RE: Significant Changes in Regard to Rehab

[Davina Demerritt]

Those areas have to change first for over 2 weeks before the criteria for significant change is meet.  Facilities just have to deal with that for however long. 

 

Davina DeMerritt, RN

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Richardson, Christine
Sent: Monday, March 29, 2004 4:08 PM
To: [EMAIL PROTECTED]
Subject: RE: Significant Changes in Regard to Rehab

 If the wt bearing status is increased wouldn't that mean that possibly toileting,transferring and ambulation would improve? Wouldn't that be a sig change?

-----Original Message-----
From: carol maher [mailto:[EMAIL PROTECTED]
Sent: Monday, March 29, 2004 10:02 AM
To: [EMAIL PROTECTED]
Subject: Re: Significant Changes in Regard to Rehab

A resident who has a new weight-bearing status would most likely need extensive assistance with ambulation.  Changing from "Activity did not occur" to "Extensive Assistance" is NOT a criteria for Significant change.  There might be other reasons that would allow a SCSA in some cases, but this is not an automatic reason for a Significant Change assessment.  You also must realize that you are receiving a rehab RUG payment for 8-10 days after all therapies discontinue when residents continue to receive skilled services after all therapies end.  So, most of the time, the payment evens out.  Many times,  when there is delayed therapy for weight bearing purposes, the Medicare coverage is delayed until weight bearing is allowed.  In these cases, the onset of therapy would be day 1 for Medicare, then the first PPS asssessment would be a rehab RUG.  So, there should not be a lot of instances where there is a delayed therapy RUG.  Sounds like your MDS coordinator is correct.


-----Original Message-----
From: Julie Schwarzenegger <[EMAIL PROTECTED]>
Sent: Mar 29, 2004 7:48 AM
To: Message Board MDS <[EMAIL PROTECTED]>
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.

/---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/

NOTE: This e-mail message may contain information that is privileged, confidential, and exempt from disclosure.  It is intended for use only by the person to whom it is addressed. If you have received this message in error, please do not forward or use this information in any way. Delete it immediately and contact the sender as soon as possible by the reply option or by telephone at the telephone number listed (if available).  In the event you cannot fulfill your obligation or there has been any improper release of this information, please contact the Privacy Officer at Carondelet Health at (816) 943-4611.