MDS Essentials: Introduction to PPS PDPM, Naming and Scheduling: PPS Discharge Assessment

The Part A PPS Discharge Assessment, as outlined in the CMS’s RAI Version 3.0 Manual for October 2023, is a crucial component of the Patient-Driven Payment Model (PDPM) under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS). This assessment is specifically designed to capture data elements that are essential for calculating current and future SNF Quality Reporting Program (QRP) quality measures as mandated by the IMPACT Act. The assessment plays a key role in the post-acute care continuum, ensuring that standardized resident assessment data related to admissions and discharges are accurately recorded.

Purpose and Components:

• Objective: To gather data that reflect a resident’s status at the end of their Medicare Part A stay, which is crucial for the SNF Quality Reporting Program (QRP).
• Components: Includes demographic, administrative, and clinical items that capture the resident's condition at the end of the Medicare Part A stay. The assessment is identified by Item A0310H.

Implementation and Significance:

• Timing: Must be completed within 14 days after the end of the most recent Medicare stay (A2400C + 14 calendar days) and submitted within 14 days after the MDS completion date (Z0500B + 14 calendar days).
• Integration with OBRA Assessments: In instances where a resident's Medicare Part A stay ends concurrently with their discharge from the facility, the Part A PPS Discharge assessment must be combined with the OBRA Discharge assessment, aligning with the regulatory requirements for comprehensive resident evaluation.

This assessment ensures the continuity and quality of care by accurately documenting the resident’s condition at the end of their Medicare Part A stay, providing essential data for quality measures and facilitating a seamless transition to subsequent care phases or services. The completion and accurate submission of the Part A PPS Discharge Assessment are critical for compliance with federal mandates, supporting the improvement of quality care standards across SNF settings​​.