Oasis Point Rehabilitation Hospital

IRF-PAI Accuracy Training Platform

Comprehensive training platform for IRF-PAI coordinators and clinical teams to master accuracy, prevent MAC audits, and ensure compliance excellence.

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The HospiTEL Model: Excellence in Care and Compliance

At Oasis Point Rehabilitation Hospital, our commitment to patient-centered care is embodied in the HospiTEL Model, a non-traditional operating system of care that redefines the rehabilitation experience. The HospiTEL Model blends advanced medical rehabilitation with the warmth and hospitality of a luxury hotel, creating an environment designed for comfort, dignity, and healing.

A critical component of this model is ensuring the highest standards of clinical and operational excellence, which includes achieving zero-fault accuracy in our Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) documentation. By mastering the principles outlined in this training, we will not only ensure compliance with Centers for Medicare & Medicaid Services (CMS) regulations but also safeguard our facility from frequent audits and financial penalties, allowing us to focus on our core mission of accelerating recovery and restoring the human spirit.

Why Would the MAC Audit Oasis Point

Common Audit Triggers

  • Failed presumptive compliance (60% Rule)
  • IRF-PAI data doesn't match medical record
  • Missing required documentation (PAS, IPOC, IDT notes)
  • Inappropriate admissions (medical necessity)

The Cost of Non-Compliance

  • Loss of Medicare certification
  • Repayment of prior year's revenues
  • Potential facility closure
  • Damage to reputation and referral relationships

Comprehensive Training Modules

IRF-PAI Overview
Understanding the IRF-PAI, MAC audits, and compliance requirements
Daily Workflow
Step-by-step daily processes for the IRF-PAI Coordinator
Accuracy Process
10-step process to ensure 100% IRF-PAI accuracy
Audit Prevention
Strategies to stop frequent MAC audits through meticulous surveillance
Audit Trigger Case Studies
12 real-world cases: 6 that trigger audits and 6 that don't
IRF-PAI Form Walkthrough
Step-by-step completion guide with sample patient
Mock Audit Simulator
Practice responding to realistic MAC audit scenarios with instant feedback
Clinician Roles
Identifying the best clinician to ensure IRF-PAI accuracy
Case Studies & Quiz
10 interactive case studies with tiered progression (90%+ advances)
Documentation
Required documentation and medical record requirements
60% Rule Tracker
Monitor and calculate compliance with CMS-13 diagnostic categories
ICD-10 Code Lookup
Search ICD-10 codes and view IGC categories and tier requirements
Comorbidity Counter
Select comorbidities and automatically calculate the correct tier
Tier Assignment Quiz
Practice tier assignment with 20 patient scenarios
Tier Coding & Capture Guide
Step-by-step methodology for accurate tier assignment
Tier Comorbidity Lookup Tool
Search ICD-10 codes to instantly verify tier qualification with prevalence data
Tier Assignment Practice Quiz
Realistic patient scenarios - identify qualifying tier-specific comorbidities
Tier Scenarios & Practice
Extensive diagnosis lists and coding scenarios for all tiers
Tier Assignment Worksheet

Printable worksheet for systematic tier documentation

Physician Query Guide
When to query, how to write queries, and templates
Physician Query Library
43 ready-to-use query templates - print or email to physicians
Clinical Coaching Hub
Training resources for coaching nurses & therapists on tier coding and documentation
Complete Assessment Simulator
Step-by-step walkthrough of full IRF-PAI assessment from admission to discharge
Competency Validation
Complete 6 patient assessments to demonstrate coordinator mastery
Diagnosis-Tier Matching
Match diagnoses with most common RIC tier assignments
Frequently Asked Questions
Common questions about IRF-PAI completion and MAC audits
Case Study Library
Searchable real-world cases for each tier with coding examples
FIM Scoring Training
Complete FIM assessment training with common errors
Submission Tracker
Real-time deadline monitoring with automated alerts
Internal Audit Checklist
Monthly self-audit tool with compliance scoring
Final Certification Exam
50-question comprehensive exam - 90% required to pass
Continuing Education
Quarterly updates on CMS policy changes and MAC audit trends
IRF-PAI Glossary
Comprehensive definitions of key terms and acronyms
Quick Reference Guide
Downloadable one-page cheat sheet for desk reference
Error Tracking Log
Monitor and analyze coding errors with trend analysis
Audit Response Toolkit
Templates and checklists for MAC audit responses
Coding Simulator
Practice IRF-PAI coding with instant validation
Progress Dashboard
Track coordinator training completion and certification status
Resources
Downloadable checklists, templates, and reference materials

Track Your Progress & Monitor Compliance

Your Training Progress
Track your learning journey and certification status
Overall Progress0%
Modules

0/15

Quizzes

0/3

Status

Not Started

Monthly Compliance Scorecard
January 2026
Key performance indicators for IRF-PAI compliance and quality

60% Rule Compliance

68%

Target: 60%+8% above target

IRF-PAI Accuracy Rate

94%

Target: 98%4% below target

Average FIM Gain

28pts

Target: 25pts+3pts above target

Days Since Last Error

12days

Target: 30days18days below target

Compliance Summary

2 metric(s) need improvement

Recommended Actions

  • Conduct internal audit of recent IRF-PAI submissions and provide targeted training
  • Implement daily IRF-PAI review process and strengthen quality control measures

Ready to Achieve Zero-Fault Accuracy?

Start your training journey today and help Oasis Point eliminate audit frequency through meticulous surveillance and best practices.