5 day assessments r/t therapy minutes

Why are *you* forecasting therapy minutes? That's the therapist's job!

You'd better not get in the habit of putting down a standard projection. Medicare has started to come down on estimated vs. actual, and if they don't match, you lose. Your therapist needs to come up with a realistic estimate, or it's fraud. Our corporate has told us that if the actual doesn't correspond to the estimate (such as if the resident is uncooperative or too ill to participate, which you might not know when you do the estimate), you have to resubmit the MDS with the actual minutes instead of the estimate.

How are *you*, as the nurse, supposed to estimate therapy minutes? That's absolutely the therapist's job.

If you haven't already submitted the 5 day, and you know you're going to need to correct it, of course it would make sense to do it before you transmit. Otherwise you can do a correction. I would, however, get a ruling from your Medicare intermediary before you start changing how you do things...l

Section T asks for estimated rx mins/days up to day 15. Depending on an individual resident's condition and motivation, a good clinician will be able project these times.

Projecting therapy minutes should be done by a discipline with the area of expertise... in which case, the Rehab. therapist. You as an RN Coordinator can enter these projected rx minutes in the MDS after conferring with the therapist.

These numbers are just an estimate. If you had transmitted the 5-day already you do not need to send a Correction if the resident gets sick on day 9 or refused rx on days 11 & 12, or if resident received an additional 2 hrs of rx . You will be paid the 5-day RUGs until day 14 regardless. Afterall, you did not know that these events would happen when you did the estimate.

The therapy absences or increased therapy mins. will be reflected on your 14 day PPS and will adjust your RUGs accordingly.

A habitual "fixed number" each time (10 days/660 mins) is an absolute RED FLAG! Get a realistic estimate as possible. When doing the 5-day, look at Section P1b: Therapies. If PT captures 2 days of rx / 110 mins. (and your facility provides 5 day/wk rx) it is safe to estimate that from day 1 to 15 the resident will receive 11 days/605 mins. of PT. (avg. of 55 mins/rx X 11 days).

Watch out though ... If Section P1b rxs is 0/0 up to the 5th day of your ARD, be very careful w/ the estimated numbers in Section T.

Hey Tex...

Have you seen the NEW shortened MDS form to be used for PPS purposes only?

Talino, what are you referring to? What new shortened form? Not that I've ever received any kind of training or updates or literature in my building so that I would know. But boy, do they expect everything to be perfect.

Not that I *care* any more, either, but I'm a little curious. Today was my last day. I start at an ICF on Monday. No Medicares, no PPS.