I agree with Sue.

Ron
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Ron Carson MHS, OT

----- Original Message -----
From: Sue Doyle <[EMAIL PROTECTED]>
Sent: Sunday, November 02, 2008
To:   [email protected] <[email protected]>
Subj: [OTlist] Doubling patients


SD> Chris,
SD> I work in the same sized rehab unit. What are you total staffing numbers?
SD> Medicare from what the last lot of consulting we had in
SD> (currently still here) CMS does not approve of "doubling" unless
SD> it is billed as a group charge. Where you see any more than one
SD> patient at a time, it is considered a group. When billed as a
SD> group charge it must be able to be clearly demonstrated that the
SD> group was in the clients best interests not the time/staff
SD> management of the unit. Groups need to be structured about similar
SD> type patients with individual but similar goals that are clearly
SD> written for the group process. I have developed several forms for
SD> the groups that we run. Our consultants also warned us that
SD> "dovetailing" is also a practice frowned upon by CMS. (Some of our
SD> consultants have been like the director at Cedar Sinai etc).
SD>  
SD> While there is now written limit on the amount of group time in
SD> the rehab setting as in SNF it is recommended that you stick to no
SD> more than 25% of the total treatment time for a patient be in group 
sessions.
SD>  
SD> Would like to discuss more about scheduling, implementing the 3 hours rule 
etc with you.
SD>  
Sue>> To: [email protected]> Date: Sun, 2 Nov 2008 17:02:48 -0500> From: [EMAIL 
PROTECTED]> Subject: [OTlist] Doubling patients> > Hey gang,> Just a little 
frustrated from last week at work.? I work in a small 13 bed acute rehab unit, 
in which the OTs have had a lot of pride in being occupationally based.? Just 
last week we were told we would have to start "doubling patients" at times 
because of increased census.? My boss is an OT so she should understand the 
correlation between one on one?OT and positive outcomes.? I understand that 
this might have to happen from time to time because of high census, but I have 
been frustrated that no plan has been initiated to find more help or at least 
calling the PRN therapists that could help cover the extra patients, since this 
has been an issue for 6 months.? I am beginning to think that?management is 
just trying to save money, but at the same time expecting the FIM scores to 
improve.? Just wanted to ask if anyone had to deal with this issue and what 
they did to remain occupationally based.? Is it ethically ok to "double", and 
is it ok from a Medicare guidline perspective in acute rehab?? Thanks.> > Chris 
Nahrwold MS, OTR> --> Options?> www.otnow.com/mailman/options/otlist_otnow.com> 
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