Fact Sheet: Administrative Level of Care Presumption under the PDPM
Guidance for the SNF PPS, which includes an administrative presumption whereby a beneficiary who is correctly assigned one of the more intensive case-mix classifiers on the initial five-day
Medicare-required assessment is automatically classified as meeting the SNF level of care
definition up to and including the assessment reference date (ARD) for that assessment. Further clarification is provided on changes and regulations as part of the changeover from RUG-IV to PDPM.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 14, 2019
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