Ask the payment expert

What should we do about our therapy services to fully capitalize on MDS 3.0 and RUG-IV?

Providers will now have to track their therapy minutes in three different ways: individual, concurrent and group therapy minutes.

Concurrent therapy only applies to Part A residents and includes treatment to two residents at the same time when the residents are performing different activities. Group therapy is two to four residents being treated at the same time when they are performing similar activities. Although you will need to identify total minutes on the MDS, software will calculate the payment impact.

You will get credit for all the individual minutes, half the concurrent minutes and all the group minutes—but only up to 25% for total minutes per discipline.

The issue that this system creates is that you will not be able to just look at the minutes given and know what your RUG level will be. Your therapy department will need to track both total minutes and resulting RUG minutes. Also, because of the anticipated loss of extensive services qualifier, your therapy department will need to guide the setting for the appropriate Assessment Reference Date.

Your therapy staff and MDS staff both need to understand the tracking system used. In addition, administrators need to remember that they are still administratively responsible for the services provided by therapy.