[amesly15]

Well, we are getting ready for the new Oasis and I read that some agencies are designing grids for the answer to MO826 the therapy threshold question - where we will now estimate the number of PT/OT/SP visits that will be made. There is a list of the top 26 diagnosis codes. I was thinking of starting there. Has anyone developed a grid for this purpose? We could always hold the lock out until therapy gives us their answer?
amesly15 SCHN

[RNKittyKat]

We usually wait for therapy to give us their answer even now. Therapy is out there sometimes the same day as the RN opener. This will probably be our method.

[jnette]

We just discussed this as well.. if I remember correctly, it will depend on the dx.

If sth. "routine" such as hip fx., etc. where PT goes in daily, then it's pretty much a given that it will be 9 wks.x 5/wk. PT = 45 PT visits.

Those which are not quite as cut and dry we will leave until we have more input from the PT folks.

[DutchgirlRN]

We have PT go out just after nursing does the admit and they give us the answer. The same holds true for OT. We can recommend a HHA but only OT can actually order one and decide the frequency. Nursing can order the OT eval.

[indbletrble]

Originally Posted by amesly15

Well, we are getting ready for the new Oasis and I read that some agencies are designing grids for the answer to MO826 the therapy threshold question - where we will now estimate the number of PT/OT/SP visits that will be made. There is a list of the top 26 diagnosis codes. I was thinking of starting there. Has anyone developed a grid for this purpose? We could always hold the lock out until therapy gives us their answer?
amesly15 SCHN

I have completed orienting staff to the new case mix model, and focused on the two OASIS questions (M0110 and M0826). My agency has looked at setting up our system to do what some of the other writers here are going to do.......get the therapists out to the patient as early as possible.

I have made our physical therapists, who are already stretched, aware that they will need to pass more of their follow-up visits to the PTA so that cases can be evaluated expeditiously. Likewise, any other therapies would be scheduled on the heels of each other.

We had thought about a grid format, but because the care must be individualized and there are so many other factors that play into it, we think the timing of the evaluation is going to be the best way to obtain the needed information. Once an evaluation is completed, the therapist telephones from the patient's house to conference the case with the Supervisor. It is at this time the number of therapy visits is determined.

I think all of us shall be sitting with bated breath waiting to see how it all works out.

[caliotter3]

Agree with indbletrble. Cases are too individualized to make a grid easy to use. You need to make certain that your therapists provide timely input and go from there. You can make a standardized list for the common dx however, like jnette said.

[amesly15]

Thanks all...looks like we will be having therapy give us the answer to MO826 ASAP. What would homecare be without yet another change? We too are training on MO110. Also focusing on MO230/MO240/ and the new MO426! Makes my head spin

[horsepoor]

my question is about PTA- we only have physical therapists and they are stretched very thin. What duties do the aide have?

[indbletrble]

Originally Posted by horsepoor

my question is about PTA- we only have physical therapists and they are stretched very thin. What duties do the aide have?

Our PTA's are an invaluable resource for us. They work directly with the PT in providing hands on care to our patients. The PT develops the plan of care and oversees the progress the patient is making.

This oversight is conducted through conferencing with the PTA, review of the medical record and visits to the patient. Having a PTA following the patient for the followup visits frees our PT so that he/she can open new cases.

We find it to be a win-win situation.

[BlueRidgeHomeRN]

Originally Posted by DutchgirlRN

We can recommend a HHA but only OT can actually order one and decide the frequency.

Are you saying NURSES cannot evaluate for and order HHA???

That's a real kick in the teeth, IMHO, to nursing. Our nurses get to make the call, with input from therapies, but it is always the RN CM call...