Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 What kind of documentation do people have to support the 3 hour rule. We have a treatment log/billing sheet which has both billed units and missed units. I haven't been able to find any regs that state documentation guidelines. Thanks Greg Woodsum, PT RMU Therapy Manager Catholic Medical Center Rehabilitation Medicine Unit 100 McGregor Street Manchester NH 03102 > ________________________________________________________________________ > ________________________________________________________________________ > > Message: 2 > Date: Thu, 21 Oct 2004 09:20:40 -0400 > > Subject: 3 hour rule > > > Here's an age old topic! I would like to hear how others are meeting > the 3 hour rule on an inpatient rehab unit. Our FI (Michigan)defines it > as 3 hours a day, 5 out of 7 days. This means that it's based on a > rolling calendar. It wasn't so difficult when we used Mon-Fri as our > five days but as you know patients are admitted and discharged on any > day of the week. > We are struggling with the shorter stay (5-7 days) patients who are > admitted late in the week so two of their days are Sat and Sun. What > kind of schedule do you create for these patients? > How different does your weekend schedules look for all patients? > Staffing and programmatically? > The other struggle is with patients who arrive late in the afternoon on > day of admission. Many times, they do not receive 3 hours of therapy so > we are now down to meeting intensity 5 out of 6 days. > Any suggestions, clarification, ideas, etc. would be much appreciated. > Thanks! > Lori Stoddart > Inpatient Therapy Manager > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 Our FI told us they would verify compliance using the start and stop times documented in the medical record - not from the billed units. We have a time log included in our daily progress note packet that has start and stop times listed for each patient. If there are missed treatments, they are also documented on the time log. From previous experience with FI audits, the easier it is for them to find the info they need, the better! Andi MS CCC SLP Coordinator, Inpatient and Acute Rehab Floyd Medical Center Rome GA 3 hour rule > > > Here's an age old topic! I would like to hear how others are meeting > the 3 hour rule on an inpatient rehab unit. Our FI (Michigan)defines it > as 3 hours a day, 5 out of 7 days. This means that it's based on a > rolling calendar. It wasn't so difficult when we used Mon-Fri as our > five days but as you know patients are admitted and discharged on any > day of the week. > We are struggling with the shorter stay (5-7 days) patients who are > admitted late in the week so two of their days are Sat and Sun. What > kind of schedule do you create for these patients? > How different does your weekend schedules look for all patients? > Staffing and programmatically? > The other struggle is with patients who arrive late in the afternoon on > day of admission. Many times, they do not receive 3 hours of therapy so > we are now down to meeting intensity 5 out of 6 days. > Any suggestions, clarification, ideas, etc. would be much appreciated. > Thanks! > Lori Stoddart > Inpatient Therapy Manager > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2004 Report Share Posted October 27, 2004 , You do daily documentation for acute rehab? Do you do 1 note for the day, or for each session? We currently do weekly documentation for acute rehab. How do others in acute rehab document? Thanks Greg Woodsum, PT RMU Therapy Manager Catholic Medical Center Rehabilitation Medicine Unit 100 McGregor Street Manchester NH 03102 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2004 Report Share Posted October 27, 2004 We recently went to daily documentation. They document at lunchtime, what occurred in am session. At end of day, they add pm start and stop times and any other information that needs to be included from pm session. We do them on the computer where they can be accessed by the UDS coordinator. Saves her time running from chart to chart to track down daily FIMS and any other needed info. Carol Rehder, PT Mgr Genesis Medical Center >>> gwoodsum@... 10/27/2004 8:17:25 AM >>> , You do daily documentation for acute rehab? Do you do 1 note for the day, or for each session? We currently do weekly documentation for acute rehab. How do others in acute rehab document? Thanks Greg Woodsum, PT RMU Therapy Manager Catholic Medical Center Rehabilitation Medicine Unit 100 McGregor Street Manchester NH 03102 Looking to start your own Practice? Visit www.InHomeRehab.com. Bring PTManager to your organization or State Association with a professional workshop or course - call us at 313 884-8920 to arrange PTManager encourages participation in your professional association. Join and participate now! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2004 Report Share Posted October 27, 2004 We switched to daily documentation when IRF PPS started. We felt it was the best way to capture FIM scores on a regular basis. The form is divided into functional categories and the staff documents how the patient performed in each area. People can document as many times in the day as they see fit since they aren't doing a narrative or SOAP note. Our FI also wants to see start and stop times for all treatment sessions and our current form accomplishes that as well. Andi MS CCC SLP Coordinator, Inpatient and Acute Rehab Floyd Medical Center Rome, GA Re: 3 hour rule , You do daily documentation for acute rehab? Do you do 1 note for the day, or for each session? We currently do weekly documentation for acute rehab. How do others in acute rehab document? Thanks Greg Woodsum, PT RMU Therapy Manager Catholic Medical Center Rehabilitation Medicine Unit 100 McGregor Street Manchester NH 03102 Looking to start your own Practice? Visit www.InHomeRehab.com. Bring PTManager to your organization or State Association with a professional workshop or course - call us at 313 884-8920 to arrange PTManager encourages participation in your professional association. Join and participate now! Quote Link to comment Share on other sites More sharing options...
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