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Thanks, this is not my understanding, but things
may have changed so I may be incorrect.
It was my understanding that the purpose of
Section T when it was originally conceived of was to protect the facility from
those times when a resident who was thought to be a good rehab candidate at the
time of the therapy evaluations and POCs did not meet original
expectations. So for instance, lets say that a resident with a recent CVA
who was receiving aggressive therapy in the hospital, was admitted to the SNF,
evaluated by the Therapists and thought to be able to tolerate 60 min. per
day from each discipline. If this were to happen, Section P would calculate the
resident to be an UH. The therapists complete Section T estimating 10 days of 3
disciplines for a total of with 9000 minutes. If the resident then becomes
ill on day four and therapy is discontinued, the resident will have only
received 240 minutes. If Section T was completed with the original projection,
the resident would RUG at RH rather than RM. If I am not
understanding this correctly, or if I have missed a CMS
Transmittal re-clarifying how to document Saction T and its purpose, please
send me the reference. Thanks in advance.
Gail Neustadt
----- Original Message -----
Sent: Monday, April 12, 2004 8:41
AM
Subject: RE: therapy minutes
Gail.
Section T is a combination of actual minutes provided up to the ARD as
well as a projection of what additionally will be provided up to day
15. You do include the actual minutes provided from Section P in your
projection in Section T.
Ron
Hi Rena,
Thanks for your comments and reference. Could
you also comment re theestimate of the minutes being just that an estimate,
prior to actual minutes being provided? Thanks in advance.
Gail
----- Original Message -----
Sent: Saturday, April 10, 2004 5:24
PM
Subject: Re: therapy minutes
It's not surprising that folks are not
certain of the answer to this question, because it has been answered a
couple of different ways in recent years. However, the regulation is
- if you know coming in the door that the resident will be leaving prior
to day 15, then you must enter the number of days the resident is expected
to be in the facility and receiving the services.
It is the
following section of the PPS Final Rule (July 30, 1999, page 41662) that
is at the center of this answer:
If the physician orders therapy
for 10
days, the projected number of days in
section T will be 10
rather than 14;
likewise, if the physician does not order
a limited
number of days, the projection
will be based on the entire two
weeks,
assuming the beneficiary's continued
stay and receipt of
services.
The RAI User's Manual clears up the question of what to
do if the resident is expected to stay for at least 15 days but leaves
early:
"Calculate the expected number of days through day 15, even
if the resident is discharged prior to day 15." and "Calculate the
expected number of minutes through day 15, even if the resident is
discharged prior to day 15. (p. 3-216)." In that case, of course,
you would bill only for the number of days the resident was actually in
the facility and receiving the services.
Rena
Rena R.
Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse
Assessment Coordinators
[EMAIL PROTECTED]
Subj: therapy minutes
Date: 4/10/04 5:56:12 AM
Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the
Internet
I work at the SNF unit of a hospital, and
most of our patients are high level.When PT and OT evaluate these
patients, usually the estimated duration of therapy is 5-7 days
only,then they're discharged home. Therapy orders are usually written PT
and OT daily for 7 days. My question is filling out the section T of the
MDS,in the estimated number of days and minutes. If the patient is
discharged after the 7th day therapy was rendered, should I enter 7 days
as the estimate number of days, and the total minutes rendered on the
estimate number of minutes? Or should I calculate the estimated number
of days and minutes through day 15 eventhough i know from the start that
this patient will only stay here after 7 days of
therapy?
i.e....April 1 - date of
admission
2 - PT/OT eval and tx day 1
= total min. for both = 60min
3 - day
2 of
therapy
45min
4 - " 3
"
45min
5 - " 4
"
45min
6 - " 5
"
45min
7 - " 6
"
45min
8 - " 7
"
30min
9 - dc
home
The total therapy minutes
for example is only 315 min. In section T, should I write 7 days and 315
min? Or estimate until day 15 eventhough I know that the patient will be
discharged?
Thanks...
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