Registered Dietitians (RD) are experts in identifying residents with criteria that meet the standards for malnutrition. With the identification and subsequent diagnosis of malnutrition, through documentation and medical diagnosis by a physician or nurse practitioner, long-term and skilled nursing care facilities (SNFs) benefit financially now with this diagnosis through the Patient Driven Payment Model (PDPM). Most SNFs, more than 65% per recent analyses, were previously seeing boost in reimbursement of nearly $52 daily in comparison to the previous Resource Utilization Group (RUG)4,5. Recent COVID restrictions and related illnesses demonstrate an increased need for review of non-therapy ancillary components of the PDPM, including the screening, identification, and treatment of malnutrition and those who are at risk for by the RD.
Cost savings and increased reimbursement rates, through PDPM, begin with proper resident evaluation with a validated screening tool including the Mini Nutrition Assessment (MNA), Malnutrition Screening Tool (MST), and Malnutrition Universal Screening Tool (MUST). Some sources even noting companies are finding losses of $500 to just over $1500 due to missed diagnoses, of both malnutrition and obesity, throughout total admissions spans of residents2.
With every dollar spent on nutrition screening and interventions, the Academy of Nutrition and Dietetics has reported savings of $3.253. Recent studies are continuing to conclude cost savings of early nutrition therapy noting nearly 36% cost decreases per patient1. The RD can assist the interdisciplinary team with the screening and review for malnutrition, and the risk of, with timely and efficient processes which benefits both the patient and bottom line. Early interventions are shown to increase positive outcomes for those experiencing acute illness on top of chronic conditions. This can be seen by reducing the potential for rehospitalization as well as addressing increased needs related to wound care, and aiding in improved outcomes for patients. When malnutrition or the risk for, is identified, interventions such as use of oral nutrition supplements, fortified foods and beverages, honoring resident food and snack preferences, and continued monitoring can be effective treatments.
Increased screening for malnutrition, along with the review and treatment can lead to cost savings, positive patient outcomes, and potential for increased reimbursements through PDPM. The RD can provide insight, knowledge, and direction into the best tools and solutions to use for each individual building, patient, and situation.
- Buitrago, Giancarlo, et al. “Targeting Malnutrition: Nutrition Programs Yield Cost Savings for Hospitalized Patients.” Clinical Nutrition, 2019, doi:10.1016/j.clnu.2019.12.025.
- Courtney, Vince. “PDPM: Make Sure Your Dietitian Is Contributing to Your Bottom Line.” BSN Solutions, 7 Feb. 2020, bsnsolutions.net/pdpm-make-sure-your-dietitian-is-contributing-to-your-bottom-line.
- Malnutrition: A Hidden Cost in Health Care. (2006). Retrieved from https://static.abbottnutrition.com/cms-prod/abbottnutrition.com/img/Malnutrition.pdf
- Spanko Alex. Early PDPM claims data reveal far more winners than losers, ‘impossible combinations’ of conditions. Skilled Nursing News website. https://skillednursingnews.com/2019/11/early-pdpm-claims-data-reveals-far-more-winners-than-losers-impossible-combinations-of-conditions/. Published November 20, 2019.
- Spanko, Alex. Winners Still Outnumber Losers in Latest PDPM Analysis, But Length of Stay Trends Could Erase Rate Gains. 29 Jan. 2020, skillednursingnews.com/2020/01/winners-still-outnumber-losers-in-latest-pdpm-analysis-but-length-of-stay-drop-could-erase-rate-gains/.