Demystifying & Maximizing IPAs to Ensure Accurate PDPM Reimbursement

As skilled nursing facilities (SNFs) continue to navigate the Patient-Driven Payment Model (PDPM), Interim Payment Assessments (IPAs) remain a critical – yet often misunderstood – tool for accurate reimbursement. While IPAs are technically optional, CMS expects facilities to complete them when significant clinical or functional changes occur. Missing an IPA can lead to underpayment, compliance issues, and increased audit risk as CMS intensifies PDPM oversight.

This session will demystify the IPA process and provide practical strategies to ensure your facility captures all the care it delivers. We’ll cover when and how to complete an IPA, identify high-impact clinical changes that drive payment adjustments, and explore the financial benefits of timely assessments. Attendees will also learn how to establish clear clinical criteria and data-driven practices to defend against audits and optimize PDPM reimbursement.

Learning Objectives

• Define an IPA and determine when/if one should be completed under current CMS guidance
• Recognize high-payment clinical items that can result in increased reimbursement
• Explore the financial and compliance benefits IPAs have on a facility’s bottom line
• Establish clinical and operational criteria for triggering IPAs to ensure timely assessment and audit readiness

Speaker

• Jim Shearon, RN, BSN, MSHA, VP of Clinical Solutions, Real Time Medical Systems

This live educational session is part of the 2026 Iowa Health Care Association Annual Convention agenda.