Can you describe SMP's?
[EMAIL PROTECTED] wrote:
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 -----
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
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