Re: Therapy on Holidays

[Guest guest]

Inpatient acute: we are closed on Thanksgiving (new this year) and

Christmas. We provide minimal coverage on New Year's Day (new ones, orthos,

stats, and perhaps may be adding some of the 10 DRGs that fall under the

transfer rule.

Our general philosophy is that we do not want patients to go any longer than

2 days without some type of therapy intervention over a holiday weekend.

This may change for some populations... due to PPS and transfer rule. We'll

see.

Would appreciate other policies/thoughts on this subject.

Tina

Indpls, IN

Therapy on Holidays

There has been a lot of recent discussion on therapy on SNFs. I'm a

relatively new Rehab and SNF hospital. What does everyone do for therapy on

holidays- specifically Thanksgiving, Christmas, and New Years? Has anyone

had any issued raised by their payors on this subject?

We do therapy on all the other holidays, but I'm looking for guidance on

these three. What does everyone do? My staff is starting to ask for their

time off.

Thanks in advance,

Jon Turton

St. ph Regional Rehabilitation Center

, Texas

______________________________________________________________________

[Guest guest]

In the PPS and reimbursement world, payors " pay " for patients to be in

facilities on those days. We handled it by having one person assigned to

provide coverage on all holidays on an as-needed basis. The staff developed

criteria for patients who would be scheduled on those days - i.e., only those

who needed therapy. It worked out well for Christmas especially since any of

our non-Christian staff would volunteer to cover that day. Worked well.

______________________________________________________________________

[Guest guest]

Jon,

We currently are closed on Thanksgiving, Christmas, and New Year's. We see

patients on all other holidays. I don't know how much longer our

Thanksgiving, Christmas, New Year's troika will survive, but I assume that

as soon as PPS hits, it will go away. It is surprising it has not yet since

we have a very aggressive managed care organization in our hospital (with a

hospitalist) along with 2 other moderately aggressive ones, and none of them

has said anything about this.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

Therapy on Holidays

There has been a lot of recent discussion on therapy on SNFs. I'm a

relatively new Rehab and SNF hospital. What does everyone do for therapy on

holidays- specifically Thanksgiving, Christmas, and New Years? Has anyone

had any issued raised by their payors on this subject?

We do therapy on all the other holidays, but I'm looking for guidance on

these three. What does everyone do? My staff is starting to ask for their

time off.

Thanks in advance,

Jon Turton

St. ph Regional Rehabilitation Center

, Texas

______________________________________________________________________

[Guest guest]

I contacted our FI about coverage on holidays and they stated holidays are not

excluded under PPS.

HCFA states in their Provider Reimbursement Manual under Prospective Payment

2837:

It is irrelevant if there is a break in therapy for a weekend or holiday

during that time. For example, if day 5 of the stay is chosen as the

assessment reference date, the assessor would look back to admission to count

the patient's OT, PT, and ST time. If PT was provided for 50 minutes on both

the second and fifth days of the stay, that would be recorded as 2 days of PT

and 100 minutes of PT. The actual time that therapy was provided should be

recorded. It does NOT have to be expressed in multiples of 15 or 10.

I would think providing coverage on holidays is dependent upon the assessment

reference date. I would suggest therapy work closely with the MDS coordinator

about assessment reference dates for new admissions, 14-day assessments,

30-day assessments, etc., especially in anticipation for holidays.

Kathy Shields

Professional Therapy Providers

______________________________________________________________________

[Guest guest]

We see wounds which have a Dr's order for 7 days a week, on Sundays and holidays

1 x. We have a PT or PTA who is scheduled to see them. If a PTA is scheduled,

and a new wound eval order comes in by noon, on Sun. or the holiday, we have a

PT on call to come in and see them by 4 pm. If we have a holiday weekend where

a patient could potentially go two days without, then it is the therapist's

option which day, (Sun. or the holiday), that they want to come in to see any

new skilled patients. In any event, the wounds are seen 1 x daily regardless.

>>> " and Tina Rosier " 09/19 1:26 PM >>>

Inpatient acute: we are closed on Thanksgiving (new this year) and

Christmas. We provide minimal coverage on New Year's Day (new ones, orthos,

stats, and perhaps may be adding some of the 10 DRGs that fall under the

transfer rule.

Our general philosophy is that we do not want patients to go any longer than

2 days without some type of therapy intervention over a holiday weekend.

This may change for some populations... due to PPS and transfer rule. We'll

see.

Would appreciate other policies/thoughts on this subject.

Tina

Indpls, IN

Therapy on Holidays

There has been a lot of recent discussion on therapy on SNFs. I'm a

relatively new Rehab and SNF hospital. What does everyone do for therapy on

holidays- specifically Thanksgiving, Christmas, and New Years? Has anyone

had any issued raised by their payors on this subject?

We do therapy on all the other holidays, but I'm looking for guidance on

these three. What does everyone do? My staff is starting to ask for their

time off.

Thanks in advance,

Jon Turton

St. ph Regional Rehabilitation Center

, Texas

______________________________________________________________________

[Guest guest]

We have a similar scenario, although we just started with holiday and Saturday

coverage at our SNF site. We do not cover Christmas, Thanksgiving and New Years

day, but try to assure that patients go no longer than 2 days without coverage.

Have not moved to 7 day week coverage, yet. We are a rural area, and staffing

for 7 day coverage would be very challenging at this point. Pressure is mounting

for increased service at SNF in our area as well. Good Luck!

Bill

Rockport, ME

>>> Carol Rehder 09/21 9:25 AM >>>

We see wounds which have a Dr's order for 7 days a week, on Sundays and holidays

1 x. We have a PT or PTA who is scheduled to see them. If a PTA is scheduled,

and a new wound eval order comes in by noon, on Sun. or the holiday, we have a

PT on call to come in and see them by 4 pm. If we have a holiday weekend where

a patient could potentially go two days without, then it is the therapist's

option which day, (Sun. or the holiday), that they want to come in to see any

new skilled patients. In any event, the wounds are seen 1 x daily regardless.

>>> " and Tina Rosier " 09/19 1:26 PM >>>

Inpatient acute: we are closed on Thanksgiving (new this year) and

Christmas. We provide minimal coverage on New Year's Day (new ones, orthos,

stats, and perhaps may be adding some of the 10 DRGs that fall under the

transfer rule.

Our general philosophy is that we do not want patients to go any longer than

2 days without some type of therapy intervention over a holiday weekend.

This may change for some populations... due to PPS and transfer rule. We'll

see.

Would appreciate other policies/thoughts on this subject.

Tina

Indpls, IN

Therapy on Holidays

There has been a lot of recent discussion on therapy on SNFs. I'm a

relatively new Rehab and SNF hospital. What does everyone do for therapy on

holidays- specifically Thanksgiving, Christmas, and New Years? Has anyone

had any issued raised by their payors on this subject?

We do therapy on all the other holidays, but I'm looking for guidance on

these three. What does everyone do? My staff is starting to ask for their

time off.

Thanks in advance,

Jon Turton

St. ph Regional Rehabilitation Center

, Texas

______________________________________________________________________