Sue, Can you explain what type of groups you are able to have and how you "clearly demonstrate that the group was in the clients best interest not the time/staff management of the unit".? I would love to hear about those forms that you have developed.
Our unit has been doing great with the three hour rule.? If the patient does not have ST, then OT and PT will usually devide the time and block by?45 minute sessions.? If the patient does have ST, they try to see them anywhere between 30-60 minutes pending the patient's need for ST.? We use a minute tracker in which we keep in a common area of the department and after each session we write in the time we were able to see them.? If we do not get the usual amount of time we try to write the minutes in red to alert the other staff to help out if able.? We also?use a team approach for our designated patients in which each OT has a team member from PT in which we can communicate when we need help. Shared your last email with my boss and now she is a little worried and is calling our prior consultant.? Thanks for your time. Chris Nahrwold MS, OTR -----Original Message----- From: Sue Doyle <[EMAIL PROTECTED]> To: otlist@otnow.com Sent: Sun, 2 Nov 2008 5:12 pm Subject: Re: [OTlist] Doubling patients Chris, I work in the same sized rehab unit. What are you total staffing numbers? Medicare from what the last lot of consulting we had in (currently still here) CMS does not approve of "doubling" unless it is billed as a group charge. Where you see any more than one patient at a time, it is considered a group. When billed as a group charge it must be able to be clearly demonstrated that the group was in the clients best interests not the time/staff management of the unit. Groups need to be structured about similar type patients with individual but similar goals that are clearly written for the group process. I have developed several forms for the groups that we run. Our consultants also warned us that "dovetailing" is also a practice frowned upon by CMS. (Some of our consultants have been like the director at Cedar Sinai etc). While there is now written limit on the amount of group time in the rehab setting as in SNF it is recommended that you stick to no more than 25% of the total treatment time for a patient be in group sessions. Would like to discuss more about scheduling, implementing the 3 hours rule etc with you. Sue> To: otlist@otnow.com> Date: Sun, 2 Nov 2008 17:02:48 -0500> From: [EMAIL PROTECTED]> Subject: [OTlist] Doubling patients> > Hey gang,> Just a little frustrated from last week at work.? I work in a small 13 bed acute rehab unit, in which the OTs have had a lot of pride in being occupationally based.? Just last week we were told we would have to start "doubling patients" at times because of increased census.? My boss is an OT so she should understand the correlation between one on one?OT and positive outcomes.? I understand that this might have to happen from time to time because of high census, but I have been frustrated that no plan has been initiated to find more help or at least calling the PRN therapists that could help cover the extra patients, since this has been an issue for 6 months.? I am beginning to think that?management is just trying to save money, but at the same time expecting the FIM scores to improve.? Just wanted to ask if anyone had to deal with this issue and what they did to remain occupationally based.? Is it ethically ok to "double", and is it ok from a Medicare guidline perspective in acute rehab?? Thanks.> > Chris Nahrwold MS, OTR> --> Options?> www.otnow.com/mailman/options/otlist_otnow.com> > Archive?> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
