Missed Therapy day

[ibtootie]

My understanding of the EOT/SOT/COT was that a COT was warranted if the Resident missed 3 consecutive days of therapy but I'm seeing that if the Resident is on only 1 Rehab discipline it would change the RUG if he gets 4 days of therapy out of the 7 day look-back. Mr. X is getting skilled nursing for IV antibiotics and wound care plus Physical Therapy only for ambulation safety with a cane. He receives PT on Monday, Tuesday, Thursday and Friday, and no PT over the weekend. During that 7 day look-back (from Sunday to Sunday because of the way the ARD fell), it shows he had 4 days out of the 7 days of therapy even though there was no 3 consecutive day gap which caused his RUG to go from RMA to CA1. Doesn't that mean a COT eval still needs to be done?

[andy3k]

An EOT is required if the resident misses 3 consecutive days of therapy (I assume you mistyped COT instead of EOT). Yes, since an EOT is not required in the situation above, the COT needs to be completed because the RUG group has changed based on the 7 day look back.

[ibtootie]

Yes, I meant EOT, sorry, all the acronyms are starting to run together in my brain. So, in doing a COT because of the change in the RUG level, I will need to reassess in 7 days and do an SOT?

[PsychNurseWannaBe, BSN, RN]

Yes, I meant EOT, sorry, all the acronyms are starting to run together in my brain. So, in doing a COT because of the change in the RUG level, I will need to reassess in 7 days and do an SOT?

OK... now I am confused (it doesn't take much LOL). He didn't miss 3 consecutive days so it is a COT. If I am understanding this right, COT is a 7 day look back from the ARD. He will have another ARD coming up if he picks up more therapy and there is a change in his rug score. Right?? Why would you need to do a SOT when he didn't have an EOT?

[andy3k]

PsychNurseWannaBe is correct, you only complete an SOT if there was an EOT and the resident did not qualify for an EOT-R.

But assuming that was another mistype: Yes, you would evaluate a second COT at ARD+7 days after the first COT. Even if you had evaluated but not completed the first COT, you would still have to assess the second COT. COTs are evaluated (and completed, if necessary) every 7 days until another scheduled or unscheduled PPS assessment is completed, which resets the COT schedule.

Example:

An Oct 20 14-day means you do an Oct 27 COT evaluation. Whether or not you complete the Oct 27 COT, you then schedule a Nov 3 COT evaluation. If the 30-day is completed on Nov 2 then the COT schedule is reset, the Nov 3 COT evaluation goes away, and the next COT evaluation is due Nov 9. Otherwise, the Nov 3 COT is evaluated and, if it is required, you combine it with the 30-day.