1. What is the QRM PDPM Calculator for FY 2024?

Definition: This calculator computes the daily rate under the Patient-Driven Payment Model (PDPM) for FY 2024 by summing all six case-mix adjusted components.

Purpose: It helps healthcare providers and administrators determine accurate reimbursement rates for skilled nursing facilities under Medicare's PDPM system.

2. How Does the Calculator Work?

The calculator uses the formula:

Where:

• \( PT \) — Physical Therapy component ($)
• \( OT \) — Occupational Therapy component ($)
• \( SLP \) — Speech Language Pathology component ($)
• \( Nursing \) — Nursing component ($)
• \( NTA \) — Non-Therapy Ancillary component ($)
• \( Non\text{-}Case\text{-}Mix \) — Non-Case-Mix component ($)

Explanation: The daily rate is the sum of all six PDPM components, each calculated separately based on patient characteristics and facility factors.

3. Importance of PDPM Calculation

Details: Accurate PDPM calculations ensure proper Medicare reimbursement and help facilities maintain financial stability while providing quality care.

4. Using the Calculator

Tips: Enter each component value in dollars. All values must be ≥ 0. The calculator sums all components to give the total daily rate.

5. Frequently Asked Questions (FAQ)

Q1: What is PDPM?
A: The Patient-Driven Payment Model is Medicare's payment system for skilled nursing facilities, implemented in October 2019.

Q2: How are the component rates determined?
A: Each component is calculated based on patient characteristics, clinical assessments, and facility-specific factors.

Q3: What's the difference between NTA and Non-Case-Mix?
A: NTA covers high-cost ancillary services, while Non-Case-Mix covers fixed daily costs not adjusted for patient characteristics.

Q4: Are these FY 2024 rates?
A: Yes, this calculator uses the Fiscal Year 2024 PDPM rates and adjustments.

Q5: Does this include variable per-diem adjustments?
A: No, this calculates the base rate. Variable per-diem adjustments would be applied separately.