TheraChirps Blog

The Centers for Medicare and Medicaid Services, (CMS) as well as The American Health Care Association, (AHCA) introduced an initiative in early 2012 to improve the quality of care by decreasing the use of antipsychotics in SNFs. Their goal was to decrease the use of antipsychotics by 15% by December 2012.

In the long term care setting, therapy departments are required to balance both Medicare Part A and Medicare Part B patients.  Though it may seem like you should just treat all the patients whenever they need it (and in theory you probably should), staffing patterns don’t always allow that to happen.  As the Part A caseload increases, the ability to treat the Part B folks diminishes.  Unfortunately, we therapists are always good at increasing the Part B caseload when the Part A is slow. 

It’s that time of year where we start to think of what we can do differently to make ourselves better people, so why not apply that same principle to your Medicare Team?  What does your team need to work on this year to be more effective providers of good clinical care?  Consider the following commonly identified areas:

Every good treatment starts with the evaluation process. A thorough evaluation is key, but the documentation is cumbersome and time consuming. Frequently, therapists give away services to the Part B population of the skilled nursing facility simply because they feel the services are too insignificant to warrant the laborious task of documenting what we do.

Intermediaries are reviewing medical records in order to recuperate Medicare Part A and Medicare Part B dollars with more force than ever.  Recently, we have found more and more audits of patients who fall into the Rehab Ultra High category.  This means the therapy documentation of skilled care is under just as much scrutiny as the nursing documentation.  How can you know if your documentation will stand up under audit?  In steps have you taken to educate your team on Medicare documentation guidelines?

CMS recently clarified the use of therapy students with Medicare Part A patients.  Utilizing students in the therapy department has many advantages.  For one, many students are reluctant to pursue the SNF setting due to misconceptions about the type of therapy practiced.  Inviting students into the SNF setting will help dispel some of those misconceptions and increase the number of therapists available for hire.  Second, with the therapy student being an extension of the practicing therapists, there are scenarios where this will increase the productivity of the department.  For example, the Rehab Director that doesn’t normally carry a large caseload can supervise a therapy student with a full caseload.