RE: changes in nursing home

[Guest guest]

Todd, this little nursing home is in trouble if they have not had training on

the MDS 3.0. The new provisions that went into effect 10/1 is part of that. Now

only 2 people can be in concurrent therapy at the time. On the MDS, if u have

both people in for 60 min - you put 60 on both MDS (in the new concurrent

therapy box) but it is recalulated to only be half the amount put in the box. I

would be happy to talk to anyone but the whole building could be in trouble if

they did not switch patients over correctly on 10/1. All treatments are to be

coded either individual, group or concurrent therapy. I would be happy to talk

to her. My email is jbates@...

Sent from my Cellular South BlackBerry® Smartphone

changes in nursing home

My wife is a part time PT in a SNF. She asked if I would post a couple

questions on her behalf. Can anyone either share the info we are looking for or

point us in the right direction? She was told today that for admissions that

were not seen for an eval on the day of admission the SNF would not be

reimbursed until the eval was completed. Is this true? Also, apparently there

have been changes in reimbursement as well, as far as treating groups vs

concurrent vs one on one - can anyone expand on what needs to be done, or what

may have changed? This is for a small SNF in Pennsylvania.

Thanks in advance for any help.

Todd Bardua PT

Director of PT

Bloomsburg Hospital

Bloomsburg PA

[Guest guest]

As of October, the RUG classifications have changed. The SNF will be reimbursed

prior to the therapy evals, but not at a rehab RUG like they have been in the

past. Rehab RUG payments, typically the higher end of the spectrum, will now

not start until therapy is initiated.

Also, concurrent treatment is now limited to no more than two patients at a

time, and only ½ of therapy time provided as concurrent counts toward the RUG.

The new mds requires that time spent treating concurrently be reported that way,

even though there is no CPT code for it.

(I no longer work in SNF, I left just before these changes took effect.)

Deb Ward, OTR, MPA

Director of Rehabilitation Services

Truman Medical Center, Hospital Hill

Phone:

Pager:

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

tbardua

Sent: Monday, October 04, 2010 12:02 PM

To: PTManager

Subject: changes in nursing home

My wife is a part time PT in a SNF. She asked if I would post a couple questions

on her behalf. Can anyone either share the info we are looking for or point us

in the right direction? She was told today that for admissions that were not

seen for an eval on the day of admission the SNF would not be reimbursed until

the eval was completed. Is this true? Also, apparently there have been changes

in reimbursement as well, as far as treating groups vs concurrent vs one on one

- can anyone expand on what needs to be done, or what may have changed? This is

for a small SNF in Pennsylvania.

Thanks in advance for any help.

Todd Bardua PT

Director of PT

Bloomsburg Hospital

Bloomsburg PA

--------------------------------------------------------------------------------\

--------------------------------------------------------

The information contained in this communication may be confidential and is

intended only for the

use of the intended recipient(s). If the reader of this message is not the

intended recipient(s),

you are hereby notified that any dissemination, distribution, or copying of

this communication,

or any of its contents, is strictly prohibited. If you have received this

communication in error,

please return it to the sender immediately and delete any copy of it from your

computer system.

[Guest guest]

You're absolutely right....sounds like they could be in a world of hurt.

Deb Ward, OTR, MPA

Director of Rehabilitation Services

Truman Medical Center, Hospital Hill

Phone:

Pager:

changes in nursing home

My wife is a part time PT in a SNF. She asked if I would post a couple

questions on her behalf. Can anyone either share the info we are

looking for or point us in the right direction? She was told today that

for admissions that were not seen for an eval on the day of admission

the SNF would not be reimbursed until the eval was completed. Is this

true? Also, apparently there have been changes in reimbursement as

well, as far as treating groups vs concurrent vs one on one - can anyone

expand on what needs to be done, or what may have changed? This is for

a small SNF in Pennsylvania.

Thanks in advance for any help.

Todd Bardua PT

Director of PT

Bloomsburg Hospital

Bloomsburg PA

[Guest guest]

Hello Todd,

This is one of several false rumors going around with the changes occurring

with MDs 3.0. There has been no change in reimbursement from the old system

for patients that are seen by therapy and have 5 days of services (or 3 with

restorative nursing) in the observation period. The use of grace days is

still allowed therefore, seeing the patient on the day of admission is not

necessary to secure a Rehab RUG level.

So if the patient came in on a Wednesday, was not seen until Thursday, then

seen again on Friday, not seen over the weekend, but then seen Monday,

Tuesday and Wednesday, the ARD (assessment reference date would be Day 8,

i.e. Wednesday and the facility will be paid at the therapy RUG from the day

of admission, therapy having completed 5 days of 1 discipline.

What has changed is that you can no longer predict the patient into a Rehab

RUG as under the MDS 2.0. Here, if the patient does not have 5 days of

therapy within the observation period, they will fall into a clinical RUG

(other than having restorative nursing for 6 days and therapy for 3.)

If the patient is discharged from the facility before obtaining a Rehab RUG

(in the first 8 days of the stay) then the facility has the choice of

completing a short stay assessment, providing all of the criteria has been

met. In this instance, the facility is paid at the clinical group up to the

day therapy starts then the therapy RUG from that day onwards.

It will become more of the norm to use grace days for the 5 day assessment

than before, but that is absolutely allowable and therapist should not be

rushing in to treat the patient on day 1 if they are not appropriate for the

evaluation that day.

We have not gone back to 1999 when we were told that you had to get in on

day one as use of grace days was a red flag. Do what is appropriate for the

patient and use grace days.

ine M. o, PT, MCSP

Owner

Encompass Consulting & Education, LLC

8114 NW 100th Terrace, Tamarac, FL 33321-1259

We work hard to make sure you are " getting it right from the start " . Visit

our website at www.encompassmedicare.com and see what we can do for you.

While there sign up for our free e-mail Newsletter " Medicare News and Rules

for Therapists " .

We specialize in consulting services, seminars and customized education

services to providers of Medicare rehabilitation therapy and related

services under SNF Part A and all Part b providers. Follow us on twitter

<http://twitter.com/medicareadvisor> cid:image002.png@...

NOTICE: This communication is intended only for the use of the individual or

entity to which it is addressed and may contain information that is

privileged, confidential and exempt from disclosure under applicable law. If

the reader of this communication is not the intended recipient or the

employee or agent responsible for delivering the communication, you are

hereby notified that any dissemination, distribution or copying of this

communication is strictly prohibited. If you have received this

communication in error, please notify me immediately by replying to this

email.

From: PTManager [mailto:PTManager ] On Behalf

Of tbardua

Sent: Monday, October 04, 2010 1:02 PM

To: PTManager

Subject: changes in nursing home

My wife is a part time PT in a SNF. She asked if I would post a couple

questions on her behalf. Can anyone either share the info we are looking for

or point us in the right direction? She was told today that for admissions

that were not seen for an eval on the day of admission the SNF would not be

reimbursed until the eval was completed. Is this true? Also, apparently

there have been changes in reimbursement as well, as far as treating groups

vs concurrent vs one on one - can anyone expand on what needs to be done, or

what may have changed? This is for a small SNF in Pennsylvania.

Thanks in advance for any help.

Todd Bardua PT

Director of PT

Bloomsburg Hospital

Bloomsburg PA