January 1 will put new evaluation codes for physical and occupational therapy into effect and we all better be paying close attention.
In this world of RACs, ADRs, denials and incentivized payback demands, it behooves us as providers to stare back at The Abyss and defy the illogical and irrational edicts of "PLOF" as the determining factor for payment.
Working in the SNF environment as long as I have (don't ask) I have encountered lots of myths, rumors, fables and tales about how therapy should operate in our very limited community.
Some necessary conversations tend to be awkward and uncomfortable. They include talking to our children about baby making. Or convincing our parents to give up the car keys. Or talking to government investigators about those astronomical therapy billings.
The 2016 Office of Inspector General work plan calls for increased scrutiny of the Ultra High therapy billing category because the amount of this therapy delivered has increased over time, despite resident characteristics not having changed. This work plan is a reminder that providers need to have all of their processes in order.
Despite my love of Halloween, there is one component of it that is distinctly not for me: Horror movies. Still, I'm enough of a pop culture enthusiast that I can appreciate those with an appetite for scary movies and their sequels. If you want to watch the 10 "Halloween" movies or six versions of "Paranormal Activity," I'm not going to judge you. (Much.)
You can bet that nursing home-hired actuaries, lawyers, consultants and other assorted bean counters are going over new rules with a fine-tooth comb. They are looking for the next generation of potential revenue streams — and any loopholes to them. If they exist, they will be found, and implemented.
Healthcare is mandated to reduce spending. The problem is that the Centers for Medicare & Medicaid Services and others are so blinded by the "reduce spending" element that we have lost our ability to appreciate prevention.
We made the decision to invest in a robust aquatics program. Many of our facilities offer therapy pools with integrated underwater treadmills and resistance jets.
Many long-term facilities are turning to doll therapy to help their residents. Some therapists use the term "Nurture Therapy," as they feel it is more appropriate when dealing with adult patients compared to children.
At Presbyterian Village North in Dallas, TX, we offer services in assisted living, skilled nursing, certified Alzheimer and dementia care, hospice and palliative care, and inpatient and outpatient rehab. As a not-for-profit organization, we offer Five Star-rated continuing care in the Dallas Metroplex to individuals of all faiths. As a company, we're focused on delivering care in the right way — concentrating our efforts on what's important to each individual with whom we come in contact.
In some ways, 2014 has been a monumental year. But it's not over yet, especially with regard to Centers for Medicare & Medicaid Services steps regarding the historic Jimmo settlement agreement signed on Jan. 24, 2013.
While some long-term care providers have been slower to look at QAPI processes, others are ready to implement. Therapy vendors also should be considering adopting and operationalizing QAPI.
Many of our therapy patients are medically complex and we, unfortunately, are not able to predict the future, as it sometimes seems that regulators want us to do.
A legal settlement involving two long-term care companies accused of not sufficiently controlling their contracted therapy provider's billing practices has created anxieties among skilled nursing operators.
Complicated grief is an under-recognized problem in the elderly, but a specific treatment can help, a new study says.
Adam Morris is the new vice president of business development at Evergreen Rehabilitation in Louisville, KY.
A Maryland nursing home company has agreed to a $1.3 million settlement over charges that it did not prevent overbilling by its contracted therapy provider, federal authorities announced Monday. This is the second such settlement this month involving therapy company RehabCare Group East Inc.
There is an option in Facebook to mark your relationship status as, "It's complicated." This is a great way to sum up everything, without getting too personal. Even though posting your relationship status on Facebook is personal. It's also great way to characterize long-term care therapy.
CMS issues memo on therapy coding changes ... Home care workers join strikes for a higher minimum wage ... National Assisted Living Week kicks off
We sometimes use high-minded phrases to describe our work and our hopes for our patients. But have we lost our connection to important words? Do they still hold meaning they once did, and if so, how strongly?
The elderly are very vulnerable to dehydration and more than just the nursing staff have to be concerned about it. Not keeping an eye on appropriate hydration can cause a variety of serious problems.
Why would anyone mention value-based reimbursement, medical necessity and the Jimmo lawsuit in the same sentence? I feel they are all related, but it will be difficult to find the perfect balancing act to maximize the benefits of each topic.
Better way to determine proper post-acute therapy duration and intensity discovered, researchers sayJune 02, 2014
Academic researchers say they have devised a more accurate way to determine "optimal" levels of therapy for post-acute patients. The method also can better judge therapy intensity, investigators at the Washington University School of Medicine said.
Providers aren't just being accused of coding therapy patients in higher payment categories than ever before. The charge is being backed by hard numbers in a recent memorandum from the Centers for Medicare & Medicaid Services.
What significant changes in Medicare occurred for us in 2014?
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.
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.
Rehabilitation professionals still are navigating challenges of providing group, concurrent therapies in a world that has come to value individual therapy more
Charges from whistleblowers have led to a $48 million settlement between operator The Ensign Group and the U.S. Department of Justice. The settlement was one of the largest of its kind, according to U.S. Attorney André Birotte Jr.