QuickInsights into PDPM Basics

Mastering PDPM starts with the foundation.

PDPM is one of the most complex reimbursement systems skilled nursing facilities have ever navigated. Five payment components. Multiple clinical categories. A single MDS assessment that drives every dollar. And a team of clinicians, nurses, and coordinators who all need to be pulling in the same direction — even when most of them have never had a clear explanation of how the system actually works.

That’s exactly what this course is built to fix.

QuickInsights into PDPM Basics takes a system that has confused entire departments and breaks it down simply, clearly, and thoroughly — so your team finally has the foundation they need to assess, document, and capture with confidence.

Built for where your team actually is.

Whether you’re brand new to PDPM and don’t know where to start, or you’ve been working in it for years but still have questions on the fundamentals — this course meets you there. Our team of former VPs and regional directors of reimbursement, with 25 years in skilled nursing and long-term care, designed every lesson to be direct, practical, and free of the jargon that makes PDPM feel harder than it has to be.

No billing background required. Just clear explanations, real patient examples, and the actual numbers behind the rate.

What the course covers:

Part 1 — The Foundations of PDPM
Start at the beginning: why PDPM replaced RUGs, how the six building blocks of every payment fit together, how the MDS becomes a HIPPS code, and how the daily rate is actually built. Covers the 5-day assessment, IPAs, the interrupted stay policy, Medicare skilled coverage criteria, and how Medicare Advantage and managed care differ from traditional Part A.

Part 2 — The Components, One at a Time
Go deep on each payment component — PT/OT, SLP, Nursing, and NTA — with a focus on what qualifies, what drives the case-mix weight, and what each category means in real dollars using FY2027 Medicare rates. Because understanding the components is where confusion usually lives, and where accuracy is won or lost.

What you’ll walk away with:

• ✅ A true working knowledge of how PDPM classifies and pays for every patient
• ✅ The ability to spot missed captures before they affect your bottom line
• ✅ Answers to the foundational questions your team has been carrying for years
• ✅ A shared language that improves communication across your entire IDT

Who it’s for:
MDS coordinators, nurses, therapists, social services, dietary, and anyone on the interdisciplinary team — whether they’re learning PDPM for the first time or finally filling in the gaps after years of working in it.

Self-paced, on-demand lessons you can finish on a lunch break. One missed capture can cost a facility thousands over a single stay — this course can pay for itself many times over.

The first course in our QuickInsights into PDPM series.

This course lays the groundwork for everything that follows. Once your team has the foundation, they’ll be ready to go deeper with the full series:

• 📌 Nursing Component Deep Dive
• 📌 NTA Component Deep Dive
• 📌 PT/OT Component & Section GG Deep Dive
• 📌 SLP Component Deep Dive

Each course in the series builds on the last — giving your entire IDT a complete, working knowledge of every dollar driving your Medicare Part A rate.

📋 Format: Self-paced, on-demand video course
📌 Based on FY2027 SNF PPS rates and CMS RAI Manual v1.20.1 (October 2025)

Questions about group or facility licensing? [email protected] | www.insightmds.com