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Hot off the presses from our first Leader -
Roshunda Drummond-Dye, JD
Good Afternoon:
I just wanted to follow-up regarding the Jimmo manual changes that we discussed before the Christmas break. CMS staff just got back to work – so I am just getting some official responses.
1) The new manual provisions regarding skilled maintenance expressly exclude physical therapist assistants in the home health and outpatient therapy setting, but PTAs may still provide these services under the SNF Part A benefit. The applicable reference is 42 CFR 409.32(a) and (b).
2) There is also confusion regarding the home health functional reassessment requirement in relation to the Jimmo manual updates. The version of the manual that CMS used to make the Jimmo changes does not include the 2013 changes that CMS made to the home health functional reassessment requirements.The regulations at 42 CFR §409.44 have been updated to reflect the changes in the CY 2013 HH PPS final rule and the regulations should continue to be the primary source of information regarding the therapy reassessment requirements. The Q&As on the HHA Center webpage are also another accurate source.
Happy New Year!
Roshunda
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Reminder Cindy and Dee Live: Dallas, TX
Therapy Revenue Protection Strategies for Home Health Agencies.
Maximize the Impact of Therapy Services
Dee Kornetti & Cindy Krafft
January 13th, 2014
Every year the home health industry is challenged by payment changes that increase
concerns about long term viability. Recent activity by the Senate Finance Committee,
Medicare and the RACs are all expected to increase the scrutiny on care delivery in
home health as many wonder if it is driven by patient needs or perceived financial
incentives. Therapy visits have had a direct relationship to home health revenue for
more than 10 years and fluctuating patterns that appear to align with payment changes
have raised concerns about clinical decision making. Taking care of patients costs
money and agency leaders are trying to balance clinical needs and the bottom line.
As many not-for-profits will confirm “without money there is no mission”. Successful
agencies are committed to the highest quality of patient care while being fiscally
responsible through interdisciplinary care management.
“Patient focused care” and the “interdisciplinary team model” have been talked about
for years but implementation has been difficult for many and elusive for some. This
session will take real life issues surrounding patient management, connect them to
meaningful care planning and provide solid documentation principles to decrease the
risk of payment denials. Lessons learned from the audit findings will be incorporated to
directly improve the quality of therapy reassessments right now.
Topics will include
- Strategies to directly connect OASIS to care planning in practice NOT just theory.
- Discussion templates for interdisciplinary care planning.
- Guidelines for therapy utilization that is driven by patient needs while being fiscally responsible.
- Examine specific areas of concern in the areas of maintenance and functional reassessments.
- Know what to look for in documentation content to meet medical necessity criteria
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