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Even though we have been into this "thing" called PPS for 5 1/2 years, we
ALL keep learning!
I am a
therapist and was a regional manager (as a Rehab manager and a Clinical
Reimbursement manager) for a nursing home company. I think that the therapist
and the regional are miss informed. They should have let you know about the
lowering of minutes and you should have been able to adjust the ARD to capture
the higher RUG group. The Rehab people (like many rehab people, and I can say
that because I am one of them) have a lot of learning to do in regard to the
MDS payment system.
Good
Luck!
Denise
-----Original
Message-----
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Joyce Nicholson
Sent: Monday, January 26,
2004 1:27
PM
To: [EMAIL PROTECTED]
Subject: therapy minutes--try
again
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?
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To admit you were wrong is to declare you are
wiser now than before.
--Unknown
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