RE: Medicare Part A documentation

[Guest guest]

If you look at Chapter 15 in the Medicare Beneficiary Manual, (220.3-

" Documentation Requirements for Therapy Services " Rev.63) you may find

what you are looking for. We do weekly progress notes at this facility.

Recently I heard through the grapevine that 85 % of treatments for

patients with Medicare Part A in skilled nursing facilities need to be

1:1 (therapist: patient). Is this true? Does anyone have a CMS

reference regarding this matter?

Sheila Farmakopoulos, MSPT

Physical Therapy Supervisor

phone:

beeper: 1071

Medicare Part A documentation

Group,

I recently started working at a SNF where they do notes every 2

weeks for Medicare Part A patients that are seen 5X/week. In all the

SNF's I have previously worked (4 facilites over 17 yrs) both PT and

OT documented weekly with a progress note, and then a d/c summary at

the end of care.

Another little twist is that they do an eval at SOC, a progress

note at 2 weeks, a " recert form " at 4 weeks, then a progress note at

6 weeks and a recert form again at 8 weeks, etc. These " recert forms

are the weirdest things I have ever seen! Basically there is no real

area for objective data or functional assessment... it seems to me to

be a form to justify the continueation of therapy .. such as

motivation, reasons to continue therapy, why resident would benefit

from more therapy, etc. You then set goals for 2 weeks, and 4 weeks

and place in chart. At the end of 4 weeks you come back to this form

and write what goals were achieved. I seems rediculous to me, I feel

weekly notes with goals assessed and updated weekly would be much

easier to use, more objective and more consisitent. This whole format

looks like a throw back to the late 90's to me.

What exaxctly are the requirements for Part A documentation?

Weekly, bi-weekly, monthly? Can you send me a CMS reference? I know I

have read info on this but during my recent moves (2 in 6 months) I

have misplaced alot! What do other SNF's do? They have been doing

this for awhile and are pretty " dug in " so I will need back up for

any changes I would like to make. Thank you so much for your help.

N Vollmer, PT