When a patient is referred to therapy, and they are receiving hospice care, then therapy needs to seek permission from the hospice company to provide any treatment. Hospice is required to reimburse the facility for the therapy services since the treatment also is included in the bundled payment rate from Medicare Part A. And, therein lies the rub.
Is that how everyone is feeling about the ICD-10 delays? Well, that's how I'm feeling. We almost got within the six-month window for implementation. Just when we were all geared up and ready to go, the government pushes the deadlines out again for one more year.
"The pen is mightier than the sword" is an age-old adage that implies that the power of communication — in this case, written communication — is more powerful than a physical weapon. Do you adopt this philosophy with your medical records and rehab documentation? You should.
How many clinicians (physical, occupational, and speech therapy) can honestly say that they have achieved full independence with 100% of every patient they have ever worked with? Unfortunately, I definitely cannot make that claim myself. But is that always the intention anyway?
What is the purpose of a rehabilitation screen? Very simply, we attempt to identify long-term residents' needs and possible rehab potential. Somehow, we don't really have an industry standard on what should take place during a screen.
How do you define tolerance? Is tolerance measurable? Is tolerance too subjective? What about activity tolerance? We love to document how patients are improving activity tolerance, but many times that's all we state in our documentation. So what have we said? Very little.
Have you started your countdown clocks yet? It looks like it's definitely happening this year on Oct. 1, 2014. The transitions from ICD-9 to ICD-10 coding will 100% absolutely take effect for the entire healthcare system, including therapy. So what is this big change all about? Per CMS, here are a couple of key facts everyone should be preparing for.
Have you ever had a day when you looked great but felt depressed? Or you looked your worst but felt great? Perception of self-image is stronger than actual self-image with determining our emotions. Would you be able to survive an entire day, week or month without looking into a mirror?
What's the point of all of our treatment interventions and plans of care if we can't relate to our patients? If you can put a face and personality behind your justification for therapy services, you'll be way ahead of the game.
How many of you will agree with me that we never fully turn off the internal therapist mode when we're in public, outside of work hours?
Rehab Realities is written by Shelly Mesure, MS, OTR/L. She is the senior vice president of Orchestrall Rehab Solutions and owner of A Mesured Solution Inc., a rehabilitation management consultancy with clients nationwide.