News Archives - Page 9 of 13 - buildingtherapyleaders.com

Four Reasons Why Cardiac Post-Acute Rehab Care Fills the Gap between Hospital and Home

December 13, 2016December 28, 2016 MP News

Cardiac PARC fills gap between hospital and home

Every 42 seconds, a person suffers a heart attack. Despite the fact heart disease remains the leading cause of death in both men and women in this country, the incidence of death because of heart disease is declining. And if you are one of the more than 30 percent who survived a heart attack last year, consider yourself lucky. Your second chance at life is about to get better, and the staff at Monte Vista Hills Health Care Center is here to help.

“I’ve seen this Heart PARC (cardiac post-acute rehab care) program help numerous lives for the better,” said Clayton South, executive director for Monte Vista Hills. “It has provided excellent outcomes throughout the industry, and I’m excited about its implementation here at Monte Vista.”

The concept of providing rehabilitation therapy is not new, but to offer services that cater specifically to cardiac care is a tremendous resource for patients and their families who are facing a permanent life-changing event. Here are four reasons why this cardiac program makes my heart skip a beat.

1. The staff provides focused care.

While other rehab therapy centers address a variety of conditions, this program focuses on the heart and all of the factors associated with recovery and education. Many patients are not yet ready to return home after cardiac surgery or a cardiac episode. This program bridges the gap that ensures patients are physically and emotionally prepared to return home safely.

“This isn’t just therapy. Instead, this is an interdisciplinary program,” said Dr. Jared Lundquist, director of rehabilitation for Monte Vista Hills. “It’s not just about the therapy but the skilled nursing and everyone else involved in this program.”

This multi-disciplinary approach focuses on the specific needs and concerns often shared by cardiac patients.

“Our team works together to progress each patient through five care levels and prepare them to succeed at home,” Lundquist said.

2.The staff communicates with the hospital.

The highly skilled, board-certified cardiac specialists review each patient’s medical history and regularly collaborate with the cardiologist to design a personalized care plan that matches the patient’s level of needed care, diet, risk levels, and ability to function.

“Each care plan is specific to the patient,” South said.

And the cardiologist is kept informed and conferred with during each phase of recovery.

3. The staff builds a relationship with each patient.

The one-on-one care each patient receives creates a unique and helpful relationship; the weekly interaction with patients means staff can perform ongoing assessments and evaluate the patient’s progress, subtle changes in symptoms, and projected responses to recent procedures, diet, medications, exercise levels, among other things. Should symptoms worsen, the staff can perform acute therapies to improve the patient’s condition.

4.The staff is prepared should immediate care be required.

The PARC environment is designed to focus on progress and recovery. During treatment, patients are assisted by a staff possessing acute knowledge in overall heart function, abilities, diseases and behaviors. This staff also knows the history and past procedures of each patient and directs a patient’s treatment plan to prepare them for existing challenges at home. But should a setback occur and emergency care is needed, it is good to know patients are surrounded by a qualified staff that can perform life-saving care until the patient can be admitted to the hospital. This reduces the chance of irreversible damage and increases a patient’s prognosis for a full recovery.

“The comfort and safety our patients feel while in this care makes a huge difference in the overall recovery process,” South said.

By being able to provide focused care, collaborate with team members and specialists, build a supportive relationship with patients and be prepared for whatever need should arise, the Monte Vista Hills is proud to offer this high-level cardiac care to the community.

Published online by The Idaho State Journal, Nov. 4, 2016

Submitted by Monte Vista Hills Health Care Center, Pocatello, ID

Cardiac Specialty Programs: Why Should They Matter to You?

December 13, 2016December 16, 2016 MP News

Why should cardiac programs matter to you? Research shows that most hospitals have a cardiac diagnosis within their top five admitting diagnoses. CMS has identified heart failure and MI as two of the most expensive diagnoses for Medicare, and new cases are increasing at a rate of 550,000 annually. The next mandatory bundled payment being considered by CMS is cardiac conditions.

Where Does the SNF Fit Into All of This?

We can be the best postacute care partner in our communities by sharpening our clinical skills in nursing and therapy to bridge the gap between a hospital stay and home.

Since implementing the Heart PARC (postacute rehab center) program in 16 of our buildings over the past year, we have begun to see some encouraging results:

Increased skilled census for this condition type
Reduced rehospitalization
Increased functional outcomes using the CARE data
Increased confidence in working with clinically complex patients due to focused training and education
Increase confidence from our health partners in our clinical expertise

The graph below shows the cardiac-specific skilled census at Park View PostAcute (PVPA) in Santa Rosa, California, from September 2015 (first month of Heart PARC implementation) to December 2015:

This graph shows the shift in skilled census at PVPA from September 2015 to December 2015:

The below graph shows PVPA hospital readmissions from September 2015 to July 2016:

The side-by-side graphs from PVPA below show that during the eight months of implementation, the cardiac census went from 20 over an eight-month period prior to HP up to 81 patients in the eight-month period post-Heart PARC. The bars below demonstrate a significant change in function using the CARE item set. Prior to Heart PARC implementation, on average, the cardiac patients still required 25 percent physical assistance at discharge. After Heart PARC implementation, on average, the patients only required verbal cueing.

So How Do I Get Training in My Building?

Currently therapy and clinical resources are being trained in a train-the-trainer format. Please signify your interest in bringing this program to your building by reaching out to your therapy or clinical resource, and we will get information to you on first steps.

Therapy Career Fair Calendar

September 7, 2016September 11, 2016 Building Therapy Leaders News

Graduating soon? Looking for a change in your therapy career? If you’re a physical therapist (PT), occupational therapist (OT), speech language pathologist (SLP), PTA or OTA, visit the Ensign Therapy booth at a nearby job fair or conference and learn about career opportunities. Therapists thrive in our unique anti-corporate culture.

Upcoming Career Fairs and Conferences

Career Fair and Convention Calendar

Ensign Therapy Is Offering FREE CEUs!

June 8, 2016June 18, 2016 MP News

Borderline or Bulletproof?
Strategies for Medicare Therapy Documentation
in SNF and Outpatient Settings

by Lori O’Hara, MA, CCC-SLP
Director of the ADR and Appeals Team for Ensign Services, Inc.
(2 credit hours)

Free! No cost or obligation! (But seating is limited…)

Two Class Times and Locations

Tuesday, June 21st, 6-8 pm
Gateway Transitional Care Center
527 Memorial Drive
Pocatello, Idaho 83201

Wednesday, June 22nd, 6-8 pm
Parke View Rehabilitation & Care Center
2303 Parke Avenue
Burley, ID 83318

Develop a vocabulary to have at your fingertips that shows how your services are reasonable and necessary, and showcases your skill as a therapist. This course will show you how to think your way through the CMS requirements to quickly and efficiently find the language you need so your documentation can stand up to an audit.

Lori O’Hara, MA, CCC-SLP, directs the ADR and Appeals team for Ensign Services, Inc. and teaches documentation strategies designed to help amazing therapists be equally amazing documenters of their services. She has more than 20 years of experience in the field of SNF and outpatient therapy as a director and trainer.

This course is free but pre-registration is required. To register please contact Jamie Funk:
1-877-595-0509 or jfunk@ensignservices.net

Are We on the Same Frequency?

June 7, 2016June 9, 2016 MP News

We are well into year three of our Corporate Integrity Agreement (CIA)! Many of you have already had an onsite Medicare Systems Compliance Audit (MSCA) conducted by one of our compliance partners for Medicare Part A services provided to residents in our facilities. We have seen many examples of excellent therapy documentation supporting the vital therapy services that help our patients improve their quality of life and in many cases return home or to a lesser level of care.

One trend that has been observed while completing the MSCAs is either over-delivery or under-delivery of therapy visits according to the Plan of Care or Updated Plan of Care and subsequently, physician’s orders.

For the evaluating therapist, there are many things to consider when developing the Plan of Care or Updated Plan of Care. When determining frequency, factors such as the patient’s medical condition, activity tolerance and cognitive level should be considered. Services must be ordered by a physician and consistent with the Plan of Care or Updated Plan of Care. Ensign Rehabilitation Policy #215 “Clarification Orders” requires documentation of frequency as one of the components of a clarification order. If frequency of visits in a given week is exceeded without a physician’s order, this could result in a disallowance of services. Frequency of therapy treatment provided is not only something that we look at on our MSCAs, but historically by outside auditors as well.

There are situations when an increase in frequency is clinically indicated such as an improvement in the patient’s medical condition — effective pain management, change in weight-bearing status or a remediated precaution. In addition, there are situations when an increase in frequency is indicated on a practical level in order to facilitate outcomes related to a revised discharge plan or caregiver training. For example, a patient may be discharging home and the caregiver is only available on Saturdays for training. All of these scenarios would support additional treatments for the patient as long as a physician’s order is obtained and the POC/UPOC is revised to reflect the new goals, approaches and frequency of services.

Conversely, a reduction in the frequency of therapy services may also be indicated at times. The reasons for this may be related to a decline in the patient’s medical condition such as a UTI or low INR levels. In addition, there may be logistical reasons related to the availability of the patient for treatment such as scheduled dialysis treatments or medical appointments requiring travel. Documentation related to the reason for a missed treatment should be found in the medical or treatment record. If there is no documentation in the record for decreased treatment, then services are not compliant with the established POC/UPOC or the physician’s orders.

The following guidance was provided to the field with the recently updated POSTette titled “Plan of Care”:

Frequency refers to the number of times in a week treatment is provided.

In Rehab Optima the start of the care date (evaluation date) initiates the seven-day cycle in which therapy must be delivered to the patient as necessary to meet the physician-prescribed dosage.

In order to establish organizational consistency, the evaluation encounter (regardless of whether treatment was provided on the same day or not) will count as part of the frequency the first treatment week for most payers.

However, for RAI purposes, number of treatment visits refers only to the number of days in which treatment was provided during the week, and those treatment days are the only days counted for the purpose of the MDS, which may or may not be used for payment with some payer sources.

Exceeding frequency of visits in a given week (whether or not treatment was provided on the day of evaluation) may or may not result in a disallowance of services and will be reviewed on a case-by-case basis.

As an overall reminder of regulatory requirements for Medicare Part A, please see the additional information as follows:

According to the Medicare Benefit Policy Manual Chapter 8, skilled therapy services must meet all of the following conditions summarized below:

The services must be directly and specifically related to an active written treatment plan that is based upon an initial evaluation performed by a qualified therapist after admission to the SNF and prior to the start of therapy services in the SNF that is approved by the physician after any needed consultation with the qualified therapist. In those cases where a beneficiary is discharged during the SNF stay and later readmitted, an initial evaluation must be performed upon readmission to the SNF, prior to the start of therapy services in the SNF.
The services must be of a level of complexity and sophistication, or the condition of the patient must be of a nature that requires the judgment, knowledge and skills of a qualified therapist.

The services must be provided with the expectation, based on the assessment made by the physician of the patient’s restoration potential, that the condition of the patient will improve materially in a reasonable and generally predictable period of time; or the services must be necessary for the establishment of a safe and effective maintenance program; or the services must require the skills of a qualified therapist for the performance of a safe and effective maintenance program.

The services must be considered under accepted standards of medical practice to be specific and effective treatment for the patient’s condition.
The services must be reasonable and necessary for the treatment of the patient’s condition; this includes the requirement that the amount, frequency and duration of the services must be reasonable.

References and Cross-References:

Centers for Medicare and Medicaid (CMS) Benefit Policy Manual 100-2; Chapter 8; Sections 30, 40.1

Ensign Rehabilitation Policy #215 “Clarification Orders”

POSTette: Plan of Care

RAI Manual

Meet Our New SPARC Award Winners!

June 7, 2016August 22, 2016 MP News

Congratulations to our most recent SPARC award winners, Catherine Whitlock and Chelsea Shearman! Read their inspiring essays below.

Catherine Whitlock, DPT student at the University of Washington, graduating in June 2016

To spark someone’s life is to provide that radiant moment of support and happiness that leaves a bright ember of a memory glowing long after its lighting.

Por favor, ayudenos. Imagine being invited into a home of someone you met less than a week ago, and they’ve asked for help. They speak an entirely different language, and they’re looking for professional guidance and suggestions to improve their daughter’s quality of life. Just over a year ago, I found myself in this exact situation while volunteering for Manos Unidas, the only private, not-for-profit school for Special Education in Cusco, Peru. I was fortunate enough to be traveling with a licensed physical therapist, and three other doctorate of physical therapy students. That day, our physical therapy mentor, I, and my colleague entered the home of one of Manos Unidas’ students with cerebral palsy to experience and better understand her home setup, the care she received, and, we hoped, to answer her mother’s burning questions regarding her continued care.

The house accessibility was notably impressive, with a spacious first floor, and the student had her own room. Her Mom showed us her resourcefulness in creating bolsters to use for exercises and expressed a profound interest in what more she could be doing to aid her daughter. The conversation initially revolved around positioning, sleeping, and demonstrating several new techniques to increase this sweet little girl’s interactions with the environment and people around her. In my mind, the most important exchange that day was between the physical therapist and the student’s mother. It was a challenging conversation concerning maintenance therapy versus improvement from therapy. The mother struggled at times to fully understand the difference between the two when her daughter was predicted to live 2-6 months by one doctor, and was also predicted to walk again by another doctor. These very conflicting prognoses are understandably confusing. She continued to express her frustration with the medical information she had received to date, and essentially asked the physical therapist, “What’s the point of therapy?”

Then came the spark. That blazing, powerful moment of caring connection as the therapist explained how physical therapy enabled the little victories in one’s life. Those two extra seconds of holding her head up and smiling at a loved one. The ability to grasp a favorite toy or point to something that she wants. That brief moment, that brilliant spark, shone a light into her life and the mother found new resolve to continue physical therapy with her daughter for those little victories.

Throughout my lifetime, I have welcomed multiple opportunities to interact with individuals of different social, cultural, and economic backgrounds. Yet it was in the work of this day in my budding career as a physical therapist that I discovered the crux of what inspiration I will bring to my interaction with every patient. My mentor physical therapist showed me through action exactly how to bring a positive light into any situation, and to celebrate the little victories with each person so they may move forward for the better. All of these moments have provided the framework for my career plans and goals, which resonates through the core of my very being. Each day I hope to rise anew to find opportunities to learn, teach, and share my passions and compassion with those I walk alongside on their path of healing. It is with the dedication of my life as a physical therapist that I hope to holistically serve those who are in the most acute need, to inspire others to do the same, and to develop programs that foster relationships and opportunities to serve the global community.

Quality, collaboration, and lifelong learning are a few of the principles at the heart of my interests in physical therapy. Throughout my educational and clinical experiences, I’ve found unwavering passion working with patients in an acute care setting. My drive to provide them with quality, safe, effective, efficient care is insurmountable, and I currently find myself in pursuit of an acute care residency in the hope that I will further develop myself as a clinician to provide the best patient-centered care possible. Intimately collaborating with other like-minded individuals in the field, I will be ever better equipped to utilize the research that develops evidence-based practice as it meets patient case scenarios. This passion for learning is one in which I proactively seek the tools to succeed, not the answers. My academic drive is for mentorship in which I am trusted as a capable colleague. The amount of intentional effort that I pour into this residency will directly correlate with what I gain from it, which impacts the quality of patient care that I can provide. My motivation to earn something through an environment rich with learning opportunities has never been greater.

Once established as a clinician, I hope to embody my passion for learning as a clinical instructor, as well as becoming a part-time instructor within either a physical therapy assistant or doctorate of physical therapy program. In my time as a student of physical therapy, I have continually expressed this deeply held desire to my mentors and have even been granted the opportunity to guest lecture on physical therapy as a piece of the rehabilitation team for the University of Washington’s Speech and Hearing Sciences: 533 Medical Speech Pathology course. Taking this presentation’s feedback in earnest, I intend to practically apply it within the acute care residency. This residency exists as the ideal catalyst for my dream of teaching as it includes the opportunity to be a teaching assistant for two acute care residency courses for a doctorate of physical therapy program. My goal as a teacher is to foster an environment that enables individuals to revel in this meeting of research and best practice, creating a ripple effect among the profession for better patient-centered care.

Beyond the classroom, I find advocacy and equity as essential components to my future contributions to physical therapy. I hope to develop and lead a program that connects physical therapy students and clinicians with other medical disciplines for global service opportunities to advocate for those who are under-resourced. It is a moral and ethical obligation to provide physical therapy services to those without access to care for financial reasons, from a lack of availability of services, or in the event of a disaster.

The spark in my life behind this goal comes from my experience as president of Global Rehabilitation Organization at Washington (GROW). GROW has provided opportunities and structure for me to participate more directly within the global community. These unique learning experiences have enabled me to collaborate with other healthcare students and clinicians, to practice cultural competency, and to transcend border, language, class, race, and ethnicity. Because of this, I know that combining my passion for local service, learning, sustainable international medical efforts, and inspiring best patient-centered care can all be realized through creating or collaborating with programs that cultivate compassion in action through globally aware service-learning opportunities. Organizations that advocate for equitable services on a local and international scale will give back to the global community through the power of physical therapy.

Perhaps then it is Mother Teresa of Calcutta who best encapsulates my deeply held vocational desire to serve as a holistically minded physical therapist — for as she boldly said, “Prayer in action is love, and love in action is service. Try to give unconditionally whatever a person needs in the moment. The point is to do something, however small, and show you care through your actions by giving your time. … Do not worry about why problems exist in the world — just respond to people’s needs. … We feel what we are doing is just a drop in the ocean, but that ocean would be less without that drop.”

There are countless people with physical needs, and my integral role in restoring function, promoting mobility, reducing pain, and preventing disability is but a moment of an individual’s lifetime, a drop in their ocean, a fleeting spark. Yet if I can serve as a shining spark, however small, who joyfully strives every day to bring compassionate, ethical and effective care to contribute to each of my patient’s well-being — that would be more than enough. For in intentionally meeting their needs, the true difference is made in empowering them to share this small positive contribution in turn, and multiply it within their own, greater communities of support and ever further still. It is in holistically healing all persons that physical therapists hold the power to revitalize communities, the spark to change lives we ourselves will never touch. Patient by deserving patient, victory by only seemingly small victory, our care empowers others to heal and better illuminate our world.

Chelsea Shearman, SLP, August 2015 SLP graduate of Northern Arizona University and student intern for Sabino Canyon

“Sister, eat, stop, chase.” These words, given to me in picture symbols, helped shape my life, ignited my spark and fueled my passion for wanting to become a speech language pathologist. My sister, a mere 14 months younger than I, was born with autism and is low functioning. Early in her life, doctors thought she did not have the aptitude to learn language. When my sister turned 4, however, a wonderful speech pathologist saw potential and taught her and me in therapy sessions how to incorporate the Picture Exchange Communication System (PECS) into our lives. Shortly after, this sentence appeared on the table before me and changed the course of our lives. My sister has never stopped learning; neither have I.

My flame grew as I learned to celebrate and embrace the differences in others at a young age. I volunteered in my sister’s classroom and went with her to early intervention therapies, as well as childhood programs for individuals with special needs. I got to know and love amazing individuals whom others considered “special” and how each of them had their own strengths, weaknesses, likes and dislikes. What worked with my sister did not work for them, and I had to learn how to build rapport with each individual and get to know each of them specifically. I shared my insights with those around me as I gave speeches about my sister in local charity fundraisers, went to IEP meetings, doctor’s offices and wanted to learn more about how to help others around me.

I continued my learning when I was 15 and volunteered in an AIDS orphanage serving the people in Uganda, Africa. First, getting there was a challenge. I had to raise money and worked hard to make my goals. The experience there was like nothing I had ever done; for such a short time of being there, I learned so much about life. While going in with the mindset of helping others, I, in turn, learned more from the people I was “serving” than I thought possible. Learning the needs of the people of Uganda and focusing on what was essential for them was way more vital than helping them with what I thought they needed. I was challenged with language acquisition and being immersed in a vastly different culture. Things were so foreign and strange, and I often made lots of mistakes. This taught me that true greatness, success comes only through trial and error. I learned about the importance of culture and background and was blessed with the patience of those Ugandan people who helped me grow.

With this experience I was excited to get a jump-start into my career and started by graduating high school at 16. In college I volunteered in undergraduate research in the “Profiles of Working Memory & Word Learning for Educational Research,” under Dr. Mary Alt. Doing research I learned the importance of asking questions and finding answers for others. I understood the need for proper paperwork and professional accountability. Lastly, I found researching evidence-based practices and working to stay abreast on the latest research findings to be essential in my therapy techniques and overall knowledge.

My lesson during this time was a hard trial I was learning to overcome. I was experiencing intense migraines which were affecting my memory and learning. I had to learn and relearn strategies to help with memory and word retrieval. I wondered if I could still be a speech therapist but I was determined to try. Through a process of elimination I learned what strategies worked best for me and learned the frustration that lies behind losing skills once mastered. I wondered why I needed to go through this and it was not until later that I learned the answer. That knowledge came while I was working with a client who was having issues with memory retrieval. Sensing her frustration, I shared my own experiences and she divulged her internal struggle. She thanked me and let me know my story gave her courage that things could get better; that although she may not return to her old self, becoming a new person was okay. I know it sounds cliché but I think sometimes we go through experiences so we can help and uplift others. I hope I can help others through my experiences — good and bad.

My passion for the area of speech continued to ignite as I received my SLPA license and started working for a clinic where I worked with clients from ages one to 40. I started implementing evidence-based practices, modifying activities to fit each individuals needs, and quickly became a liaison between my clients, their families and other team members. Later, I was accepted into graduate school and continued working full time in the area of speech pathology but changed to school-based therapy. I took techniques I learned in class and constantly changed my approach to therapy with all the knowledge I gained.

For my internship I was blessed to get a position in Ensign’s Sabino Canyon Rehabilitation and Care Center. It was a whole new kind of therapy for me and I tried to sponge all the knowledge I could from my talented and bright supervisor and other therapists. I enjoyed getting to know how to talk with and ask questions from my elders to learn their needs, their stories and how to help their quality of life. Some days it was overwhelming but I got the unique experience to help Ensign in my own way. Ensign opened up a new facility and I got to help with the transition and iPad programming. It may be small but I loved sharing the little knowledge of IT I had to support their skilled employees and got to see what working with Ensign is like — a family.

When I see the faces of the individuals I work with, I think about the love I have for my sister. In my life I have learned everyone is an individual, to set and meet goals, help others in areas of their needs, make mistakes and learn from them, ask questions and find answers, implement evidence-based practices, be a liaison, overcome obstacles, gain knowledge in every area and work as a family with my team. Every day I strive to work with others exactly the way I want others to work with my sister. I am not sure what the future has in store for me as I gain my full certification but I still have more to learn. I have a passion to try and ignite sparks in others; to help others grow beyond limits they or others might have put on them. Only through sparks can fires be set ablaze.

ICD-10 Coding Corner

June 7, 2016August 22, 2016 MP News

Continuing the ICD-10 Journey
The good news is that our operations did not grind to a halt on Oct. 1, 2015, as others in the industry; we made it. Many are reporting that the transition from ICD-9 to ICD-10 went smoothly. Overall, everything we did to get ready for ICD-10 paid off. However, with everything new, ICD-10 didn’t come without its challenges. Hot topics were reported to be coding with Excludes 1 notes, the seventh characters for fractures and injuries. Coding accuracy is very important. With all the potential changes to the billing system, we need to have a strong understanding of coding and the coding guidelines. There is still some work ahead of us.

With that said, we need to focus on getting accurate coding not only for billing, but also for reporting and trending. Our BPCI facilities know this more than most. We need to make sure we are all painting that picture the same. For example, when we code for a hip replacement, we need to make sure we are using the most accurate code.

Code Highlight – Replacement Coding

This month’s code highlight is coding surgeries. When you look at a patient/resident recovering from a recent surgery, we need to first ask ourselves why they need our services. Most of time, it is going to be to heal from the surgery, so in that case we need to look at aftercare codes. I know when ICD-10 first came out, we said no aftercare codes; this only applies to our fracture codes. There are times when it is appropriate to code an aftercare code. Then it was said we need to use the other ortho aftercare code. Now with some research we have a final answer. Here are the steps to look up a hip replacement.

Hip Replacement (when coding in Optum)

First, type in “aftercare”; this will bring you to Z47 Orthopedic aftercare. Click on the folder to open more code options.

Next, look at the list of codes you have to choose from, and you will find Z47.1-Aftercare following joint replacement surgery. This the code that fits this case. When you look in the tabular list, the note will tell you to Use additional code to identify the joint (Z96.6). From there, you can see there are codes for:

Z96.641, Presence of right artificial hip joint
Z96.642, presence of left artificial hip joint
Z96.643, presence of artificial hip joint, bilateral
Z96.649, presence of unspecified artificial hip joint

Choose the code that is most appropriate to the documentation you have. You will end up with two codes for this one diagnosis, so we want to make sure we go the extra step and get the codes we need.

Coding Challenge

The Coding Challenge is back by popular demand. Each month I will put up coding scenarios that I get from the field and have you code what you think needs to be coded. Then next month, I will have answers to this one and a new one. Send in your tricky coding scenarios to codingpartner@ensignservices.net.

By Casey Bastemeyer RHIT, CCA, CHPS, RAC-CT, AHIMA-Approved ICD-10-CM Trainer

Therapy Career Fair Calendar Archive

December 9, 2015September 9, 2016 Building Therapy Leaders News 4 Comments

Looking for upcoming events? Check out the Therapy Career Fair Calendar.

2016 Conferences Archive

Feb 5, 2016 – TWU (OT) Dallas, TX
Feb 18-20, 2016 – CSM 2016 (PT, PTA) Anaheim, CA
Feb 24, 2016 – Rockhurst University Health Fair (OT, PT, SLP) Kansas City, MO
Mar 1, 2016 – UWM Health Sciences Career Fair (PT, OT, SLP) Milwaukee, WI
Mar 10-12, 2016 – TSHA Convention (SLP) Fort Worth, TX
Mar 16, 2016 – University of Toledo Job Fair (PT, OT, SLP) Toledo OH
Mar 18-19, 2016 – NOTA Conference – College of St Mary (OT, OTA) Omaha, NE
Apr 2, 2016 – AZ SSIG Student Conclave – Midwestern University (PT, PTA) Glendale, AZ
Apr 2, 2016 – UTHSCSA Job Fair (PT, PTA. OT) San Antonio, TX
Apr 2, 2016 – UW Rehab Job Fair (OT, PT, SLP) Seattle, WA
Apr 5, 2016 – UW La Crosse PT, OT Career Fair (PT,OT) LaCrosse, WI
Apr 7-9, 2016 – AOTA Annual Conference (OT, OTA) Chicago, IL
Apr 12, 2016 – Samuel Merritt Presentation (OT, PT) Oakland, CA
Apr 13, 2016 – TX Healthcare Career Fair (OT, OTA) Abilene, TX
Apr 27, 2016 – CSUDH OT Career Fair (OT, OTA) Carson, CA
Apr 29, 2016 – University of Puget Sound (OT, PT) Tacoma, WA
May 4, 2016 – AT Still PT Recruitment Fair (PT, PTA) Mesa, AZ
May 4, 2016 – Blinn College Job Fair (PTA) Bryan, TX
May 26, 2016 – Grossmont College (OTA) El Cajon, CA
Jun 3, 2016 – University of St Augustine Career Fair (PT, OT) Austin, TX
Jun 10, 2016 – University of St Augustine Career Fair (PT, OT) San Marcos, CA
Jun 17, 2016 – Spalding University ASOT (OT) Louisville, KY
Jun 23, 2016 – University of TX Medical B (UTMB) PT Career Fair (PT) Galveston, TX
Jul 12, 2016 – Stanbridge College (OT, OTA, PTA)
Aug 17, 2016 – UNT Health Science Center, Fort Worth, TX

2015 Conferences Archive

Sept 8, 2015 – AT Still University OT Career Fair – Mesa, AZ
Sept 10, 2015 – University of New Mexico Job Fair (PT, OT) – Albuquerque, NM
Sept 22, 2015 – TX State University (PT, SLP) – San Marcos, TX
Sept 24, 2015 – Nebraska SLP Conference – Kearney, NE
Sept 26-27, 2015 – CPTA Annual Conference – (PT, PTA) – Pasadena, CA
Oct 2-3, 2015 – PTWA Conference (PT, PTA) – Bellevue, WA
Oct 9-10, 2015 – WOTACON 2015 (OT, OTA) – Tacoma, WA
Oct 12, 2015 – SLCC Career Fair – Salt Lake City, UT
Oct 14, 2015 – College of St Mary Job Fair (OT) – Omaha, NE
Oct 14, 2015 – University of St Augustine Job Fair (PT, OT) – Austin, TX
Oct 21, 2015 – University of St Augustine Job Fair (PT, OT) – San Marcos, CA
Oct 23-24, 2015 – APTA National Student Conclave (PT, PTA) – Omaha, NE
Oct 23-24, 2015 – TPTA Annual Conference (PT, PTA) – Arlington, TX
Oct 23-24, 2015 – OTAC Annual Conference (OT, OTA) – Sacramento, CA
Oct 26, 2015 – TWU Career Fair (OT, PT) – Houston, TX
Oct 30, 2015 – USC Career Fair (OT) – Los Angeles, CA
Nov 6-7, 2015 – TOTA Annual Conference (OT, OTA) – Richardson, TX
Nov 13, 2015 – Creighton University Career Fair (OT, PT) – Omaha, NE
Nov 17, 2015 – TWU Career Fair (OT, PT) – Dallas, TX
Nov 20, 2015 – SLCC OTA Career Fair, West Jordan, UT
Dec 9, 2015 – Hardin Simmons Career Fair (PT, SLP) – Abilene, TX

2014 Conferences Archive

Mar 29-30, 2014 – CPTA Student Conclave – U of St Augustine (PT, PTA) – San Marcos, CA
Mar 29, 2014 – University of TX (UTHSCSA) Job Fair (PT, PTA) – San Antonio, TX
Mar 29, 2014 – APTA Colorado Conference (PT, PTA) – Parker, CO
Apr 3-5, 2014 – AOTA Annual Conference (OT, OTA) – Baltimore, MD
Apr 12, 2014 – University of Washington Rehab Job Fair (OT, PT SLP) – Seattle, WA
Apr 16, 2014 – University of Puget Sound Job Fair (PT, OT) – Tacoma, WA
Apr 22, 2014 – St Ambrose University Health Sciences Job Fair (OT, PT, SLP) – Davenport, IA
May 21, 2014 – University of St Augustine Job Fair (PT, OT) – Austin, TX
May 28, 2014 – University of St Augustine Job Fair (PT, OT) – San Marcos, CA
Sept 9, 2014 – AT Still University Career Fair (OT) – Mesa, AZ
Sept 19, 2014 – University of St Augustine Job Fair (PT, OT) – Austin, TX
Oct 2, 2014 – Marquette University Health Fair (PT, SLP) – Milwaukee, WI
Oct 3, 2014 – University of St Augustine Job Fair (PT, OT) – San Marcos, CA
Oct 10-11, 2014 – PTWA Conference (PT, PTA) – Seattle, WA
Oct 10-11, 2014 – WOTA Conference (OT, OTA) – Spokane, WA
Oct 17-18, 2014 – OTAC Annual Conference (OT, OTA) – Pasadena, CA
Oct 17-18, 2014 – TPTA Annual Conference (PT, PTA) – Galveston Island, TX
Oct 21, 2014 – Texas Tech Health Sciences Job Fair (PT, OT, SLP) – Lubbock, TX
Oct 24, 2014 – Midwestern University Career Fair (PT, PTA) – Glendale, AZ
Oct 31, 2014 – USC OT Career Fair (OT, OTA) – Los Angeles, CA
Oct 31-Nov 1, 2014 – APTA National Student Conclave (PT, PTA) – Milwaukee, WI
Nov 3, 2014 – Fox Valley Technical College Health Job Fair (OTA) – Appleton, WI
Nov 7-8, 2014 – TOTA Annual Conference (OT, OTA) – Sugarland, TX
Nov 14, 2014 – Creighton University Health Fair (OT, PT) – Omaha, NE
Dec 10, 2014 – Hardin Simmons Career Fair (PT, PTA) – Abilene, TX

2013 Conferences Archive

Jan 21-24, 2013 – APTA Combined Sections Meeting (PT, PTA) – San Diego, CA
Jan 22, 2013 – Brookline College Career Fair (PTA) – Phoenix, AZ
Feb 8, 2013 – TX Women’s University OT Vanderkooi Event – Dallas, TX
Feb 11, 2013 – TX Women’s University Health Professions Career Fair (PT, OT) – Houston, TX
Mar 7-9, 2013 – CA Speech/Hearing Association Convention – Long Beach, CA
Mar 23, 2013 – University of Texas Career Fair (PT, PTA) – San Antonio, TX
Apr 13, 2013 – University of Washington Job Fair (OT, PT, SLP) – Seattle, WA
Apr 25-27, 2013 – AOTA Annual Conference & Expo – San Diego, CA
May 8, 2013 – Pierce College Job Fair (PTA) – Lakewood, WA
May 10, 2013 – Cal State Dominguez Hills (OT, OTA) – Carson, CA
May 15, 2013 – Pierce College Job Fair (PTA) – Puyallup, WA
May 15, 2013 – St Augustine University Job Fair (OT, PT) – St Augustine, FL
May 22, 2013 – St Augustine University Job Fair (OT, PT) – San Marcos, CA
May 23, 2013 – Grossmont College Job Fair (OTA) – San Diego, CA
June 26-28, 2013 – APTA Conference (PT, PTA) – Salt Lake City, UT
Sept 20-21, 2013 – CPTA Annual Conference – (PT, PTA) – Pasadena, CA
Oct 25-26, 2013 – OTAC Annual Conference – (OT, OTA) – Sacramento, CA
Nov 8-10, 2013 – TOTA Annual Conference (OT, OTA) – Sugarland, TX

2012 Conferences Archive

Feb 17, 2012 – Academic Day (PT/OT) at TWU – Dallas, TX
Feb 28, 2012 – Keiser University (OTA/PTA) – Fort Lauderdale, FL
March 1, 2012 – Rockhurst College (PT/OT) – Kansas City, MO
March 6, 2012 – Blinn College (PTA) – Bryan, TX
March 7, 2012 – The University of TX-Pan American (OT/SLP) – Edinburg, TX
March 7-10, 2012 – TSHA Convention (SLP) – San Antonio, TX
March 9-11, 2012 – NE PT Association Spring Conference (PT) – Kearney, NE
March 15-18, 2012 – CSHA Annual State Convention (SLP) – San Jose, CA
March 22, 2012 – CA State Dominguez Hills’ Spring Job Fair (OT) – Carson, CA
March 30, 2012 – USC OT Career Fair (OT) – Los Angeles, CA
March 31, 2012 – 42nd Annual Spring Conf & Expo (PT) – Aurora, CO
March 31, 2012 – University of TX Health Science Fair (PT) – San Antonio, TX
Apr 12, 2012 – Eastern Washington University (PT/OT/SLP) – Seattle, WA
April 16, 2012 – University of Milwaukee (PT/OT/SLP) – Milwaukee, WI
April 20, 2012 – Iowa Physical Therapy Association (PT) – Ames, IA
May 10, 2012 – CSU Dominguez Hills’ Spring Job Fair (OT) – Carson, CA
May 12, 2012 – University of WA Rehab Job Fair (PT/OT/SLP) – Seattle, WA
May 16, 2012 – University of St Augustine (PT/OT) – St Augustine, FL
May 23, 2012 – University of St Augustine San Diego (PT/OT) – San Diego, CA
May 24, 2012 – Grossmont College (OTA) Career Fair – El Cajon/San Diego, CA
July 12, 2012 – A.T. Stills University Career Fair (PT/OT) – Mesa, AZ
Aug 31, 2012 – PIMA Medical Institute PTA Job Fair – Seattle, WA
Sept 11, 2012 – UTEP Health Professions Career Fair (PT/OT/SLP) – El Paso,TX
Sept 12, 2012 – University of St Augustine (PT/OT) – St Augustine, FL
Sept 19, 2012 – University of St Augustine San Diego (PT/OT) – San Diego, CA
Sept 20, 2012 – LSU Health Science Job Fair (OT/PT/SLP) – New Orleans, LA
Sept 26, 2012 – Texas State Healthcare Job Fair (PT/PTA) – San Marcos, TX
Sept 28-29, 2012 – California PT Association Conference (PT) – Santa Clara, CA
Oct 5-6, 2012 – OTAC Conference (OT/OTA) – Pasadena, CA
Oct 8, 2012 – University of Puget Sound Job Fair (PT/OT) – Tacoma, WA
Oct 12-13, 2012 – WOTA Annual Conference (OT) – Wenatchee, WA
Oct 12-13, 2012 – Nebraska OT Association Fall Conference – Omaha, NE
Oct 16, 2012 – Texas Tech University Health Sciences Job Fair (OT/PT/SLP) – Lubbock, TX
Oct 19-20, 2012 – Nebraska PT Association Fall Conference – LaVista, NE
Oct 24-26, 2012 – Iowa Speech/Hearing Assoc Conference – Des Moines, IA
Oct 25-27, 2012 – TPTA Annual Conference (PT/PTA) – San Antonio, TX
Oct 26, 2012 – USC OT Career Fair – Los Angeles, CA
Oct 26, 2012 – Loma Linda University Career Fair (OT/PT) – Loma Linda, CA
Oct 26, 2012 – Iowa OT Association Conference – Des Moines, IA
Oct 29, 2012 – Texas Women’s Univ Health Professional Career Day (OT, PT) – Houston, TX
Nov 2-3, 2012 – TOTA Annual Conference (OT/OTA) – Austin, TX
Nov 7, 2012 – University of Utah OT/PT Career Fair – Salt Lake City, UT
Nov 8, 2012 – St Ambrose Health Sciences Fair (OT/PT/SLP)-Davenport, IA
Nov 9, 2012 – Creighton University Health Career Fair (OT/PT) – Omaha, NE
Nov 13, 2012 – Texas Women’s Univ Health Career Fair (OT/PT) – Dallas, TX
Dec 12, 2012 – Hardin-Simmons University Career Fair (PT) – Abilene, TX

Fast Track to Therapy Leadership!!!

December 4, 2015 MP News

Northbrook Healthcare in Willits, CA, is offering an exciting opportunity for therapists of any discipline who have a passion for leadership. We are opening our Director of Rehab position up to candidates who have not yet had experience as a rehab director and are committed to provide the following support to assist you in being successful:

Dedicated mentoring and support by the area Therapy Resource
Monthly opportunities to shadow or ask for in-depth explanations in regards to managing staff, billing, documentation, Ensign culture, regulatory requirements, etc., with experienced DOR’s in the cluster
Highly experienced facility administrator committed to supporting and mentoring you
$1500.00 in external continuing education money
$5,000.00 student loan repayment or signing/retention bonus
Invitation to attend expenses paid DOR meeting in June 2016 (held in So Cal)
Special training in our Abilities Care Approach program

Are You A Contender?

The ideal candidate will be a licensed PT, OT or SLP, have some level of exposure to Ensign’s unique culture (either as a staff therapist or a student during a fieldwork experience) and have demonstrated solid experience in delivering high quality care to adult and geriatric patients in a long term and post-acute rehab setting. In addition, this special therapist will also demonstrate a passion for learning, a love for patients and colleagues, the drive to solve problems and overcome barriers, and the desire to build something great.

For More Information:

Contact Paul Medvene

(949) 230-8384 or pmedvene@ensigngroup.net

Compliance Corner

November 12, 2015November 23, 2015 MP News

2016 MSCA Process Updates and the Importance of Medicare Meetings

Ironically, the old adage that does not change in healthcare is “The only thing that is constant is change.” Year two of the IRO on-sites is now over, and there is always a lot we can take away as an organization from these audits. Oftentimes, it makes us reflect upon the processes that we have in place in both operations and compliance, and how effective they are in preparing our facilities for success.

With that said, there will be some tweaks in the works for the 2016 MSCA compliance auditing process to help capture where we may be vulnerable and also to mimic the process of IRO on-sites more closely. Also, one of the areas we always focus on but that still needs constant fine-tuning is our Medicare Meeting and how we, as an organization, can be better. A question you may want to ask yourself when looking in the proverbial mirror is, “How can I be better?”

MSCA Process Updates

The MSCA process for 2016 will remain relatively the same in terms of the number of audits and the types of things we will be auditing. One of the things that will be changing is how we select some of the claims we will be auditing. The biggest change with the claims selection process comes with our “High Risk” facilities. We will still have a split audit for these buildings, but for the first portion of the audit, we will use Length of Stay reports found in PCC to help guide the claim selection process. This makes sense, as we know and have learned (sometimes the hard way) that our claims with longer lengths of stay are the most vulnerable.

The other things that are changing are the additions of therapy treatment observations and DOR interviews during the on-site portions of the MSCA. This will closely mimic what is done during IRO visits and will help us not only prepare for possible IRO selections, but also help us at the facility level to identify possible root-cause weaknesses in our processes. Your compliance partners will inform their facilities of the changes and will be happy to go over these new processes with you and your facility teams should there be any questions.

Importance of the Medicare Meeting

The Medicare Meeting is always an emphasis to look at and improve upon, even in the best of our meetings. This year’s IRO on-site helped us identify some areas where we can definitely improve not only as an IDT, but as DORs.

For one, make your voice known. We found yet again, the best meetings were the ones where IDT members were fully engaged and challenging each other, asking the right questions about patient care, discharging of therapy disciplines, appropriate lengths of stay, etc. So, what if you notice your IDT members are relatively quiet or things are going a little too smoothly and everyone agrees completely with everything? Ask yourself if all the right questions have been asked and key factors have been analyzed regarding the patient’s care. Take the onus and help engage your fellow IDT members if need be.

The improvement in use of standardized testing was great to see and was noticed by the IRO. However, let’s not lose sight of the fact that our IDT members may not be as well-versed in these tests as you may be. Take the time to help educate and explain to the team what these tests are and how the scores impact the patient. The more they know, the more relevant the information and conversation you will have with standardized testing.

Finally, we all have full days and run busy programs, relying greatly on our therapy staff to support us. Gathering information from the therapy staff about resident care is vital to providing pertinent information during the Medicare Meeting. I think it’s safe to say that we all do that in one form or another, but how sure are we the information we are providing during the Medicare Meeting is being captured in the actual therapy documentation? Unfortunately, it was a hard lesson learned this year, that that situation can occur. So I ask all of you not to rest on your laurels and your past successes, but rather to re-evaluate your current systems to answer the question, “How can I be better?”

News