial phase and implementation of EVV has affected managed care organizations (MCOs), and their provider networks. This blog recaps a recent Netsmart webinar that addressed the details of this topic with the talented Dr. Melissa Berdell, Director Fraud, Waste and Abuse at Highmark Wholecare.

More
CareThreads Blog Stock Image for SiteCore (370 × 158 px) (1)

Part 5: Current State of Peers in the United States - Demographics and Economic Impact

Monday, September 19 | Human Services,Thought Leadership,Value-based Care

In our most recent blog, The Role of Peers and Mutual Support in Alcoholics Anonymous, we discussed the fascinating history of Alcoholics Anonymous and its contributions to today's health care continuum. Evolving in parallel to the mental health peer movement, AA and its affiliate organizations, e.g., Narcotics Anonymous came to identical conclusions about the unique value of mutual support. Join Denny Morrison, as he unpacks how often peers are used, how they are credentialed and how they affect the economics of health care in the United States.

More

A Call for Action: Devastating Medicare Rate Cut Proposed for Home Health

Monday, September 12 | Post-Acute Care,Thought Leadership,Netsmart in the Community,Legislative/Policy

Ready access to quality home healthcare services is critical to the future of our nation’s healthcare system and the millions receiving these services today. Jen Sherman, community strategist, Netsmart will be a voice for home health providers in Washington D.C. at the upcoming NAHC Advocacy Day and shares why the proposed rate cuts by CMS will leave a devastating negative economic and operational impact on home health and post-acute providers.

More