On Jan. 24 of this year, the Jimmo vs. Sebelius class action lawsuit was settled. This was a significant win for us, the healthcare providers. As we continue to work out the details, I feel now is a good time for a reminder of the ins and outs the lawsuit. No doubt about it, it was a blockbuster decision.
Finding out therapy dogs slow down dementia symptoms is like discovering water quenches thirst, or shoes reduce firewalker foot pain. Of course they do. As my dogs like to say, "Grrrrr," followed by "Duh!"
Well, Oct. 1 has passed, and we're all still hanging in. The biggest changes we saw to rehab were the addition of reporting co-treatment minutes on our billing logs and Section O on the MDS. And, the new question of "how many DISTINCT calendar days" were received between SLP, OT, and PT.
Rehabilitation professionals have been presented with significant new challenges since new functional G-code requirements became effective July 1. Those who use them wrong could lose big. Various experts describe here how to best deal with them and win.
As you read this, you might be eyeing the new RAI manual that takes effect today, and are feeling a bit overwhelmed at the sheer number of new pages. So it's with great regret that I have to add yet another burden, and let you know that it looks like a whole new therapy discipline will need to be provided at long-term care facilities around the country.
On Oct. 1, the Centers for Medicare & Medicaid Services will be updating the Minimum Data Set with another round of changes. Most are minor but there will be two changes to the therapy section. Your case-mix utilization and scheduling, will determine the degree of impact of these new changes.
The Centers for Medicare & Medicaid Services has released a memorandum clarifying transition policies for new Minimum Data Set items related to swallowing and nutritional status, as well as therapy.
Have you received your provider-specific PEPPER report yet? The Program for Evaluating Payment Patterns Electronic Report (PEPPER) were mailed on August 30 and have been slowly arriving at skilled nursing facilities throughout the country.
Many stroke survivors have undiagnosed attention-related disorders that could be treated with therapy, according to newly published research.
With all the recent regulatory changes that have come down the line, or are about to, we developed a simple five-question survey that each provider had to ask every therapy employee. If you can develop strong policies and procedures based on these questions, you will have a good offensive game plan in place.
"What is therapy?" sounds like a simple question, but it requires a separate and very complex answer for each discipline.
In recent years, many skilled care operators have nervously watched the Centers for Medicare & Medicaid Services reduce and sometimes eliminate payments for physical, occupational and speech therapy services. But thanks to a recent class-action lawsuit settlement, the funding pendulum might be about to change direction. As a result, the skilled care sector could be in for a massive funding windfall.
RightTrack by Functional Pathways officially launched on Monday. The software allows a provider to be able to track key functional outcomes, such as safety and pain, and to track progress.
Sorry, ladies, I didn't mean to get your hopes up with that title. But does anyone else feel like there is a lot of ambiguity to the new G-Coding system? Well, it's a little too early to tell for sure, but I can already see how the new G-codes will be riddled with red flags in the next few months.
Is it time for a diet? Not a food diet, but a documentation diet. I've written previous blogs about documentation quick tips, top 10 reasons for denials, and so on. But, how many of you are guilty of over-documentation? Is that even possible? Well, yes, it is.
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers need to be ready by June 1.
How do skilled nursing facilities, clinics and hospitals think about therapy? Focusing on patient satisfaction and revenue is a good start, but it is not enough. As therapy continues to be scrutinized by the government and insurance companies, it's a good idea for administrators, directors of nursing and compliance staff to become more familiar with therapy operations.
As we've been predicting here for some time, allegations of mismanaged therapy care are starting to land nursing homes in some seriously hot water.
While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare Part B patients have become more medically complex than just a few years ago?
Government agencies and lobbyists are famous for conducting studies that prove a point — theirs, namely. That's why I'll be very interested to see who will have the courage to conduct one of the most important long-term care-related studies that should be completed over the coming year.
Here's the good news for providers: new analytics are making it possible to understand and bill your care in ways that would have been impossible just a few years ago. Here's the bad news: The government is quite aware of these new options.
A False Claims Act lawsuit involving a nursing home chain and therapy providers in Missouri can move forward, a federal judge has ruled. The case originated when a whistleblower alleged that a therapy company received more than $10 million in kickbacks as part of a scheme to overbill Medicare and Medicaid.
Tennessee-based nursing home operator Grace Healthcare LLC will pay the federal government more than $2.7 million, settling charges that Grace violated the False Claims Act by billing Medicare for unnecessary rehabilitation therapy.
Each time I visited a restroom during a routine site visit, I noticed a very pretty toilet-paper flower there. It was made of toilet paper and folded into a flower, including the stem. It was then sitting in an unused toilet paper roll to serve the purpose of the vase. It was such a clever and creative idea, I wanted to know who was behind this craft.
It's official: A federal judge approved a settlement agreement the last week of January that will allow Medicare patients to continue receiving therapy services even if they are not making measurable improvement.
Fairhaven Manor's Amy Kotterman wasn't sure her incoming graduate student intern was the Katie Smith until receiving an unusual voicemail. Smith called to say she would miss a day of her upcoming rotation to attend a USA Basketball board meeting.
A new U.S. Senate bill would change a Medicare provision preventing many seniors from getting coverage for skilled nursing therapy after hospital "observation stays."
The Centers for Medicare & Medicaid Services is encouraging provider input as it seeks to change the payment system for therapy provided by skilled nursing facilities.
A keynote address by Farzad Mostashari, MD, ScM, the National Coordinator for Health Information Technology, will highlight opening day of the annual winter Legislative and Regulatory Conference of the National Association for the Support of Long-Term Care.
Instead of spending more time doing hands-on patient care, therapists who work with Medicare beneficiaries have been strapped with increased administrative tasks, sometimes leading to delayed services, or worse.