An efficient rehabilitation department in a Long Term Care facility can dramatically improve that facility’s Medicare reimbursement levels and drive fiscal sustainability.
As of October 1, 2011, numerous changes to Medicare reimbursement rules impacted the operations of your healthcare facility’s rehabilitation department.
Specifically, these changes include:
- Modification of grace days and patient assessment windows,
- Changes in the application of Other Medicare Required Assessment (OMRA) days, and
- A new definition of reimbursable therapy minutes used to obtain the appropriate Resource Utilization Group (RUG) level.
The rehabilitation service is a crucial component of Medicare reimbursement. An effective and efficient department will positively impact the fiscal performance of your Long Term Care Facility.
Problems?: Imagine a case where a patient gets no weekend coverage (fairly common) and then misses a Monday therapy session because they have a Doctor’s appointment outside the building during their scheduled therapy session. As of 10/1/11, if a Rehab skilled patient misses therapy for 3 consecutive days, an MDS coordinator must complete an End of Therapy (EOT) OMRA and the facility loses reimbursement for those three days.
Solution: Comprehensive scheduling, better monitoring of PPS, daily coordination with nursing, and other tactics can avoid these losses. (Note: There are a series of management steps that can reduce the need for EOT and Continuance of Therapy (COT) OMRAs, a vital necessity in a system that now pays for actual minutes of treatment, not prospective minutes.)
Glass Jacobson’s ElderCare Provider Services team can help you avoid these losses. Our Rehab Services consultants are industry experts and know how to help you more effectively manage your rehab team. Contact us to maximize your reimbursements.