Therapy minutes for PPS

Nascar nurse, ASN, RN · May 31, 2007

Can grace days be used to add minutes if the patient has already been seen 5 days on a 5 day MDS/PPS assessment?

Yes. If resident is seen and expected to continue to be seen for 7days/wk = 740 minutes, I use grace days to capture that. Why not take credit and get paid for what you are doing. Otherwise, you can just project the minutes in section T.

nratchet · Jun 1, 2007

If therapy is ordered 5 x week and therapy sees them on day one of admission and continues to see them for 8 days to gain enough minutes to put them in a very high or an ultra is this going against doctors orders to treat 5 days a week? :confused:

Talino · Jun 1, 2007

If therapy is ordered 5 x week and therapy sees them on day one of admission and continues to see them for 8 days to gain enough minutes to put them in a very high or an ultra is this going against doctors orders to treat 5 days a week?

The therapist's treatment plan must be approved by the physician. If the order approved by the physician calls for therapy 5 days a week, then a therapist cannot give treatment beyond that.

To capture Ultra or Very High with a 5-day rx:

Ultra - At least 2 therapies (1st discipline at least 5 days, 2nd discipline at least 3 days) must total 720 minutes or higher within the 5 day timeframe.

Very High - One therapy given at least 5 days (w/ or w/o another therapy combined) must total 500 - 719 minutes.

The extra therapy days delivered cannot be counted or captured in the MDS since it is not approved by the MD.

Nascar nurse, ASN, RN · Jun 2, 2007

Most often a resident will receive both PT and OT, each ordered for 5 days a week. That does not mean that each therapy has to use the same 5 days (ie: both treat Monday thru Friday), in fact it is often better for the resident if they break it up to prevent fatigue. Example PT treats on Sun, Mon, Wed, Thurs, Fri. OT treats Mon, Tues, Thurs, Fri and Saturday. This is how we go about providing therapy 7 days/wk. Most residents prefer it this way, as they came specifically for therapy and feel "cheated" if they are just lying around in the bed all weekend (feel they may as well be at home in their own bed if they aren't doing anything). In the end, we end up capturing 7 days for therapy and 720 minutes (we get lots of RU's) and the resident got good care and are well prepared to return home safely.