You have read and heard me talk about PDGM,but here comes another P ? acronym:


The Patient-Driven Payment Model (PDPM) is the proposed new Medicare payment rule for skilled nursing facilities. It is intended to replace the current RUG-IV system with a completely new way of calculating reimbursement.

Right now you are thinking – Melanie you just have been saying PDGM, PDGM, PDGM for the last 6 months NOW you want me to learn about PDPM????

Quick answer: YES! Those agencies that know what is happening to their referral sources will be better prepared to support them AND GET MORE REFERRALS!

So let’s talk PDPM. I have a client who owns Home Health, Hospice, and Skilled Nursing Facilities and he says this will be a tricky transition. The therapy points are dropping out of the payment calculation. This is interesting because as a therapist in a skilled rehab when I was younger the direction from my director of rehab was to make sure I’ve got in my points and made productivity. Now what?

The real answer is it’s different for each SNF. The agencies I work with across the country are finding each rehab is preparing in their own way. That is where your AMAZING open-ended questions are going to come in handy! You know I LOVE a great open-ended question that can’t be answered with aYES? or NO. One that is going to generate and stimulate the sales conversation!

And this particular one SHOULD GENERATE DISCUSSION!

Insider’s Note: Your Social Workers MAY NOT know the answer. Start at your normal point of contact but do not get discouraged if they look at you like they have NO IDEA what you are talking about. Many reps have found the trickle-down message has not flowed to the Social Worker YET! This is an AMAZING conversation for the therapy department or administrator. Really juicy conversation! This is about THEIR business and they LOVE to talk about their business!


Tell me about how PDPM will affect your business?

Once you understand how they are handling the changes and their fears THEN you know how to BEST POSITION YOUR AGENCY! THIS payment change creates an opportunity for your agency!

Want to discover the best tactics to take advantage of PDPM at your SNFs with rehab? We are doing a whole session on it in VEGAS at The Growth Summit!


Melanie Stover, OT

Co-Owner of Home Care Sales