Why would anyone mention value-based reimbursement, medical necessity and the Jimmo lawsuit in the same sentence? I feel they are all related, but it will be difficult to find the perfect balancing act...
Palliative possibilities: Therein lies the rub
By
Shelly Mesure, MS, OTR/L
Apr 22, 2014
When a patient is referred to therapy, and they are receiving hospice care, then therapy needs to seek permission from the hospice company to provide any treatment. Hospice is required to reimburse the...
Defining tolerance in therapy
By
Shelly Mesure, MS, OTR/L
Feb 12, 2014
How do you define tolerance? Is tolerance measurable? Is tolerance too subjective? What about activity tolerance? We love to document how patients are improving activity tolerance, but many times that’s...
Personal stories every therapist should know
By
Shelly Mesure, MS, OTR/L
Dec 17, 2013
What’s the point of all of our treatment interventions and plans of care if we can’t relate to our patients? If you can put a face and personality behind your justification for therapy services,...
Jimmo and the future of rehab
By
Shelly Mesure, MS, OTR/L
Nov 07, 2013
On Jan. 24 of this year, the Jimmo vs. Sebelius class action lawsuit was settled. This was a significant win for us, the healthcare providers. As we continue to work out the details, I feel now is a good...
No more Rehab Medium RUG defaults
By
Shelly Mesure, MS, OTR/L
Oct 08, 2013
Well, Oct. 1 has passed, and we’re all still hanging in. The biggest changes we saw to rehab were the addition of reporting co-treatment minutes on our billing logs and Section O on the MDS. And,...
Ready or not: The MDS is changing again!
By
Shelly Mesure, MS, OTR/L
Sep 25, 2013
On Oct. 1, the Centers for Medicare & Medicaid Services will be updating the Minimum Data Set with another round of changes. Most are minor but there will be two changes to the therapy section. Your case-mix...
What’s on Your PEPPER Report?
By
Shelly Mesure, MS, OTR/L
Sep 10, 2013
Have you received your provider-specific PEPPER report yet? The Program for Evaluating Payment Patterns Electronic Report (PEPPER) were mailed on August 30 and have been slowly arriving at skilled nursing...
Are you prepared? 5 questions you need to know the answers to
By
Shelly Mesure, MS, OTR/L
Aug 27, 2013
With all the recent regulatory changes that have come down the line, or are about to, we developed a simple five-question survey that each provider had to ask every therapy employee. If you can develop...
What is therapy? It’s not as simple as it might seem
By
Shelly Mesure, MS, OTR/L
Aug 13, 2013
“What is therapy?” sounds like a simple question, but it requires a separate and very complex answer for each discipline.