12 CASE STUDIES: TREATMENT INTERVENTION AND DOCUMENTATION EXAMPLES FOR OCCUPATIONAL THERAPISTS WORKING IN SKILLED NURSING FACILITIES by Timisha Tross
How Do I Document Medicare Part A in Skilled Nursing Facilities?
Course Description Occupational therapy within a skilled nursing facility SNF can be a varied and challenging experience. Clients no longer receive all of their rehabilitation in the inpatient setting and are discharged to post-acute care SNFs to complete their rehabilitation process. In addition, recent changes in payment for clients within this setting require occupational therapy practitioners to have knowledge of coding and billing practice and acceptable modes of intervention. Client discharge from a SNF back to the community is an ever-increasing expectation with shorter lengths of stays and higher patient expectations for quality outcomes. This courses is designed to help practitioners better manage practice within SNF settings for inpatients Medicare Part A and outpatients Medicare Part B , this fully updated course addresses the importance of documentation, requirements for different payers, significance of managing productivity, understanding billing considerations, and maintaining ethical practice standards. Learning Objectives At the conclusion of the course, participants will be able to:.
Occupational therapy consistently ranks high as one of the top jobs. Register to join us in suburban Washington, DC on Nov. Read recent news articles about occupational therapy. Find out how occupational therapy helps people with polytraumatic injuries. Need help with documentation? AOTA helps members by providing best practices for documentation to help you increase reimbursement, decrease denied claims, and articulate the distinct value of occupational therapy. Payment for Value Based OT: Implications for Quality and Practice Practitioners will be financially rewarded for demonstrating value and potentially penalized for not meeting the value criteria.
So you may be wondering why or what in the world subacute rehab , short term care , long term care , patients vs residents , and skilled nursing facility entails or why they are grouped together under one post. The BEST way I can describe the characterization of the skilled nursing facility SNF setting is to first envision a singular large building and second think of the building as two parts of a whole.
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New Evaluation Codes
Practicing occupational therapy in a skilled nursing facility can present many challenges for even the most skilled therapists. This changing environment means that occupational therapists need to be experienced in a variety of conditions and situations while maintaining the drive to provide their patients the ability to lead healthy and active lifestyles. It also means that occupational therapy professionals need to be on their toes when documenting every step of their patients' recovery. Unfortunately, even the best of skilled therapy can be denied reimbursement without correct coding and the requisite skilled documentation. The complexity of the rules has led to many myths and urban legends. Therefore careful planning is needed to assure success in reimbursement and to prevent denials or fines secondary to an actual audit.
SNF patients in the first days of a post-acute episode are covered under Part A. The combination of Part A and Part B rules in SNFs, along with the requirements of the Minimum Data Set MDS —the data collection system used as the basis for Part A billing in long-term care facilities—causes confusion for many speech-language pathologists documenting their skilled services. Here are some Part A pointers. Therapy time is recorded in the MDS in one-minute increments, and includes:. The initial evaluation necessary to develop the plan of care and time spent on documentation even if the patient is present is not included in the MDS treatment minutes.
If you or a loved one is admitted to a skilled nursing facility SNF , there is a good chance you will quickly become acquainted with the rehabilitation department, among which is occupational therapy. Many people arrive at an SNF because they no longer require the level of care given at a hospital but are unable to go home. You may still need daily access to skilled nursing services such as monitoring the healing of a wound or assistance with medication , daily rehabilitation services, or some combination of both. Your doctor remains the ultimate overseer of your care, but nursing and rehabilitation workers are who you will see most frequently. Medicare certifies skilled nursing facilities; therefore, Medicare regulations and reimbursement play a significant role in how facilities are run. In some cases, you will stay in the same hospital room but switch to an SNF level of care. Medicare certifies some small rural hospitals known as critical access hospitals to provide SNF level care under the status of Swing Bed when geographical access to a step-down rehab facility is limited.