Reimbursement Day: Maximizing PDPM for Ohio Medicaid and Medicare

October 9, 2025 - Quest Conference Center - 9200 Worthington Rd., Ste 400 Westerville, OH

Every coding choice counts—and starting January 1, 2026, it will matter even more. Ohio Medicaid’s move to the nursing-only component of PDPM, phased in over three years, will directly influence your facility’s revenue, while PDPM for Medicare Part A continues to shape reimbursement at the federal level. This one-day, in-person workshop is designed to equip MDS nurses and clinical leaders with the strategies, coding precision, and documentation practices needed to capture every dollar your facility has earned. Participants will see their own facility’s projected financial impact under Ohio’s PDPM methodology and learn proven tactics for maximizing case-mix scores across both payers. The training will also connect the dots between MDS coding and its impact on Quality Reporting Program (QRP) measures and the Skilled Nursing Facility Value-Based Purchasing (VBP) program, ensuring reimbursement strategies support quality outcomes and incentive payments. With interactive coding exercises, real-world case studies, and actionable best practices, you’ll walk away with the tools to strengthen interdisciplinary protocols, avoid costly errors, and optimize reimbursement in 2026 and beyond.

Learning Objectives:

• Explain Ohio Medicaid’s adoption of the nursing-only PDPM component, its three-year phase-in, and the associated impact on facility reimbursement.
• Review facility-specific PDPM financial projections and identify opportunities to improve revenue capture.
• Describe how to apply best practices for MDS coding that ensure qualifying services and clinical conditions are fully and accurately reported.
• Discuss how to implement interdisciplinary protocols to align clinical care, documentation, and assessment timing for optimal PDPM scoring.
• Recognize how MDS coding influences QRP and VBP performance, and develop strategies to support both reimbursement and quality incentives.
• Identify common PDPM-related compliance risks and develop strategies to avoid coding and documentation errors for both Medicaid and Medicare.

CE information to follow.