Re: Counting Minutes in PPS

[Guest guest]

So then HCFA is saying that the 720 minutes must be provided in the

first five days.

Well within the first 7 days at least, if you want to use part of the

grace period.

Kathy Shields

Professional Therapy Providers

St. Louis, Missouri

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[Guest guest]

So then HCFA is saying that the 720 minutes must be provided in the

first five days.

> Re: Counting Minutes in PPS

>

>This is straight from the horse's mouth (HCFA that is):

>

>Q. Can a patient classify into the RUx or RVx groups based on his

>5-day

>assessment?

>

>A. Yes, it is possible. The only patients who will classify into

>either of

>these sub-categories are those for whom a week's worth of minutes at

>the

>Ultra-High or Very-High level have been provided and recorded in

>Section P by

>the assessment reference date of the 5 day MDS. As on all 5 day

>assessments,

>Section T must be completed, but the minutes of expected therapy

>recorded

>there will NOT (emphasis added) influence the classification of the

>patient.

>

>Hope that helps Albert!!

>

>Kathy Shields

>Professional Therapy Providers

>St. Louis, Missouri

>

>______________________________________________________________________

>

>

[Guest guest]

My understanding is that part of what you say is correct and part

incorrect, please see www.hcfa.gov/medicare to find the MDS Q and A's

1) P is actual minutes from the " assessment reference date " (day 1-8 your

choice) back to the day of admit. Our policy is that it can be completed

within 7 days after the actual " assessment reference date " , but we will

fill it in within 2-3 days so that nursing can input into our MDS software.

2) Rehab ultra high and very high, function differently than the High,

medium and low categories, in that in order to " sort " into the 2 highest

categories the P minutes are the only ones that will be used according to

the guidelines, e.g. 5 days in one discpline, 3 days in another, and 720

minutes total inclusive of all disciplines for ultra high.

3) locking in only means that this is the time when nursing determines the

MDS is complete(hopefully by day 14, but sooner in some cases) and then

they transmit it to the data for payment.

4) the ADL scores determine subcategories within the RUG category e.g.

rehab ultra high A, B or C. A, B or C categories each have different

payments attached to them.

5) again, 720 minutes is not per week per say but from the admit date to

the assessment reference date.

6) the tricky part comes with T, for high, medium and low categories, i was

told by someone at HCFA that they are going to fax me info on the

" pseudocode " that may help to determine minutes for people who are rehab

high patients, but havent' met the actual P minutes (e.g. 325), because as

you know you can get into the high category with 65 P minutes, and 520 T

minutes, for example.

I will share this when I get it as I don't believe it has been posted here,

and even though the MDS FAQ says that it is posted at www.hcfa.gov i have

not been able to find it there, and question what exactly exists, a

computer code or some kind of chart.

Kind Regards,

>I was at a conference about PPS, again, and have heard that if we are

>seeing a patient and believe this patient belongs in the highest RUG

>category, (i.e., the Ultra group), we need to get all of our 720 minutes

>(not just a percentage of the minutes)in within the first 5 days, if that

>is what we are " locking " in as our values in Section P of the MDS.

>

>My belief is that you put in the actual minutes you have treated the

>patient for, but that in Section T, you put in what you project the

>patient's number of minutes to be per week. This reporting, plus an

>accurate reporting of the patient's ADL's drive the RUG category, not the

>fact that you did or did not get the 720 minutes in. I would also argue

>since the 720 minutes is per week and not per when you lock in (5 days),

>that the logic does not work in this case.

>

>Understanding? Rebuttals?

>

>Albert J. Yoshida, MBA, PT

>

>

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