Harmony Healthcare Blog

COT OMRA: What to Consider?

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA 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, RUG, PPS, ARD, Change of Therapy

Capturing Mood Disorders On The MDS 3.0

Posted by The Harmony Team on Wed, Jan 18, 2012

For MDS 3.0, the importance of coding accuracy for Mood indicators continues to be significant, as well as relevant to quality care, care planning, and reimbursement. One of the goals of MDS 3.0 was to provide residents in SNFs with the opportunity to have a "voice", thus contributing to their overall plan and quality of care in a very individualized way. This is accomplished via the PHQ-9 ©, a questionnaire designed to identify indicators that could possibly predict the presence of depression, and based on the scores, the severity of the symptoms as well. The results are beneficial for the purpose of referral to the physician and/or the appropriate mental health professional, as well as to promote optimal care planning to provide for the resident's personal needs. Mood distress is often under diagnosed and under treated in the long term care setting, yet it is associated with significant morbidity. The presence of depression often correlates with weight loss due to refusals to eat, decline in ADL independence, decline in social skills and peer, staff, and family interaction, as well as overall reduced quality of life.

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Topics: RUG, MDS 3.0

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