Stories from the Field

Featuring Marita Huey, PTA

At age 43, Marita Huey decided to go back to school to pursue a career in which she could serve people within the healthcare space. This journey led her to becoming a PTA. Marita has now been with HTS for seven years!

One of Marita’s newest therapy tricks is the use of The Point of Care (POC) functionality provided by Optima. Marita first was drawn to documentation on POC due to its portability. After a couple uses of the system, she began to understand the user-friendly features which made her more efficient. One of Marita’s pain points, however, is that the goal build function does take longer than what she is used to when documenting on COM (the web-based documentation platform utilized via laptop and desktop). She now typically uses narrative vs the build function which is a blessing in disguise since created goals are now more individualized to meet resident needs.

Another time saving feature Marita described as user-friendly is the ability to bring up all past notes when completing a progress report so the skilled interventions data is able to be easily reviewed. Marita has some advice for new POC users, “Get a peer to help you navigate the Chromebook if you are not techy. Also, it’s a good move to keep a copy of the training manual with you the first one or two times you use POC.”

All in all, Marita is glad to have the use of POC as a documentation option. In a building with a total of nine therapists, there is a possibility to have a device with you to document at all times which in her opinion is a “game-changer.”

Past Stories From the Field can be found on the HTS Portal. Have a great “Hoping & Coping Story from the Field ” you would like to share with fellow HTS therapists?

Email Sheena Mattingly, Director of Clinical Outcomes at sheena@htstherapy.com for your chance to be featured in a “Story from the Field!”

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The Proof is in the GG

By: Sheena Mattingly, Director of Clinical Outcomes

In case you are in need of a recap, let’s start from the beginning. PDPM came into our lives on October 1, 2019. IDT processes and collaborative effort toward patient-centered care became even more imperative. Therapy remained a necessity in the recovery process under the methodology. The Centers for Medicare & Medicaid Services made it clear as mud that they will be looking at provision of services and outcomes. Presumably, medical review will surround any substantial changes in these areas. Let us also not forget that outcomes are publicly reported and impact quality measures, QRP, VBP, five-star, and so much more. Now that you are all caught up, let’s get to the good stuff!

HTS has shown improved Section GG outcomes when FY2019 is compared to the first six months post PDPM implementation.

So, what does this mean? If outcomes are equal to or above historic values, there is less risk for medical review and it means patient care and delivery is not compromised under PDPM. Also, improved outcomes provide further evidence of the great care HTS therapists deliver…even during a Public Health Emergency!

The proof is in the GG but in case you want more, check out the list below to see just a few more accomplishments from the past couple months:

  • Outpatient clinics are back up and running at almost full capacity!
  • Therapists are now equipped to use two new delivery service modes: telecommunication technology and telehealth.
  • Procedures such as cleaning, disinfecting, and sanitizing have been successfully implemented company-wide in order to mitigate risk of exposure to COVID-19.
  • Therapists have utilized a new Treatment Hierarchy Guide provided by HTS to help prioritize the treatment visits and provide services in a sequential manner according to priority level to further mitigate risk of exposure.
  • The Breathe Program introduced in April has improved pulmonary intervention for patients.
  • Therapists have demonstrated commitment to best practice by accommodating new regulation and compliance standards due to the public health emergency with quick turnaround time! This has allowed HTS to continue to provide services to patients in need during uncertain times.

The Bottom Line… HTS therapists have been rocking it out even harder than ever before and for that we thank you!

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Keep Moving for Better Health

As we get older, society tells us to take it easy and rest. However, research shows that this whole “sitting around all day” can actually do us more harm than good. According to the CDC, statistics show that 75% of older adults are sedentary.

Having an inactive lifestyle can be very harmful to your health. Sitting for long hours a day can decrease your bone density and heighten your risk for a heart attack or stroke. Physical activity is an important part of healthy aging.

Ask yourself these questions…
• Do You Ever Feel Tired?
• Do You Have Unexplained Aches and Pains?
• Are You Afraid That You Might Fall or Injure Yourself?

If you answered “yes”, you may want to consider adding a little exercise to your life. This doesn’t mean you need to go out and join a gym, many things can count as exercise like walking, gardening, cleaning, swimming, and dancing. At all ages, some physical activity is better than doing none.

Therapy Can Help Adults Stay Active & Independent

Physical therapists can teach you how to exercise appropriately for joint mobility, muscle strength and fitness. Occupational therapists help older adults to safely do the things they want to do, stay active and live well despite limitations. Talk to your doctor today about the benefits of physical and occupational therapy!

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Q4FY19 PEPPER Now Available for Download

SNF PEPPER summarizes data statistics which are obtained from paid SNF Medicare UB-04 Claims for SNF episodes of care that end in the most recent three federal fiscal years (the federal fiscal year spans October 1-September 30). The current version of PEPPER now available reviews episodes of care through quarter 4 of FY2019 including statistics for 2017, 2018, and 2019. SNFs are compared to other SNFS in three comparison groups: nation, MAC, and state. These comparisons enable a SNF to determine if their results differ from other SNFs and whether it is an outlier and/or at risk for improper payments.

Target Area Updates

The following RUGs focused target areas will be phased out for FY2020 as a result of PDPM: Therapy RUGS with High ADL, Nontherapy RUGs with High ADL, Change of Therapy Assessment, & Ultrahigh Therapy RUGS. These target areas are included in the current FY2019 report along with the target areas: 20-day episodes of care, 90+ day episodes of care, and a new target area: 3-5 day readmissions which reviews readmissions to the SNF following a 3-5 calendar day gap. Please note this target area will not reflect claims until FY2020 and is intended to give providers information on readmission practices before and after PDPM implementation in order to assess the level to which facilities “may attempt to circumvent interrupted stay rules.”

Please click here for a table of target area definitions and suggestions.

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New SNF QRP COVID-19 Tip Sheet Now Available!

On July 24, 2020 CMS released a SNF QRP COVID-19 Tip Sheet. Here’s what you need to know:

  • Starting on July 1, 2020, SNFs are expected to resume timely quality data collection and submission of measure and patient assessment data for the MDS/RAI.
  • Specific quarters requiring reporting of data for the QRP program for CYs 2019 and 2020 are listed below:October 1, 2019–
    • December 31, 2019 (Q4 2019)
    • January 1, 2020–March 31, 2020 (Q1 2020)
    • April 1, 2020–June 30, 2020 (Q2 2020)
  • The MDS should be submitted for all new admission records and discharge records that occur on or after July 1, 2020.
  • Timely submission and acceptance requirements of MDS data to meet the 80-percent threshold are unchanged. SNFs are required to submit at least 80 percent of the necessary data to calculate the SNF QRP quality measures.
  • Before QM data is publicly reported on Nursing Home Compare, SNFs have the opportunity to review and correct and/or preview their data. A quarterly Provider Preview Report can be accessed via the Certification and Survey Provider Enhanced Reports (CASPER) application which is accessible from a SNF’s “Welcome to the CMS QIES Systems for Providers” page. Full instructions are available here.

 

Did You Know?

As part of the HTS Partner Plus Program you get access to multiple MDS specialists and nursing consultants to assure your coding is accurate which not only impacts PDPM reimbursement but also QRP? Contact HTS Director of Clinical Outcomes today for more details at sheena@htstherapy.com.

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CMS Issued FY 2021 SNF Final Payment Rule

On July 31, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates the Medicare payment rates and the quality programs for SNFs.

These updates include routine technical rate-setting updates to the SNF PPS payment rates, as well as finalizes adoption of the most recent OMB statistical area delineations and applies a 5 percent cap on wage index decreases from FY 2020 to FY 2021.

CMS is also finalizing changes to the ICD-10 code mappings that would be effective beginning in FY 2021, in response to stakeholder feedback. CMS projects aggregate payments to SNFs will increase by $750 million, or 2.2 percent, for FY 2021 compared to FY 2020.

Updated Base Rates for PDPM Components

For FY 2021, the unadjusted federal rate per diem for urban and rural will be as follows, prior to adjustment for case-mix.

TABLE 3: FY 2021 Unadjusted Federal Rate Per Diem – URBAN

Table 4: FY 2021 Unadjusted Federal Rate Per Diem – RURAL

Click here to view the SNF PPS Final Rule Fact Sheet.

Link to the Final Rule – http://www.federalregister.gov/inspection.aspx

Source: Centers for Medicare & Medicaid Services, www.cms.gov

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Managing Pain

Chronic pain is one of the most common reasons adults seek medical care.  In fact, statistics show that 60-75% of adults age 60+ report at least one type of chronic pain. Living with chronic pain can be overwhelming and greatly impact your quality of life. Pain can be debilitating making it very difficult to get around and complete daily activities.  Also, many adults suffering from pain may experience depression, anxiety, trouble sleeping, weight loss and cognitive impairment.      

Pain is not a normal part of aging.  If you or someone you know suffers from chronic pain, talk with your doctor to discuss ways to manage your pain without prescription opioids.  Pain relief can include many strategies including physical and occupational therapy, exercise, acupuncture, massage, spinal manipulation, interventional therapies (injections), cognitive behavioral therapy, and meditation among many others.  These methods can often be more effective than drugs and have fewer risks and side effects.

 

How Can Therapy Help?

Physical therapists can assess your pain and establish a therapy treatment plan fit for you. Treatment goals may include: pain relief, extended range of motion, increased strength and improved functional mobility. Non-invasive technology such as electrical stimulation (e-stim), ultrasound therapy, and hot and cold therapy can help to reduce pain and inflammation.

Occupational therapists work to evaluate how pain may be impacting your desired activities and quality of life. They can teach skills and strategies to help manage your pain.

 

Pain Quiz

    1. Does pain affect your ability to handle daily responsibilities or activities?
    2. Does your pain make it difficult for you to bathe or get dressed?
    3. Does your pain make it difficult to climb or descend stairs?
    4. Does your pain make it difficult to get out of bed or a chair?
    5. Are you taking opioid medications daily?

If you answered yes, talk with your doctor about physical and occupational therapy treatment options.

IASP® – Facts on Pain in Older Persons,  www.iasp-pain.org

CDC – https://www.cdc.gov/drugoverdose/patients/index.html

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Daily Stretches for Better Health

Morning stretching is important for your body to help kick-start your energy levels and improve circulation. Stretching can help loosen tight muscles and improve your range of motion making it easier to move and perform daily activities like getting dressed and picking up objects from the floor.

Try these simple stretches you can do every morning in bed. If you have any concerns about stretching please consult with your health care provider. We recommend stretching at least 2 to 3 times per week.

Full-body Stretch: Inhale, reach your arms overhead & straighten your legs out. Hold for 5 counts, then exhale & release the stretch. Repeat 3 times.

Knees-to-Chest: Lay on your back, bend your knees and use your hands to draw one knee in toward your chest at a time, wrapping your arms around both shins. Hold for 10 deep breaths.

Seated Forward Bend: Begin by sitting up and keeping your legs straight. Inhale and lengthen through your spine; as you exhale, start to walk your fingertips toward your feet. When you get to your farthest point, let your neck hang heavy toward your legs, releasing any tension. Hold for 10 rounds of breathing.

If you are experiencing pain or having trouble moving around and performing daily activities, talk with your doctor about Physical and Occupational Therapy. Physical therapists can teach you how to exercise and stretch appropriately for joint mobility, muscle strength and fitness. Occupational therapists can help older adults to safely do the things they want to do, stay active and live well despite limitations.

 

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Nurses Week Winners

Last week, HTS held a Nurse Appreciation contest to celebrate National Nurse’s Week! Thank you to everyone for sending in nominations. We are honored to work alongside so many wonderful nurses in our communities. Thank you for your sharing your incredible hearts and devoting tireless service to our industry.

Our Nurse’s Week Winners Are…

Each winner will receive a $50 gift card and swag bag from your friends at HTS.

Ashley Plue, LPN at Milner Community Health Care
Alison Snow, Director of Nursing at Nazareth Home Clifton
Cassandra Brown, RN BSN Director of Nursing at Metcalfe Health Care Center
Barb Sword, RN, HFA, CDP Director of Clinical Services at Hickory Creek
Christy Canter, RN at Hickory Creek at New Castle
Laurie Briggs, LPN at Grayson Manor
Katrina Wilson, Director of Nursing at Guerin Woods
Kelly McDougal, Health Services Director at Crestwood Village South
Michelle “Missy” Ryan LPN, MDS Coordinator at Northview Health & Living

A Special Shout Out to All the Amazing Nurses Nominated!

As a special thank you to all the nurses nominated, HTS will be sending each nurse a small gift from us to express our sincere appreciation and gratitude.

Alicia Tankersley at Swiss Village
Alma Ahmetovic at Swiss Village
Barb Simpson at Good Samaritan Home
Cynthia Palm at Maple Manor
Dana Roach at LLV Pine Valley
Debbie Rohrig at Ripley Crossing
Delisa McCloud at Glenburn Home
Heath Haver at Golden Years
Jaymee Brockhaus at LLV Pine Valley
Jayne Melton at Ketcham Memorial
Jessuca Willis at Hickory Creek at Hicksville
Kate Molin at Golden Years
Kelly Badjek at Hamilton Grove
Kim Davis at Heritage Pointe of Huntington
Kim Ray at Spring Creek
Kim Smith at Golden Years
Kristy Uhrick at Swiss Village
Mandy Bonbrake at Heritage Pointe of Huntington
Megan Rittenhouse at Heritage Pointe of Huntington
Monica Broady at Maple Manor
Nada Wireman at Parkview Haven
Natalie Bergman at Compass Park
Nicole Kubley at Grace Village
Pam Grabbe at Golden Years
Patty Engle at Ripley Crossing
Rona Westrich at Hamilton Grove
Sandy Stearns at Metcalfe Health Care Center
Sharon Smitty at Guerin Woods
Shona Kirkpatrick at Golden Years
Steve Brian at Guerin Woods
Teresa Headington at Guerin Woods
Teresa Medler at Good Samaritan Home
Theresa Wright at Golden Years
Tressa McNeely at HIckory Creek at Scottsburg
Viola Sheckles at Hickory Creek at Franklin

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CMS Approves for Therapy Minutes to Be Counted for Donning & Doffing of PPE

Blog by Cassie Murray, OTR, MBA, QCP, Chief Operating & Clinical Officer

During the May 12th CMS Office Hours broadcast, CMS provided guidance for SNF therapists to include the time spent donning and doffing PPE in the MDS Section O minutes. Therapists should begin including this time in the total treatment time for each session. This topic is covered in the recorded podcast between time markers 3:02 and 3:54. The link below is to the recording and written transcript.

Tuesday, May 12, 2020, CMS Office Hours (ZIP)

For questions or additional information, contact your Regional Director or Cassie Murray.

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