Summer allows us to enjoy many outdoor activities and time with family and friends. 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. Problems like dehydration, sunburn and exasperation of pre-existing conditions are common after too much sun exposure. It’s important to stay safe when the temperature rises.

Staying active is very important no matter the season. On days when the summer sun is too intense for outdoor activities, moving indoors may be the best option. Here are some fun activities older adults can do to stay active and beat the heat:

  1. Get your steps in and explore a museum or aquarium
  2. Visit a local senior center to socialize and enjoy outings and activities
  3. Take dance lessons for a fun way to stay active
  4. Walk and window shop at an indoor shopping mall
  5. Join a health club that offers group fitness and aquatic classes
  6. Go bowling with friends or join a bowling league
  7. Workout at home with weights and bands or invest in easy-to-use home gym equipment

Therapy Can Help Aging Adults Stay Active & Independent
Exercise is extremely important in managing many common symptoms of aging. Physical therapists evaluate your needs and teach you how to exercise appropriately for joint mobility, muscle strength and fitness. It can help strengthen the muscles around your joints, help you maintain bone strength, give you more energy to get through the day, help you control your weight, improve your balance and help you enhance your quality of life. Occupational therapists help older adults to safely do the things they want to do, stay active and live well despite limitations. Talk to your doctor today about the benefits of therapy!

Cool off this summer with a refreshing slice of watermelon!
At 92% water, this favorite summer snack is a great source of hydration and loaded with essential vitamins. Watermelon also contains high levels of the antioxidant lycopene, a famous cancer-fighting substance found in tomatoes.

HTS is feeling optimistic as we read the latest reimbursement model change proposed by CMS and released late afternoon on Friday, April 27th. If you haven’t had the chance to dive into RSC-1, this was gearing up to be the biggest reimbursement overhaul since PPS.

The RSC-1 has now been modified and renamed to the Patient-Driven Payment Model (PDPM). The new model is designed to improve the incentives to treat the needs of the whole patient, instead of focusing on the volume of services the patient receives. CMS noted that RCS-1 received considerable feedback expressing concerns with the complexity of RCS-1. As a result, CMS has made significant changes that we are feeling pretty good about. If passed, this would take place starting October 1, 2019 — which means we don’t have much time before it becomes reality.


Here are 7 things we know up front about the PDPM changes to note:

  1. PDPM will be Much Less Complex than RSC-1
    Under the RSC-1, there were actually over 130,000 different possible classifications. The PDPM reduces this by nearly 80%. RUGs will certainly be going away, but this may make the reimbursement calculations much less of headache for all parties involved.
  2. Therapy is Detailed in the Discharge PPS Assessment
    A proposed modified section O requires PT, OT and ST details on all PPS discharge assessments for all Medicare A discharges (including those who DC from the facility). Therapy details include: start and end dates, total individual minutes provided, total concurrent minutes provided, total group minutes provided, and total days provided. This may be CMS’s way of safeguarding against underproviding and ensuring that patients receive what they need versus greatly reducing or eliminating necessary therapy services.
  3. PT & OT are Separate Payment Categories
    Under the RSC-1 model, PT and OT were a combined payment and ST was considered separate. Noting the obvious concerns, we are happy that each discipline will receive their own payment classification. Additionally, the new model eliminates the cognitive impairment factor from the PT and OT classification.
  4. Group & Concurrent Allow for a Total of 25%
     Under RSC-1, it was proposed to allow 25% group therapy and 25% concurrent therapy. Under the PDPM, there is a 25% group and concurrent therapy combined allotment.
  5. Section GG is Even MORE Important
     Replacing section G with GG for the functional component is required for PT & OT payment classifications, as well as,nursing case-mix classification. 6 areas are scored and totaled for the functional measure: eating, oral hygiene, toileting, sit-to-lying, lying-to-sitting on bed, sit-to-stand, chair/bed-to-chair, toilet transfer, walk 50 feet with 2 turns, and walk 150 feet. HTS implemented mandatory use of the CARE Tool for all therapists in 2014 to ensure that our outcomes and benchmarks are congruent with CMS.
  6. Reduced Burden of Multiple Assessments
     The reduction in required assessments as proposed with RCS-1 remains in the PDPM. Only 2 PPS assessments are required: 5-day assessment and D/C Assessment. PDPM adds an optional “Interim Payment Assessment” (IPA) which would allow for a resident to be re-classified if criteria are met.
  7. Reduction in Reimbursement with Length of Stay
    PDPM calls for reduction in reimbursement correlating with length of stay for PT, OT, and Non-Therapy Ancillary (NTA) classifications. For PT and OT, days 1-20 would be reimbursed at the full rate. On day 21, a decreasing adjustment factor of 2% is applied every 7 days throughout the remainder of the stay. NTA days 1-3 are reimbursed at an increased adjustment factor of 3. Day 4 through the remainder of the stay, the reimbursement is adjusted to a factor of 1. These adjustments are based on Medicare’s research indicating PT, OT, and NTA costs decrease the longer the resident stays.
Read More About the PDPM:

We Are Optimistic and Committed

We continue to be optimistic considering the enormous changes we are facing with this new payment model. CMS has an open forum and NASL and other groups are already collaborating on the details. CMS posted provider-specific impact data reflecting FY 2017 payment under RUG-IV compared with what the payment would have been under PDPM. After a full review, the total payment was indeed budget neutral.

You may view your SNF’s impact by following the link above (“CMS provided tools”). As we know more information, we will gladly pass it along. We are committed to being good partners in rehabilitation by informing our clients and colleagues with the most up to date information on rehabilitation and post-acute care.

Cassie Murray, OTR, QCP, IASSC CYB
Executive Director of Clinical Services
Healthcare Therapy Services, Inc. | 800.486.4449 ext 210

HTS is a leading contract therapy and wellness provider in the Midwest. As the trusted authority in post-acute rehabilitation, our clients look to us to not only maintain exceptional clinical collaboration and outcomes, but also to be a trusted partner in helping their organizations perform better. Since 1988, HTS has been an independently owned, trusted, ethical provider of therapy services for senior living communities, home health agencies and hospitals.

Therapist owned and managed, our mission is to provide the very best people and programs to move our clients and employees forward so that together we can provide a “hope and a future” Jeremiah 29:11 to those we serve. We have grown from a single provider (who has been a longstanding client since 1988) to a company employing over 1,800 therapists in the Midwest and Southern states.

Living With Arthritis

Arthritis is a condition characterized by painful inflammation and stiffness of the joints. More than 50 million adults have one of the 100 different types of arthritis. Although we think of arthritis as a disease associated with aging; it affects people of all ages, sexes and races.  It can be life changing and debilitating. In the United States it is the leading cause of disability.


Common Arthritis Joint Symptoms:

  • Swelling
  • Pain
  • Stiffness
  • Decreased range of motion

*Symptoms may come and go and they may even change in their severity. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs.


Get Moving!

Walking is a great form of physical activity to help manage chronic diseases like Arthritis. In fact, walking has been shown to improve arthritis pain, fatigue, function, and quality of life.  Adults with arthritis are encouraged to get 2 hours and 30 minutes of moderate-intensity aerobic activity (brisk walking) per week and do muscle-strengthening activities at least 2 days a week.


Therapy Can Help Manage Arthritis Symptoms

A physical or occupational therapist can help you manage the symptoms of arthritis. Physical therapists evaluate your needs and teach you how to exercise appropriately for joint mobility, muscle strength and fitness. Physical therapists can also recommend exercises for you to do on your own. These exercises might include; range-of-motion exercises, aerobic exercise and strength training. Exercise is extremely important in managing arthritis symptoms. It can help strengthen the muscles around your joints, help you maintain bone strength, give you more energy to get through the day, help you control your weight, improve your balance and help you enhance your quality of life. Occupational therapists can also help by teaching you how to protect and reduce stress on your joints while exercising and performing daily tasks. Talk to your doctor today about the benefits of both physical and occupational therapy for your arthritis needs.


Sources: Arthritis Foundation,