Summer is a great time to spend time with family and friends. The summer sun allows us to enjoy many outdoor activities. Barbecues, swimming, and trips to the beach make summer an exceptional time of year!

For aging adults, the summer months can also be hazardous to your health and heart. Problems like dehydration, sunburn, and exasperation of pre-existing conditions are common after too much exposure to the sun. For people with heart conditions, the heat can be a matter of life and death. It’s important to stay safe when the temperature rises!


Tips for Beating the Heat:

  • Stay Hydrated: Seniors are less likely to feel thirsty and dehydration can set in quickly. Be sure to drink the recommended 6 to 8 glasses of water a day.
  • Apply Sunscreen: Sunscreen takes time to work, so apply it prior to going outdoors. Reapply the sunscreen every two hours.
  • Dress for the Weather: Wear lightweight, breathable fabric such as cotton. Wide-brimmed hats can help protect from the sun.
  • Wear Protective Eyewear: Sunglasses can help reduce damage that could cause cataracts and age-related eye disease.
  • Stay Indoors During Peak Heat: The sun is most intense during the middle of the day (12pm to 3pm). Schedule your outdoor activities in the morning or evening when the weather is cooler.
  • Check Your Medications: Some medications can cause increased sensitivity to the sun. Look at the warning labels and talk to your doctor about concerns or questions you may have.


How Therapy Can Help
Heat is stressful on the cardiovascular system and can exasperate cardiopulmonary conditions making it more difficult to breathe. If you have heart and lung disease, you may benefit from Physical and Occupational therapy. Therapy can help individuals manage and minimize the debilitating effects of pulmonary and cardiac diseases by helping you control your symptoms and resume an active life within the limits of your condition. Talk to your doctor today about the benefits of therapy for your cardiopulmonary needs!

Are you making evaluation complexity coding too complex? Don’t make this more difficult than it is! Instead of trying to navigate all of the fancy terminology being used to educate us on how to correctly code complexity, let’s try looking at it plain and simple.

Here are some common problems that have already been discovered and tips for improvement (in plain language):

1. Clinical Decision Making
Clinical reasoning and decision making occurs throughout the evaluation as the clinician decides which questions to ask, what assessment tools and tests to use, identifying goals, deciding what modifications are necessary, etc. Keeping in mind all decisions being made through the course of the evaluation and documenting/justifying those decisions will provide support of the complexity chosen.

2. Patient History
Consider what you need to know about the patient’s medical history to make clinical decisions and develop a skilled POC. Be sure to clearly document all aspects of the patient’s history that you used to determine the plan and goals. Explain specifically how the patient’s medical history is impacting the current POC and your approaches to therapy intervention.

3. Occupational Profile
OT should document detailed description of the occupational profile. Use an Occupational Profile worksheet to assist. If you don’t already have a worksheet, create one for your OTs to help guide the narrative within the documentation. AOTA has provided an occupational profile template. Utilize the available tools from your associations and simply describe the areas within the evaluation.

4. Formal Tests
In order to accurately code the complexity of the evaluation, formal testing must be completed. Make frequently used tests readily available. With the new coding, it is necessary to go ahead and complete at least one formal test on day 1 with the initial evaluation and summarize the results within the POC. This is another component to accurately coding the complexity of the evaluation. Be sure to update the results of the selected tests at re-cert and DC as well.

5. All Criteria Required
Remember that you must code “down” if all criteria for the complexity level is not met. All criteria must be met (and documented) for each complexity level.

Keep in mind that the evaluation is still the same evaluation! Consider that by coding the complexity level, this is really just a way to ensure that we are documenting more thoroughly and justifying our services. I think that often we take for granted the skill and sophistication that we provide. Document your thinking process as you are creating the plan for your patients. No one else is able to do what you do!

Guest Blog

Cassie Murray, OTR, IASSYC CYB 
Cassie Murray is the Executive Director of Clinical Services for Healthcare Therapy Services. A 1994 graduate from Indiana University in Occupational Therapy, Cassie has over 22 years of experience in long term care, hospital, outpatient and home health. She provides support for HTS therapists and partnering communities through program development, training on regulatory requirements and ongoing quality assurance. She is active in state and national associations such as Leading Age, AHCA, NASL, AOTA. Her passion for rehabilitative services is inspired from personal experience with her father suffering a stroke while Cassie was in high school. This lead to her successful career path in occupational therapy.

To contact the author: | 800-486-4449 ext 210 |


How Would You Rate Your Rehab Department?

If your answer isn’t a solid 4-Star or better, it might be time for a long discussion, or possibly a change or overhaul of how your services in your rehab department are being delivered.  If you can’t give them at least the high school equivalent of a B+, you’ve got some valid issues to discuss and work to be done.

Amidst the enormity of never ending and changing federal and state policies, issues, mandates and initiatives that affect our long-term care industry, we must begin to expect our partners (a.k.a. our vendors, business associates and internal departments) to accept a portion of the burden and help our SNF facilities move forward.

I’ve spent the last 26 years working both directly for SNF’s and other providers, as well as the last sixteen years in contract rehab, auditing and risk management. I have seen a lot of great…and not so great therapy departments. I have assisted in cleaning up a fair amount of therapy programs, and I’d like to share just a few pointers on what to look for, and how to begin.  In essence, what qualities or attributes should you look for?

I’m sorry, but fancy equipment, lovable therapists, low rates and glossy sales binders simply don’t make the difference between success and mediocracy these days. I hear it all the time. Let me share a verbatim statement from one of my old cases.

“Oh, we just really love Ruth Ann, our therapy manager.  She is just wonderful.  I don’t get any reports or hear anything from the corporate office, but I love our therapy team.”

Not. Good. Enough.

It’s 2017 people!  7 days a week is a standard expectation.  Therapy managers in the morning meeting and care plans should be a given. Competent therapists that are skilled in the treatment of older adults is a no-brainer. This is basic stuff. What I am asking you to do is dig deeper. Look at the systems, look at the foundation of this partner. What have they done for you lately? And what are they doing for you tomorrow to compliment the objective and vision for the future of your building?

Here is what your therapy provider should be doing for you…

  • Complete transparency as a Partner; if a reimbursement changes, address it then so you aren’t on the losing end, such as in Managed Care contracts.
  • Case mix support. They should know your state’s system, and identify routes to help improve and maintain this.
  • Extensive programming and protocols, especially for those diagnosis most prominent in your mix.
  • Full auditing services (and not by someone with a vested stake for it to look “good”).
  • Complete ADR and Denial support.
  • Marketing, and not just talking about it, but doing it.
  • Tracking and reporting your Outcomes. Value based is coming, it’s time to be prepared.
  • Provide you with hospital reports for your feeder hospitals, including re-hospitalization numbers.
  • QM and QAPI active participants.
  • NOT turn a blind eye on your behavioral and dementia patients. They have needs, too, and the therapists should be trained on programming and techniques.
  • PUF analysis and a plan of correction if they are putting you at risk.
  • PBJ uploads.
  • Management of the Program and Staff! If that Regional or Manager above the building level isn’t there regularly, there is an issue.  Not everything can be seen, completed or corrected remotely.

A culture of stewardship and servitude involving real people that are  true partners that exhibit  forward thinking, progressive and strategic ideas and with the momentum for actual implementation, are the cornerstones that effectively help drive SNF providers forward and upward in service and success . This success is triggered and facilitated by not only your internal team but also your vendors, especially rehab. These areas are what can truly, ultimately make the difference between being a 3-star building and a 5-star building.  It determines being financially viable or struggling with odious and resource-draining factors such as audits, tags and/or reduced census.

If you take nothing else away from this short statement, please just take the time to look closely, seek outside help or assistance, or at least review your current status in all areas.  You may be surprised at what a difference a few changes can make.

HTS is your partner in therapy. If your facility or company would like a free financial and clinical analysis or consultation, contact us.


Kerry Wright, OTR/L
Executive Director of Business Development and Southern Operations
Healthcare Therapy Services, Inc.