Re: therapy minutes--try again

[KDeniseSRN]

If they feel the resident's minutes should be taper because of the care that is needed, then by all means therapy should taper their minutes, but you should not taper a RUG score and toss money out the window. If they are truly tapering the therapy minutes it should show on their grids, therefore if a review happens it would show that the therapist is ramping down, but to purposely deny the facility their just income is absurd (in my opinion at least). I do believe there are many times that therapy care for residents should be ramped down, but never the RUG level. (again just my opinion) I questioned our lead therapist last week about several resident's who had missed a therapy RUG group by 10-15 minutes, wanting to know why she hadn't brought it to my attention so that the assessment period could be adjusted to capture the minutes. She told me that she was purposely lowering the minutes during the assessment period because one of the two disciplines was planning on discharging the resident the following week or so, and the lower RUG group would better reflect what services would be given. My response was that per MDS rules, we should code the services given now, not what we think might occur within the next month. The therapist brought in her regional boss and they are insisting that if we don't "taper" the minutes to reflect what is expected to occur during the payment period, then we are opening ourselves up for Medicare auditing and could be seen as being fraudulent. What are your thoughts?