I am an occupational therapist that practices part of my day in skilled nursing facilities. I have listened to a couple of audio conferences on the new MDS changes. Our facility is questioning the need for weekend coverage, wondering if it will be necessary now that reimbursement is not based on projected minutes but rather actual. Since 5 out of the first 8 days must have therapy provided, it will be impossible not to use grace days unless every patient comes on a Monday (unless we provide weekend coverage). or if the facitlity is ok with completing a SOT OMRA if we don't get the five days.......wondering if any of you have a better grasp on the changes and can give me any input, greatly appreciated!!!!
I work in a SNF and just discussed this today. We currently provide Sat coverage already and are discussing the possibility of offering Sunday sessions as well. We did not have problems getting at least 5, even 6 sessions within that first 8 days for most all of our patients. Where the problem is going to be in the future is the situation where a patient goes out of the facility such as re-admit back to hospital before those actual 5 or 6 days of therapy time is administered. Used to be you got the minutes at the projectd rate. In the new situation we will not get at the projected rate because there are no projections, only actually done and only at the RUG rate that is achieved. Our assessment coordinator RN said the rate for short term OMRA is very small and is basically throwing away those therapy minutes that happened before the RUG was met. By getting the eval and treats started ASAP (even Sundays) then the minutes are done and logged. I can see the rehab dept. hanging onto the stretcher, getting minutes, as the EMTs try to get the patient back to the hospital!!
We are also hearing that TKR and THR will no longer warrant sub-acute rehab via Med A. Can't beleive this rumor is true but lots of people are saying it. How fresh hips can go home and function is beyond me-- but what do we know?