What is the difference between an IPA and a Significant Change Assessment?



The IPA, which is completed for payment purposes under PDPM is often confused with the SCSA, which is a clinical assessment. The OBRA SCSA is required to be completed when there is a significant decline or improvement in the resident’s status the meets the criteria outlined in the RAI Manual. The IPA is optional and should be completed when deemed appropriate by the IDT to identify changes in the patient’s clinical condition and comorbidities such that the patient’s higher acuity level is not reflective of the current rate of reimbursement. The IPA should only be completed when there is a change in one or more of the qualifiers under the PDPM components that impact the payment rate under PDPM in a manner that the current rate of reimbursement is lower than the rate supported by the completion of an IPA.


Christine Twombly, RN-BC, RAC-MT, RAC-MTA, HCRM, CHC
Clinical Consultant

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