IRF Countdown Clock is Ticking: Fewer than 30 Days to Go

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Original story posted on: September 4, 2019

Changes are effective Oct. 1, 2019.

With fewer than 30 days remaining before the transition of payment for inpatient rehabilitation facility (IRF) services to the new formula based on the use of Quality Indicator Data, providers should be winding down their preparations and simply fine-tuning processes.

Patients discharged on or after Oct. 1, 2019, will be paid based on the new formula, and some of those patients will be cared for in IRFs across the nation. With a national average length of stay of just under two weeks, it’s likely that most patients admitted after the middle of September will be discharged on or after Oct. 1.

A Reminder about Changes in the Final Rule

As we have noted previously, the Centers for Medicare & Medicaid Services (CMS) delayed the use of weighted scores in the Final Rule for the 2020 fiscal year to ease the transition – a helpful move for IRFs that might have been a bit behind in training staff related to scoring and in assigning responsibility for both assessment and documentation of the key motor and functional indicators.

Down to the Wire

In these final few weeks and days, we encourage IRFs to go through the following checklist:

  • Test and fine-tune template or form changes made to address the transition;
  • Continue training in scoring criteria and in the documentation required to support scoring. Remember, it is not sufficient to simply enter a score; the record must have adequate documentation to support the score;
  • Audit open records to be certain staff understand both the scoring and documentation requirements, and provide last-minute training as needed; and
  • Utilize the reporting capabilities of your software to evaluate your scoring trends and make comparisons to regional and national scoring.

What’s the Bottom Line?

The clock keeps ticking!  We’re down to fewer than 30 days to the final transition and should be implementing any final changes while monitoring as needed. We’ll update things after the transition as we identify issues and best practices.

Angela Phillips, PT

Angela M. Phillips, PT, is President and Chief Executive Officer of Images & Associates. A graduate of the University of Pennsylvania’s School of Allied Health Professions, she has more than 40 years of experience as a consultant, healthcare executive, hospital administrator, educator, and clinician. Ms. Phillips is one of the nation’s leading consultants assisting Inpatient Rehabilitation Facilities in operating effectively under the Medicare Prospective Payment System (PPS) and in addressing key issues related to compliance. Ms. Phillips is a member of the RACmonitor editorial board and a popular guest panelist on Monitor Mondays.

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