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We LOVE Supporting Our Communities with our Partners!

We had a Great Time at the MCHS Back-to-School Bash

Thanks for including us, Metcalfe Health Care Center, at the Back to School Bash. We are proud to be your partner in therapy!

“Starting the School Year off Strong! We had a great time at the MCHS Back to School Bash last Thursday. Amy Neighbors and our therapy department conducted grip strength testing for both adults and kids and made it a bit of healthy competition. We are proud to provide outpatient therapy services for all ages. Just another way we serve our entire community. Here’s to a great 2019-2020 school year. Go Hornets!”

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PDPM: What Hospitals Need to Know

1. Start Date: October 1, 2019

2. Applies only to traditional Medicare Part A Skilled Nursing Patients

3. PDPM is a site-neutral reimbursement structure for post-acute care.

4. May impact SNF episodic spending

5. May create opportunities for SNF to increase their clinical scope to accept higher acuity patients

6. Increase of information needed from the hospitals transfer documentation to justify all active conditions:

  • History
  • Physical
  • Medication List
  • Labs
  • Therapy progress notes
  • Chest X-ray
  • Immunizations

Additional requested information under PDPM

  • ICD.10 codes with specificity
  • All active diagnoses
  • Post-Operative Reports
  • Any physician consults

7. PDPM should NOT affect the timeliness in which patients are accepted by Skilled Nursing Facilities

8. PDPM should not drastically reduce the amount of therapies provided or weekend availability

9. This is the largest change to SNF reimbursement in 20 years

10. There is opportunity to improve processes and care collaboration between hospitals and SNFs for optimal success under PDPM

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National Rehabilitation Awareness Week! September 15–21, 2019

Every year, the National Rehabilitation Awareness Foundation designates a week in September to educate people about the benefits and impact of rehabilitation.

Physical Therapy ◆ Occupational Therapy ◆ Speech Therapy

The goal of rehabilitation is to help an individual heal and achieve their highest level of independence possible. Physical Therapists (PT), Occupational Therapists (OT), and Speech-Language Pathologists (SLP) all work together to help individuals overcome obstacles and accomplish normal tasks of daily living. These therapists work on an individual level, which is beneficial for a range of conditions/diseases, ages and abilities.

Physical Therapy are experts in the examination and treatment of musculoskeletal and neuromuscular problems that affect peoples’ abilities to move the way they want and function as well as they want in their daily lives. Treatment is aimed to reduce pain and improve range of motion, flexibility, strength, endurance, and mobility.

Occupational Therapy uses goal-directed activity in the evaluation and treatment of persons whose ability to function is impaired by normal aging, illness, injury or developmental disability. Treatment goals in occupational therapy include the promotion of functional independence and prevention of disability.

Speech-Language Pathology (Speech Therapy) is the study, diagnosis, and treatment of defects and disorders of the voice and of spoken and written communication. Speech therapy also evaluates and treats neurological and physical disorders and conditions caused by an injury or illness.

When Can Therapy Help?

  • Joint Replacements
  • Post-Orthopedic Surgeries
  • Balance & Gait Training
  • Arthritis
  • Fractures
  • C.V.A (Stroke)
  • Lymphedema
  • Cardiac Conditions
  • Pain Management
  • Back & Neck Pain
  • Parkinson’s
  • Neurological Conditions
  • Swallowing Disorders
  • Language & Cognitive Function
  • Generalized Weakness, or Decrease in Strength
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CMS Finalizes $851M Pay Bump for Nursing Homes, Rolls Out PDPM Clarifications

Article by Skilled Nursing News

The federal government on Tuesday finalized a predicted funding increase for nursing homes, while also formalizing changes to several key quality programs — with an eye toward clarifying some parts of the new Medicare payment model for skilled nursing facilities.

Under the terms of the 2020 final rule for Medicare skilled nursing facilities, the Centers for Medicare & Medicaid Services (CMS) will increase payments to nursing homes by $851 million in the coming fiscal year, which begins October 1 of this year.

That figure represents a slight drop-off from the increase of $887 million projected in the proposed version of the rule, which CMS released back in April; the $851 million comes from a 2.8% increase to the Medicare market basket rate in the final rule, as opposed to a 3% rise in the proposal.

The Tuesday announcement also includes several clarifications related to the Patient-Driven Payment Model, also set to take effect October 1. CMS formally changed the definition of “group therapy” to any modality with two to six residents performing the same or similar activities. That change brings group therapy in SNFs more in line with other care settings, such as inpatient rehabilitation facilities, which use the same definition; CMS currently defines group therapy as activities with exactly four residents.

“As PDPM implementation takes place, CMS believes aligning the group therapy definition serves to improve the agency’s consistency in payment policies across PAC settings,” the agency wrote in a fact sheet about the changes.

Click here to continue reading this article.

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Final Rule Released: What You Need to Know to Win the Race to October 1st

The Centers for Medicare and Medicaid Services issued the FY 2020 Skilled Nursing Facility Prospective Payment System Final Rule which will take effect on October 1, 2019.  This rule finalizes payment policies for Medicare Part A in SNFs and updates the SNF Quality Reporting and Value-Based Purchasing Programs. Below are the highlights:

  • SNF market basket percentage is 2.4% or $851 million for FY 2020 (decreased from the proposed update of 2.5%).
  • The unadjusted urban and rural federal per diem rates will decrease slightly compared to the proposed rule rates.
  • Come October 1, 2019, group therapy will be defined as, “a qualified rehabilitation therapist or therapy assistant treating two to six patients at the same time who are preforming the same or similar activities.”
  • The sub-regulatory process for updating the ICD-10 codes used to classify patients under PDPM has been finalized for FY 2020.
  • Two new quality measures for the SNF QRP related to transfer of health information have been adopted.
  • Baseline nursing home residents will be excluded from the Discharge to Community Measure.
  • The quality measure for Drug Regimen Review Conducted with Follow-Up for Identified Issues will be publicly displayed.
  • The “5-Day Assessment” will be called “Initial Medicare Assessment.”
  • Clarification on the optional Interim Payment Assessment was provided stating, “…the SNF’s underlying responsibility to remain fully aware of (and respond appropriately to) any changes in its resident’s condition is in no way discretionary. Moreover, the discussion of the IPA in the FY 2019 SNF PPS final rule (83 FR 39233) clearly envisions a role for this assessment that is not strictly limited to payment alone: “We continue to believe that it is necessary for SNFs to continually monitor the clinical status of each and every patient in the facility regularly regardless of payment or assessment requirements and we believe that there should be a mechanism in place that would allow facilities to do this.” At the same time, in making the IPA optional, we recognized “. . . that providers may be best situated, as in the case of the Significant Change in Status Assessment, to determine when a change has occurred that should be reported through the IPA.”

 

For more information see  the CMS Press Release and Fact Sheet.

HTS is not only your partner in therapy – Power through PDPM with HTS’ strategies for success. HTS is able to provide comprehensive tools, policies, clinical pathways and education at all levels to ensure success under PDPM. Contact us today for more information on the HTS Partner Plus Program.

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