Here is what the Medicare SNF Manual (Pub 12) has to say about SLP (the new online manual crosswalk seems to need some additional work, but the regulation has not changed from the old manual system to the brand new one):

<<
230.3    Physical, Speech, and Occupational Therapy Furnished by the Skilled Nursing Facility or by Others under Arrangements with the Facility and under its Supervision.--
B.  Speech Pathology.--
1. General.--Speech pathology services are those services necessary for the diagnosis and treatment of speech and language disorders which result in communication disabilities and for the diagnosis and treatment of swallowing disorders (dysphagia), regardless of the presence of a communication disability. They must relate directly and specifically to a written treatment regimen established by the physician after any needed consultation with the qualified speech pathologist.
>>

When it comes to evals, it is the minutes for the initial eval on admission that are not to be included on the MDS.  However, as the RAI User's Manual states on page 3-186:  Subsequent evaluatons conducted as part of the treatment process may be counted.  However, I believe that the barium study would fall into the category of diagnostic study.

You know what I always say:  When it doubt, contact your state RAI coordinator.

Rena


Subj: Re: Counting "outside" therapy minutes
Date: 12/17/03 4:11:55 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet



Rena, I have a question about this.  In the past, the SLP never included the time in the hospital in the "therapy minutes" because they stated they were not providing therapy, they were evaluating a swallowing function.  It is my understanding that minutes spent in the evaluation are not considered when counting therapy minutes.  How, therefore, should the minutes spent during the MBS in evaluating swallowing function be included in section P as therapy?

 
Corey

----- Original Message -----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent: Wednesday, December 17, 2003 3:37 PM
Subject: Re: Counting "outside" therapy minutes


This is incorrect.  All therapy minutes delivered after admission to the SNF may be included as long as they were ordered by a physician, performed by a qualified therapist, and were medically necessary.  According to page 3-185 of the RAI User's Manual, "The therapy treatment may occur either inside or outside the facility."

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]

Subj: RE: Counting "outside" therapy minutes
Date: 12/17/03 12:25:18 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet



No.  No therapy minutes from the hospital stay may be used.  This is in the PPS Final Rules; look on page 41661 of the July 30, 1999 Federal Register-line 12 of the 1st column on this page begins:  âIn addition to the issues discussed...â.  You will note the eval of the residentâs need for therapy must begin in the SNF not in the hospital.



Jane Craven, RN, C.

Sr. Consultant, Nursing Services

Tendercare (Michigan) Inc.




-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Holly Sox, RN, RAC-C
Sent: Wednesday, December 17, 2003 11:15 AM
To: [EMAIL PROTECTED]
Subject: Counting "outside" therapy minutes




Hi Group,


I have a question to relay from an email-impaired friend.





When a Med A resident is sent out to the hospital for modified barium swallow, and returns with documentation of the minutes provided by the SLP doing the study, can these minutes be counted on the MDS?  





Thanks!





Holly F. Sox, RN, RAC-C
Clinical Editor






Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]

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