Re: Rehab Low Category

[Gail Neustadt]

Hi Delores, This is too bad because I know there are some excellent therapists out there. We can't give up. For many years I was on the road conducting seminars on how to set up Functional Maintenance Programs (FMPs) which I now call Skilled Maintenance Programs (SMPs) differentiated from Restoative Maintenance Programs (RMPs). The one thing that may be a wake up call to therapists and restorative nurses are audits. Audits from the DPW which requires back-up documentation for skilled claims. "If it wasn't written, it wasn't done," still applies and the Medicaid program may just ask for the overcharges from undocumented therapy training and/or restorative procedures to be paid back. If the corporations had any idea that a comprehensive restorative program is not only a best practice, but brings in $$$$$.   Regards, Gail ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Tuesday, March 16, 2004 12:37 AM Subject: Re: Rehab Low Category Gail, It sounds perfect to me.  When I first saw the RUGs I was very encouraged.  I thought that everyone got it that we now had a system covered by Medicare Part A benefits to treat residents at the level they required.  And that level could go up and down during the covered period according to resident needs. Start slow on admission and build as endurance and strength increased and then taper down and smoothly transition to restorative nursing.  What I get is same old same old.  I have been consulting since 1980  I have no idea why therapists don't just have rubber stamps made Gait training Transfer training Strengthening exercises Care giver training 5xwk for 30 days And I almost never find documentation of WHO the caregiver is AND what TRAINING was done. If restorative or mention of care giver is documented before the last two days I am elated. I have given up, I rarely audit therapy as it only results in resentment from therapists. [although I give copious handouts on regs, documentation info from THEIR organizations, etc.] and administrators telling me they have never been denied and they think therapy is 'doing' fine.  I never said they were not 'doing' fine, they are probably providing great therapy but documentation stinks.  I have this sneaking suspicion that what is not documented IS NOT DONE. Delores Delores, I think that the therapists have some problems understanding that Restorative plays an important role during ongoing rehab. Many therapists 1. fear for the safety of the resident but need to ask restorative nurses to carry out unskilled procedures that supplement what they are doing and 2. the therapists are afraid that if restorative can function independently then Medicare might question the need for skilled services. However the restorative nurses are under the direction of a licensed nurse and also taking direction from rehab. Does this sound logical or convoluted???!!!   Gail Neustadt, NHA Delores L. Galias, RN, RHIT STATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify D. Galias, RN, RHIT immediately at [EMAIL PROTECTED] and destroy all copies of this message and any attachments.  Thank you for your cooperation