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5-Star Preview Reports Available on 1/23/2023

CMS announced that the Five-Star Preview Reports are available on January 23, 2023.

To access these reports, select the CASPER Reporting link located on the CMS QIES Systems for Providers page. Once in the CASPER Reporting system, select the ‘Folders’ button, then select ‘My Inbox’ or the Inbox beginning with ‘LTC’ and the state abbreviation followed by a facility ID. The reports only remain in the QIES system for a short time, so please save and/or print these reports for your records.

Nursing Home Care Compare will update with the Five Star data on or around January 25, 2023.

Important Note: The 5-Star Help Line (800-839-9290) will be available from January 23 through January 27, 2023. Please direct your inquiries to BetterCare@cms.hhs.gov if the Help Line is not available.

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OIG to Audit Telehealth Services in 2023

CMS has a substantial influence on how telehealth services are delivered and paid. Specifically, CMS sets forth regulation for payment and coverage requirements.

The Office of Inspector General (OIG)’s 2023 Work Plan will provide significant oversight on telehealth services including the impact of PHE flexibilities. The OIG reviews will provide objective findings and recommendations that can further inform providers about telehealth. The oversight intent is to ensure that the potential benefits from telehealth are realized for beneficiaries.

We got you! Here are our top 5 takeaways:

  1. Due to the PHE, actions have been taken to allow practitioners to provide telehealth services.
  2. Telehealth may offer an alternative method for necessary care to be safely delivered to residents in appropriate situations. This flexibility has been extended through CY 2024 and is no longer tied to the end of the federal PHE.
  3. If a beneficiary denies the use of telehealth, services will not be performed via this delivery mode.
  4. Creating an environment for successful telehealth services can make a huge difference in the efficacy of treatment. More guidance can be found here.
  5. Document, document, and then document some more. Proper documentation of the validity of the use of telehealth is imperative. Review entities will be looking for documentation as proof that the “right” steps were taken when performing telehealth (and other) services. Document any interdisciplinary collaboration, beneficiary consent to the delivery mode, the clinical appropriateness of the delivery mode, and that other options for safely delivering services in the direct presence between the resident and staff have been exhausted.

 

Need a Powerful Therapy Partner? Contact Amanda Green, Executive Director of Strategic Development amanda@htstherapy.com for information about our contract therapy partnerships.

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Taking Care of Your Heart

Heart disease is the leading cause of death in the United States and is largely preventable! There is so much you can do to take care of your aging heart and reduce your risk of developing heart disease.

Sleep Well
Poor sleep quality is associated with high blood pressure and cholesterol. Aim for at least 7– 8 hours of restful sleep each night to promote healing and improved brain function.

Manage Weight
Being overweight can cause damage to your heart and impact cholesterol, blood pressure, and blood glucose.

Eat Healthily
Eat a healthy, balanced diet of fruits, vegetables, low-fat dairy, and whole grains. Limit foods high in saturated fat which can raise your cholesterol as well as foods high in sodium which can raise your blood pressure.

Stay Active
Daily exercise such as a 30-minute walk can help improve blood flow and lower blood pressure and cholesterol levels. Avoid inactivity! The more activity you can do the better.

Reduce Stress
Stress causes your heart rate to increase and blood vessels to narrow. Learn how to control stress through deep breathing and other healthy relaxation exercises.

How Can Therapy Help?

Physical and Occupational Therapists can help you develop a healthier lifestyle and reduce many risk factors that cause heart disease. Physical therapists can help teach you how to exercise appropriately for joint mobility, muscle strength, and fitness. Occupational therapists can help you safely do the things you want to do, stay active, and live well despite limitations. Talk to your doctor today about the benefits of physical and occupational therapy!

Source: National Heart, Lung, and Blood Institute

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Benefits of Afternoon Naps

Daytime napping is common across many cultures and age groups. Did you know taking a short daily nap can boost your mood, energy, and memory? In fact, napping has many proven health benefits.

Benefits of Napping:

  • Reduce Stress
  • Improve Performance
  • Heighten Alertness
  • Improve Mood
  • Improve Memory
  • Reduced Risk of Heart Disease

Tips for Healthy Napping
The National Sleep Foundation recommends napping for about 20 minutes. This length of time will help you recharge but not leave you feeling sleepy. After approximately 30 minutes of sleep, your body may enter deep sleep. Waking during this cycle can be difficult and leave you feeling groggy.

Take your nap in the early afternoon before 3:00 pm. Napping too late in the day can disrupt your regular nighttime sleep. Some people like to nap shortly after eating lunch. To get into a healthy napping routine, try scheduling your nap at the same time every day.

How Can Therapy Help?
Physical and Occupational Therapists help address sleep issues and promote optimal sleep performance. Therapy helps by addressing conditions that may be causing poor sleep quality, managing pain and fatigue, overcoming common barriers, and also helping establish good bedtime routines. Talk with your doctor to see if therapy could benefit you!


Source: Sleep Foundation

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Breathe Better with Postural Drainage Therapy

Mucus in the lungs is a common symptom of many chronic lung diseases. Mucus plays an essential role by trapping irritants to protect your body from infection. However, for people living with chronic lung conditions such as COPD, asthma, and chronic bronchitis – the mucus can collect in your airway in excess.

Percussion and Postural Drainage Therapy can help treat breathing problems due to inflammation and mucus in the airways and lungs. Postural Drainage Therapy uses percussions, gravity, vibration, and deep breathing to loosen and drain mucus from the lungs and stimulate a productive cough to clear airways. Unclogging the airways is vital to keeping the lungs healthy.

Our therapists can provide treatment for respiratory conditions and help you remain physically active. Talk with your doctor about your condition and ask if Physical, Occupational, or Speech Therapy could benefit you.

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Tips to Prevent Low Back Pain

Low back pain is very common and can affect 4 out of 5 people at some time during their lives. As a person ages, lower back pain becomes even more prevalent. The lower back is involved in almost all activities of daily living like standing, walking, and lifting. Low back pain can limit many activities and reduce your quality of life. Although the causes can vary for each person; here are a few tips to prevent injury and pain.

How Therapy Can Help
If back pain is impacting your quality of life, talk with your doctor about physical therapy. A physical therapist will assess problems and recommend an individualized treatment plan with key exercises to improve your condition.


Sources: Sleepfoundation.org, Merck Manuals Online Medical Library

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Physical Therapy Can Help You!

Physical therapists work with people of all ages to feel and move better.  They can help maximize your movement, manage pain, avoid surgery, manage chronic conditions and recover from and prevent injury.

Here are some ways physical therapy can help you:

Manage Pain

Physical therapists use a variety of treatment approaches to address the root cause of your pain and movement limitations.  Physical therapy is recommended as a safe alternative to opioids for pain management.

Maximize Movement

Physical therapists can help you maintain or restore as much function as possible to move safely and effectively.  Regular physical activity can improve many chronic conditions and overall quality of life.

Improve Balance and Reduce Fall Risk

Physical therapists can help assess your fall risk factors and design a treatment plan to address your balance deficits.  Physical therapy helps to restore balance, mobility and strength.

 

Physical therapists work hard to help patients maintain and regain their quality of life. Speak with your doctor to find out how Physical Therapy could benefit you!

Source:  ChoosePT provided by APTA

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Falls Prevention for Older Adults

Each year 1 in 3 older adults will experience a fall; which is why it’s vitally important to pay attention to your body and stay on top of your balance. To prevent falls, the CDC recommends adults age 65+ should be screened yearly for fall risk or any time after a fall occurs. You can also check your risk for falling by answering the below 12 questions.

https://www.cdc.gov/steadi/pdf/STEADI-Brochure-StayIndependent-508.pdf

Therapy Can Help Reduce Falls & Improve Balance

Talk with your doctor if you fall, worry about falling, or feel unsteady. Physical Therapists provide balance training to restore and correct your balance. Occupational Therapists provide training on assistive devices and home safety to reduce your risk for falls.

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SNF Claims with Zero Hospital Days Prior to Admission Under Review

Blog by: Stacy Baker, OTR/L, RAC-CT, CHC, Proactive Medical Review

Effective July 15, 2022, HHS Secretary extended the PHE, the new expiration date being October 13, 2022. CMS continues to recognize that disruptions arising from a PHE can affect coverage under the SNF benefit:

  • Prevent a patient from having the 3-day inpatient QHS.
  • Disrupt the process of ending patient’s current benefit period and renewing their benefits.

While providers may continue using the QHS and Benefit Period Waivers, documentation needs to support how the skilled stay relates to the PHE, and in the absence of the pandemic, that the skilling condition would have required an inpatient hospital stay.

Going back to the March 13, 2020 letter to HHS from CMS Administrator, “SNF care without a 3-day inpatient hospital stay will be covered for beneficiaries who experience dislocations or are otherwise affected by the emergency, such as those who are (1) evacuated from a nursing home in the emergency area, (2) discharged from a hospital (in the emergency or receiving locations) in order to provide care to more seriously ill patients, or (3) need SNF care as a result of the emergency…” The letter goes on to state that the benefit period waiver “will apply only for those beneficiaries who have been delayed or prevented by the emergency itself…”

Furthermore, Proactive has seen recent medical review activity from the Supplemental Medical Review Contractor (SMRC), Noridian. Their current project reports that data analysis completed by CMS and the SMRC identified a potential area of vulnerability, and the SMRC is tasked to perform a medical review on SNF claims (3/1/2020 – 12/31/2021) that had zero hospital days prior to admission.

Click here to continue reading this blog.

 

About Proactive Medical Review
HTS partners with Proactive Medical Review, a third party company who specializes in ensuring compliance with regulatory standards and promoting measurable care excellence. The team includes SNF experienced nurse, MDS, Health Facility Administrator, therapist and reimbursement specialists with experience serving in multi-site contract therapy operations, as corporate directors of quality, clinical program specialists, and Compliance Officers. Proactive is uniquely positioned to assist in managing the many changes and challenges facing providers partnered with HTS. Learn more about our commitment to compliance here.

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What We Are Loving Right Now… Benchmarking!

By: Sheena Mattingly, HTS Director of Clinical Outcomes

What we’re loving right now is benchmarking. Before you call me a data nerd, which I certainly am, let me explain. HTS invests in Business Intelligence (BI) software which is used to analyze outcomes. This information is used for everything from reviewing areas of opportunity to optimizing processes.

Recently, we have been able to benchmark HTS data against national peers. It’s extremely important to be able to measure key performance indicators at the site level compared to internal standards. Arguably, more importantly, we need to be able to measure data at the company level and compare it to external standards. This is the way most industries operate. Unfortunately, benchmarking data in the long-term care space has not been available to us in the past.

Now that Net Health has acquired the two largest therapy documentation software companies (Optima and Casamba), this means we have access to most SNF rehab data across the nation. See below for two examples of how HTS uses benchmarking within BI.

National Outcomes

This Dashboard allows HTS to benchmark outcomes against national peers using admission and discharge GG scores as well as the length of stay.

National PDPM Stats

This Dashboard allows HTS to compare facility specific data to the data of similar facilities nationwide. The key performance indicators analyzed include:

  • ALOS
  • Group & Concurrent Percentages
  • Average Daily Treatment Minutes
  • PT/OT CMG Patient Distribution
  • SLP CMG Patient Distribution

With this new tool in our toolbox, we are able to show therapy outcomes in a more objective manner. Also, legislatively speaking, national associations are now more easily able to show CMS the significant impact therapies have on the long-term population’s independence and wellness. This information is crucial to prove why additional cuts to our industry are detrimental.

 

Need a Powerful Therapy Partner? Contact Amanda Green, Executive Director of Strategic Development amanda@htstherapy.com for information about our contract therapy partnerships.

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