Harmony Healthcare Blog

Change of Therapy and End of Therapy: Unnecessary Assessment Completion OMRA

Posted by The Harmony Team on Thu, Jun 01, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


The Change of Therapy (COT) OMRA and End of Therapy (EOT) OMRA Assessment completion can be complex and confusing.  

It is not uncommon to observe an unnecessary End of Therapy (EOT) Assessment completed resulting in payments at a Nursing RUG Level versus a Rehabilitation RUG Level. 

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Topics: Change of Therapy, End of Therapy, OMRA

MDS 3.0 OMRA Management: Change of Therapy (COT) and Start of Therapy (SOT)

Posted by Kris Mastrangelo on Thu, May 18, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


What is trending this week? A bit of confusion with OMRA Assessment completion. Let’s simplify.

Defining Start of Therapy OMRA

  1. Optional Assessment: 
    • Completed only to classify a resident into a Rehabilitation group after therapy initiates
    • Not required if current nursing rate is higher
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Topics: OMRA, Change of Therapy

Change of Therapy Assessment (COT): To Combine or Not to Combine?

Posted by Sally Fecto on Tue, Mar 21, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


This week’s travels uncovered another pattern.  Many MDS Teams appear to be combining the Change of Therapy (COT) with the next scheduled PPS Assessment.  In many instances, this is not only unnecessary but the combination results in decreased reimbursement for 6 days, (specifically in the case of combing a COT with the scheduled 14-Day MDS). 

It is important to know when to combine the COT MDS Assessment and when to complete the Standalone Scheduled MDS Assessment. 

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Topics: Change of Therapy

COT OMRA: What to Consider?

Posted by Kris Mastrangelo on Wed, Sep 12, 2012

Today I want to talk about the Change of Therapy (COT) Other Medicare Required Assessment (OMRA).  There are a couple of major points that should be kept in mind when considering whether COT OMRA needs to be completed.  For one, how do we manage our therapy case load to prevent continually needing to complete an off schedule assessment for our PPS or our Medicare Part A patients?  Always remember the COT OMRA is generated because there needs to be a change in the level of payment. This is due to the level of therapy intensity that is being provided.  So, if you have a PPS Assessment and it generates a nursing RUG classification, a nursing RUG score is being paid for a particular PPS Assessment.  If Therapy is involved, you are monitoring your COT Assessment Reference Dates, and the change in therapy intensity decreases, you do not need to complete a COT OMRA (if you are being paid at nursing RUG level).  Many times it is forgotten that this is both clinically related as well as payment related.

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Topics: Medicare Part A, PPS, RUG, ARD, Change of Therapy

COT Assessment through the Eyes of CMS

Posted by Kris Mastrangelo on Thu, Aug 09, 2012

Change of Therapy Assessment as it was discussed during the CMS Provider training in St. Louis, MO.: 

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Topics: CMS, ARD, Change of Therapy

CMS COT - Medicare Minute

Posted by Kris Mastrangelo on Wed, Apr 11, 2012

CMS COT - Medicare Minute

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Topics: CMS, ARD, Change of Therapy

Change of Therapy - Medicare Minute

Posted by Kris Mastrangelo on Wed, Feb 08, 2012

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Topics: Change of Therapy

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