RE: Significant Changes in Regard to Rehab

[Priscilla Bullard]

When a rehab patient goes off skilled therapy, the facility is paid for 8-10 days at a rehab rate without delivering rehab services. CMS feels that this compensates for the periods that a resident receives skilled therapy without being in a rehab category. A couple of possible solutions are: -If you are dealing with a resident who is NWB for an extended period of time(ie a TKR), defer the start of Part A coverage until weight bearing is ordered.  Sometimes this means the resident ends up at home after a week of training in NWB techniques, with a readmission when able to tolerate more therapy. -go ahead and give a few days of therapy. I have seen that pull up transfer/ambulation in Section G enough to meet SCSA criteria. Don’t forget, though…..you are paid for therapy even when you don’t provide it, so sometimes you have to provide it without being paid.  You have to provide a certain number of days/minutes without a rehab RUG category before the ARD to get a rehab category ON the ARD.   Cil Bullard RN, CPC   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Julie Schwarzenegger Sent: Monday, March 29, 2004 10:48 AM To: Message Board MDS Subject: Significant Changes in Regard to Rehab   I am the operations manager for a contract therapy company in NC so this questions may seem trivial to you -- I apologize for that.   Here's the scenario:  A patient is discharged from therapy but remains skilled by nursing.  Several weeks later, when the patient is between assessments, he/she becomes appropriate for rehab services as a result of a weight bearing status change, for example.  Is there any way to achieve a rehab RUG by completing a significant change?   We encounter this problem frequently in our nursing homes and end up treating the patient for up to two weeks under a nursing RUG.  It seems like Medicare should allow the facility to capture a rehab RUG but our MDS coordinators often say that a patient's weight bearing status change or increased ability to participate in therapy is insufficient in warranting a significant change.    Any information you can offer is greatly appreciated.     Julie Schwarzenegger, OTR/L Operations Manager Ballard Therapy Services [EMAIL PROTECTED] (704) 293-9859   Confidentiality Notice: This electronic mail message, including my attachments, is for the sole use of the intended recipients and may contain confidential and/or privileged information. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Any unauthorized review, use, disclosure or distribution is prohibited.