I think there are many different things
such as this that different facilities will see. I agree that anything standard
all the time indicates a tendency to treat by a rule of thumb. If this
is going on in your facilities I would have the DON, Administrator and Therapy
company or department head look at why this is being done. Sometimes this
is in response to a contractual issue and sometimes it is just what the
therapists think they ought to be doing/were "taught" to do. If you get together
and discuss it, perhaps you can work why it is being done and how it should
be modified.
-----Original Message----- From: dfrias
[mailto:[EMAIL PROTECTED] Sent: Monday, November 03, 2003 11:25
AM To: [EMAIL PROTECTED] Subject: Re: Therapy
minutes
Dolores.....how about this little
addition....
First day of treatment ALWYAS has an
additional 15-30 min. Hummmm sounds like a screen charge to me! However,
when asked the answer is...."first day of treatment always takes longer
because we don't know the resident".
This is correct. However, I have about ten
clients that have NEVER had therapy documented other than in 15 minute
increments. And I have never had an FI question this in the last 24
years. I have had therapy denials for other reasons, but not for
this.
When are the fiscals, the OIG, CMS , etc., going to wake
up to the rubber stamp therapy documentation?
Fractured
femur with ORIF with pin or rod, or replacement Resident can be 65 or
95 doesn't matter. PT 5xwk x30 days--if therapists work only
5 days a week PT 6xwk x30 days--if therapists work 6 days a week. Now
I see very creative documentation. They figure out the minute criteria
for each RUGIIIgroup so we now
have M
T
W
T
F
(S) 60
45
60
45
60 45
And no one questions
this. Comments? Delores
Recording therapy
minutes in 15 minute increments all the time can make reviewers very
suspicious - now this may get more attention depending on the region.
However, the PPS final rule addressed this issue and indicated that exact
minutes spent treating were to be documented and not always in 5 or 10
minute increments. Also, the Part B therapy time is to be calculated based
off of timed or service based codes, timed code units are to be calculated
according to the provided rounding table ( i.e 8 to less than 23 minutes
is one unit) and still the exact minutes documented.
Delores L. Galias, RN, RHIT
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