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Medicare Meeting Report

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1 – 4$14.55
5 – 9$12.50
10 – 14$10.35
15 +$8.20
SKU: 1442

Updated form provides for documentation of key elements of skilled services and documentation reviewed during Medicare meetings.  Updates correspond with the implementation of the PDPM reimbursement system, effective October 1, 2019.

Updated to track fourteen (14) residents on this two-sided form: 

         Primary diagnosis for skilled care (I0020B)

         Current CMI classification

         ARD of initial Medicare assessment

         Medicare days used and days available

         Skilled services provided: nursing, P.T., O.T., SLP

         Interim Payment Assessment (IPA) indicated

         Continue skilled care

         Anticipated discharge date

         Date beneficiary notice given

         Skilled certification/recertifications complete and signed

         Therapy certifications complete and signed


This form provides for six (6) signatures/titles of the Interdisciplinary Team (IDT) attending the meeting.

Download a sample today!

  • Size:  11” x 8 ½”
  • White paper, black ink printed one side
  • 3-hole punched top (11” edge)
  • 100 per pad

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