In the wake of the 2012 Medicare Part A regulation changes, administrators and owners need to be aware of the reasons behind End of Therapy (EOT) and Change of Therapy (COT) OMRA assessments occurring in their facilities; most of which are often unnecessary and avoidable.
Without this awareness, valuable patient care and Medicare dollars are being left on the table. Compounding this is the increased burden placed on already stressed MDS nurses created by the need to perform additional MDS 3.0 assessments. Poor planning on the part of inadequately trained and educated therapists by their therapy company can result in unnecessary drops in RUG levels and reimbursement. It is important to remember that there can also be valid reasons for COT assessments and that COT’s can result in increased RUG levels in cases where patient tolerance for treatment improves between regularly scheduled PPS assessment windows.
It is now more critical than ever before that your therapy provider understands the intricate details associated with the 2012 SNF Final Rule to ensure adequate reimbursement.
Therapy companies who have historically struggled with staffing will likely find their staffing issues compounded due to the decreased flexibility for facilities, MDS Coordinators, and therapists, to adjust ARD windows to avoid COT and EOT situations. This will inevitably result in an increase in problems due to the increased demands on staff.
We encourage nursing home administrators to be aware of the challenges posed by the new guidelines and communicate with therapy and MDS coordinators to ensure that additional work and loss of revenue is being minimized.
Therapy Center is prepared. We have provided our therapists with detailed training on COT’s and EOT’s – both the benefits and the risks. Our dedicated Compliance Department serves as another layer of support to work through patient scenarios to avoid negative COT or EOT situations. Our managers are constantly monitoring patient treatment for potential issues, coordinating staff where needed and taking a proactive approach to ensure that EOT OMRA’s and negative COT’s are minimal or negated completely.
Call us to find out how we can help your facility.
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