Expect More When You Use HTS for Contract Therapy.

As health care continues to evolve, we know your therapy team needs to walk beside you — and even a little ahead of you — to bring solutions, navigate change and anticipate needs. Our dedicated experts keep you well informed and ahead of changes effecting our industry.

Partnering with HTS Means You’ll Receive 

  • Custom Marketing Solutions
  • Commitment to Compliance
  • Clinical Expertise

Click here to learn more about our Contract Therapy Services.

Article by James M. Berklan, www.mcknights.com

Journalists are supposed to be “words” men and women, but to be honest, I love a good set of numbers as much as anything. Especially when they’re tied to a pertinent analysis.

That’s why I find this period of transition with the Patient Driven Payment Model intoxicating. There’s mystery (Will providers fare well under the drastic overhaul?), cunning (How might providers get the best bang for their buck?) and suspense (What will regulators yank back if they don’t like what they’re seeing?).

And numbers. Lots and lots of numbers.

Wednesday I got a chance to talk initial PDPM numbers with three of the biggest LTC numbers crunchers around, Marc Zimmet, Vince Fedele and Steven Littlehale. We talked about Zimmet Healthcare Services Group’s initial PDPM reimbursement analysis of October Medicare claims.

The overall impression coming out of it? You’re going to be alright, providers. Just as many had predicted, those who did their homework — and vow to keep getting better — should be just fine.

In fact, as colleague Danielle Brown writes in today’s top Daily Update news item, many providers who paid attention in their PDPM educational classes are making, on average, more than $50 more per patient day then they would have under the old RUGs-IV system. When adjusted for one-time exceptions, it’s about half that, but it’s still a big positive. In addition, Zimmet estimates that providers can gain another $40 per patient day more once they get better at coding and, well, simply remembering to claim what they have coming.

While OT and PT therapy pay rates won’t necessarily budge much, better can be had in speech language therapy, nursing and non-therapy ancillary services, Zimmet explained.

A big caveat here: The analysts were clear that theirs was not a random sample and should not be taken as an ironclad predictive argument. The sample included a lot of East Coast clients, and they tended to be on the larger size, but it was still significant and close to what others should be finding.

The biggest worry isn’t so much what PDPM will do to providers’ bottom lines, but, much as I predicted a few weeks ago after talking to a long time marketplace exec: What the Centers for Medicare & Medicaid Services will do to the flow of cash when it eventually recalibrates pay rates. Because we can assume with these kinds of cheery numbers Uncle Sam will want to get back what he feels is rightly his.

Zimmet predicted with “95% confidence” that a rate readjustment will be coming, eventually. Providers will know in “less than a quarter” how finances will shake out, but CMS will likely take about six months before it makes any pronouncements about rate readjustments.

Make no mistake: This is good. It means you’re not getting riffed right now, wondering how to make ends meet. The CMS policy is not going to be budget neutral — but in a good way.

And the best thing of all is, you can do even better at it once you get better at coding and stop leaving money on the table.

Click here to continue reading this blog.

Southfield Village Therapy Team Celebrates a Successful Recovery!

Patient, Brenda, enjoyed therapy so much that she dressed up for her last day at Southfield Village.

Pictured left to right are Derek Gokee PT, Brenda, and Brian Kemp PTA.

Follow along with our Facebook page to see how we’re helping communities just like yours!

Everyone has heard the phrase “Stand Up Straight! Don’t Slouch!” Behind those long forgotten words lies a very valuable and surprisingly simple message: Good posture is important because it helps your body function at top speed. It promotes movement efficiency and endurance and contributes to an overall feeling of well-being.

Our bodies change as we age. If you have poor posture, your bones are not properly aligned, and your muscles, joint and ligaments take more strain than nature intended. These natural changes make it especially important for older adults to maintain good posture, strength, flexibility and balance. Good posture can decrease your risk of falls!

Poor Posture Can Cause:

  • Headaches & Fatigue
  • Back, Neck & Shoulder Pain
  • Breathing Problems

Tips for Maintaining Good Posture:

  1. Avoid staying in one position for long periods of time; inactivity causes muscle tension and weakness.
  2. Maintain a healthy weight; excess weight exerts a constant forward pull on the back muscles and weakens the abdomen.
  3. Sleep on a firm mattress and use a pillow under your head just big enough to maintain the normal cervical-neck-curve.
  4. Wear comfortable and well-supported shoes. Avoid high heeled or platform shoes, which distort the normal shape of the foot and throw the back’s natural curves out of alignment.
  5. Walk with good posture; keep head erect with chin parallel to the ground, allow arms to swing naturally, and keep feet pointed in the direction you are going.

For more exercise and posture tips, talk with your doctor about physical and occupational therapy. Therapy can help correct your bad posture and help alleviate chronic pain. No matter what age you are, every BODY will feel the benefits of better posture.

Update on CMS & MAC Claims Processing

Below is an update from AHCA on processing of Medicare claims under the Patient-Driven Payment Model. Please note particularly the part that suggests holding claims until Thursday, October 24.

On October 17th, CMS transmitted is quarterly update to all Medicare Administrative Contractors (MACs) as scheduled. CMS also indicated the MACs would need until October 24th to load, test, and launch the update.

Today, we have heard from several members about problems with claims submitted last Friday and yesterday. This likely is because the MACs require more time (e.g., until the targeted October 24th) to finish installation and testing.

Last evening, we informed CMS (both payment policy staff as well as MAC officers about the responses from MACs to-date (e.g., lower likely payments than billed). We will remain in contact with CMS in the coming days.

For now, we recommend holding submission of claims until October 24th – the date CMS indicated the MACs should be ready. On October 25th, COB, we will be in contact with membership about the result of claims submission. If problems persist, AHCA will escalate the issue quickly.

The final submission deadline for this quarter is November 14th, 2019. Only data successfully submitted by this time is used on the Nursing Home Compare website and in the five star rating calculations.

Tips:

  • Once information is uploaded, check your Final Validations Report which is accessed in the Certification and Survey Provider Enhanced Reporting (CASPER folder) to verify data was submitted successfully.
  • It may take up to 24 hours to receive the validation report.
  • QIES helpdesk is available for assistance help@qtso.com
  • Do not wait until just a few days before the deadline to submit PBJ data for the reasons above.

Click here to learn more.

According to the National Osteoporosis Foundation, one in two women and one in four men age 50 and older will suffer an osteoporosis-related fracture. Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to weak and brittle bones. Breaking a bone is serious, especially when you’re older and broken bones can cause severe pain.

How Can Therapy Help?

Physical therapy can help manage and prevent osteoporosis as well as reduce falls and injuries for those diagnosed with the disease. Based on a thorough assessment of your posture, balance, strength and flexibility, a physical therapist will work one-on-one with you to target your specific areas of weakness. Also, an occupational therapist will work with you to evaluate your lifestyle, home environment and activities of daily living to ensure you can safely do all the things that you want and need to do. Talk to your doctor about your fall risk and ask if physical or occupational therapy could help. Be sure to have your doctor or pharmacist to review you prescriptions regularly.

Therapy Goals for Preventing & Treating Osteoporosis:

  • Maintain or Increase Bone Mass Density Using Exercise
  • Improve Muscle Strength, Balance, Posture, and Cardiovascular Fitness
  • Improve Psychological Well-being
  • Prevent Fractures
  • Reduce Falls
  • Provide Education

For more information, please contact the therapy department.


References: National Osteoporosis Foundation

The Physical Therapy Team at Heritage Pointe Huntington Celebrates National Physical Therapy Month

We are certainly proud of our awesome Physical Therapy team at Heritage Pointe Huntington. One of the PT therapy students made these shirts for the therapists. How great is that?!

Follow along with our Facebook page to see how we’re helping communities just like yours!

CMS announced the MDS 3.0 RAI Manual v1.17.1 which will take effect on October 1, 2019 is now available. 
This version of the RAI manual provides clarification to existing coding and transmission policy.

Click here to download the manual.

Exclusive PDPM Training For HTS Partners

We are committed to supporting our partners by offering exclusive PDPM webinar and live trainings in critical areas to foster success as we “Power through PDPM.”

Moving From RUG-IV to PDPM:  The Transitional IPA

Wednesday, September 25, 10:00 a.m. – 11:00 a.m.

Join us for the 1st High Impact PDPM Workshop where we will review how to successfully navigate the upcoming transition from RUG-IV to PDPM. This webinar will focus on completion of the required transitional Interim Payment Assessment (IPA) for current Medicare Part A beneficiaries including gathering quality assessment data and considerations for ARD scheduling.

Presented by: Eleisha Wilkes, RN, RAC-CT

 

PDPM Billing Processes

Wednesday, October 23, 10:00 a.m. – 11:00 a.m.

The importance of billing accuracy becomes more important than ever under the PDPM (Patient-Driven Payment Model) effective October 1, 2019. This session will focus on tools and strategies to establish a robust Triple Check process that providers cannot afford to overlook.

Presented by: Stacy Baker, OTR/L, CHC, RAC-CT

 

Please contact us to register. Not a partner? Contact us to learn how we’re providing even more value to our partners.