TheraChirps Blog

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. 

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?

Some states pull their Case Mix information quarterly and some twice a year.  Do you know how often your state pulls information for Case Mix?  Are you using that information to manage your Part B caseload? If so, how?