by Stacy Baker, OTR/L, CHC, RAC-CT, Proactive Medical Review

The Quality Improvement Organization (QIO) Program originated with the Peer Review Improvement Act of 1982 and is authorized by Title XI Part B and Title XVIII the Act. The goal of the QIO program is to improve the quality of care for Medicare beneficiaries, including beneficiary complaints, skilled service termination appeals, and Immediate Advocacy to protect the Medicare Trust Fund. The QIO program is to achieve this goal through performance of various case review directives promulgated by CMS in the QIO Contract.

As of June 8th, important updates apply to the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QI) in Indiana and Kentucky. Providers should review documents and publications noted below with references to KEPRO. The following actions should take place:


  • Remove KEPRO (effective June 8, 2019) and replace with Livanta information

About Proactive Medical Review
HTS partners with Proactive Medical Review, a third party company who specializes in ensuring compliance with regulatory standards and promoting measurable care excellence. The team includes SNF experienced nurse, MDS, Health Facility Administrator, therapist and reimbursement specialists with experience serving in multi-site contract therapy operations, as corporate directors of quality, clinical program specialists, and Compliance Officers. Proactive is uniquely positioned to assist in managing the many changes and challenges facing providers partnered with HTS. Learn more about our commitment to compliance here.

According to the CDC, more than 25% of all American adults sit more than 8 hours a day. In fact, adults spend more time sitting and being couch potatoes than sleeping. That number increases even more for older adults; statistics show that 75% of older adults are sedentary.

Sitting too much can be very harmful to your health. Numerous research studies show that the more you move and stop sitting, the longer you will live. Sitting too much increases your risk of obesity, diabetes, cancer and early death.

What Happens to Your Body When You Sit?

  • Electrical Activity in Leg Muscles Shuts Off
  • Calorie Burning Drops to 1 per Minute
  • Enzymes that Help Break Down Fat Drop by 90%
  • Good Cholesterol Drops by 20%
  • High Amounts of Stress are Placed on Your Lower Back and Neck


The World Health Organization suggests adults aged 65 years and above should do at least 150 minutes of moderate-intensity physical activity throughout the week. Regular physical activity of moderate intensity has significant benefits for health. At all ages, some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can quite easily achieve the recommended activity levels. Walking is the easiest form of exercise for older adults and swimming is a good option as well.


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. Occupational therapists help older adults to safely do the things they want to do, stay active and live well despite limitations. Therapy can help with pain associated with sitting too much, address postural issues, and create strategies to get you moving more and sitting less.

References: World Health Organization, CDC,

Byron Health Center Fights to End Alzheimer’s
Byron is a class act group who laughs in the face of mediocrity and never stops challenging the status quo. Be sure to follow them on Facebook and check out their gorgeous website as they recreate senior living at their new location coming soon! We are proud to be your partner in therapy and changing lives!

Follow along with our Facebook page to see how we’re helping communities just like yours!

Ripley Crossing Receives National Accreditation For Excellence
Congratulations, Ripley Crossing and thank you for your commitment to quality! We are proud to be your partner in therapy.

Follow along with our Facebook page to see how we’re helping communities just like yours!

We LOVE our friends and partners at Golden Years Homestead!

Set Your Community Apart with Rehab Services
HTS Outpatient Rehabilitation provides your senior living community with convenient, on-site therapy and wellness services to support independence, safety and quality of life for your residents. We provide the very best in programming, equipment and care collaboration to restore your residents to their maximum potential.

Follow along with our Facebook page to see how we’re helping communities just like yours!

Physical & Occupational Therapy

More people in America suffer from pain than diabetes, cancer and heart disease combined. When pain lasts for a long time (more than 6 months), it is called chronic pain. Chronic pain affects more than 130 million Americans.

“Older Adults should not accept pain as a common and accepted part of ageing.
There are ways to manage it.” – American Chronic Pain Association


Managing & Treating Your Pain

Treating chronic pain can be difficult because it varies from person to person as well as many different causes and possible treatments. Developing the right treatment plan for your diagnosis is often the work of a multidisciplinary team of medical professionals. When consulting with your doctor, he may refer you to visit a physical and occupational therapist.

Physical Therapy (PT)
Physical therapists can assess your chronic pain and establish a therapy treatment plan fit for you. Treatment may include both passive and active treatments. Passive treatments help you to relax, while active treatments are therapeutic exercises that strengthen your body and help you deal with your pain.

Occupational Therapy (OT)
Occupational therapists understand that pain is subjective and complex. OT’s work to evaluate how pain may be impacting your desired activities and quality of life. They can teach skills and strategies to help manage and cope with your pain.

Pain Reducing Technology
Therapists may use non-invasive technology such as electrical stimulation (e-stim) which blocks the pain signal to the affected area while reducing inflammation. Also, ultrasound therapy and a combination of heat and cooling therapies may be used to reduce pain.

If pain is affecting your ability to perform daily tasks or keeping you from enjoying activities, talk with
your doctor about physical and occupational therapy treatment options.

The Spring Conference Season has Sprung!

HTS leadership and corporate office team members exhibited at the Leading Age Indiana Spring Trade Show on May 6th, 2019 in Indianapolis. It was wonderful to see our partnering communities and hear all the wonderful things they have to say about our therapists. Hot topics this year included staff retention and PDPM.

Pictured left to right: Holly Skidmore, Shaleen Bhatnagar, Katie Grissom, Amanda Green, Cassie Murray, Steve Chatham and Kory Coleman.

Article by:  Sheena Mattingly, HTS Clinical Specialist

Speech Therapy’s role is going to become exceedingly important under PDPM. This is due to the change in reimbursement which will be focused on patient characteristics rather than therapy minutes. Here are the top 5 things you need to know:

  1. Medical complexity and clinical outcomes are the basis for the new patient-driven payment model (PDPM). SLPs will play an important role in determining SNF payment which will require system optimization for timeliness in order to code the most accurate information.
  2. PDPM does not change coverage criteria for skilled care. SNF care is still only covered if all four of the following are met:
    • SNF or skilled rehab services are required to be performed by or under the supervision of professional or technical personnel and is ordered by a physician for the condition which the patient received inpatient hospital services.
    • Skilled services are required daily.
    • Daily skilled services can only be provided on an inpatient basis in a SNF.
    • Services delivered are consistent with the nature of the severity of the illness or injury, medical needs, and accepted standards of medical practice, and are reasonable in duration and quantity.
  3. Understanding the components related to the payment model will help with adjustment to the new system. The need for ST is related to the presence of a swallowing disorder, a mechanically altered diet, a ST comorbidity related, and/or cognitive impairment. Combinations of these characteristics produce 12 ST case-mix groups. Our data analytics have observed a trend in need for optimization especially in section K of the MDS. For this reason, we have created tools and resources to help your SLP, dietician, and nursing staff code section K. Please contact us today for more information!
  4. Sections B, C, K, and I are crucial for accurate coding for the ST reimbursement component. Check out our 5 Day Assessment Tool to optimize IDT communication to improve your coding.
  5. CMS will monitor provider practice during PDPM implementation to audit changes in volume and intensity of therapy services, compliance with group and concurrent therapy limit, and coding practices.

Registration NOW OPEN!

We are committed to supporting our partners by offering exclusive PDPM webinar and live trainings in critical areas to foster success as we “Power through PDPM.” Not a partner? Contact us to learn how we’re providing even more value to our partners


Supercharge Your MDS:  6-Part Webinar Series

June 14 — Determining Clinical Category & Care Planning for the Complex Resident
June 19 — PDPM: SLP Component & Accurate Reporting of SLP Comorbidities
June 26 — PDPM: NTA Component & Comorbidities
July 10 — PDPM: Section GG & Functional Scoring
July 17 — PDPM: Best Practices for 5-day & IPA Data
July 24 — Transitioning to PDPM & Ensuring Billing Accuracy


July 31 — Supportive Documentation for SNF Level of Care Under PDPM

Physical activity is a vital component to maintaining overall health. According to the CDC, “Older adults can obtain significant health benefits with a moderate amount of daily physical activity. The loss of strength and stamina attributed to aging is in part caused by reduced physical activity.” Did you know walking is one of the very best exercises you can do? Walking is an activity that most everyone can take part in and can be done just about anywhere. For older adults, the World Health Organization recommends at least 150 minutes of physical activity weekly. Walking has many health benefits as it can help prevent coronary heart disease, lower blood pressure, and improve circulation! Below are recommendations that can assist you in developing your own walking program. Always make sure to consult with your physician before beginning any new exercise routine.

Getting Started:

  • Doctor’s permission
  • Good pair of walking shoes
  • Safe place to walk
  • Walking buddy
  • Water bottle

Warm up your muscles to avoid stiffness and to reduce the risk of injury. Try flexibility exercises such as heel and toe raises.

Walk at a speed in which you feel comfortable. Start slow and gradually increase as tolerated. Walking should be continuous
and rhythmic. Pay attention to your posture, hold your head up, eyes forward and walk tall!

Stay Hydrated! Drink plenty of water before, during and after exercise.

Cool down after walking to return your body to its “resting state” and reduce risk of muscle soreness. Try stretching exercises such as a seated arm reach and piriformis stretch.

If you are having trouble standing, walking or moving around, physical therapy can help. Physical therapy can improve mobility and strength, and manage or eliminate pain. Talk to your doctor about any challenges you’re having and if physical therapy can help your condition.