PT eval day count as missed day?

crazyforthis · Nov 2, 2011

Resident had a PT & OT evals on 10/28/11 (day of admit) only. No minutes
Did not recieve any minutes 10/29, 10/30/11 due to refusals/confusion
Recieved therapy 10/31/11
Boss says do not need to count 10/28/11 as a missed day as he got Therapy service (the evals)
I say no, you count minutes as day of therapy so i10/28/11 s a missed day and therefore had 3 days in a row missed
and needs a EOT R.
What does everyone else think?
Thank you for your help

Interesting question! I had thought you don't count the eval day if it was only an eval? We occassionally have a patient admitted Friday before noon, they usually get eval'd only Friday for PT/OT etc and might not start actual therapy services until Monday because we don't always have therapy services on weekends. Gulp! I hope I have not been doing this wrong. :smackingf

montecarlo64, BSN · Nov 3, 2011

I don't think that the 3 day rule doesn't apply for the 5D assessment..That's why we set it on day 8, so that therapy has time to get orders, eval and then get 5 days of treatment before the ARD,

crazyforthis · Nov 4, 2011

scenario; Doc writes order for PT/OT eval on Thursday aftrenoon, patient gets eval'd for PT/OT on Friday which is day 16 of admit. Patient is eval'd only that day so we dont use those minutes, correct? Then as it is a weekend patient does not get any rehab therapies Sat/Sun. Monday patient gets PT/OT and continues to get it the entire week each day M-F. I think that because the Friday patient was eval'd only and we dont get to count those minutes that we dont count it as patient missing therapy 3 days in a row (Fri/Sat/Sun), correct? I start counting minutes Monday along with watching for the 3 day rule. Correct?

andy3k · Nov 4, 2011

All of these questions are very good and not as simple as they seem. The RAI Panel is currently discussing these issues. I'll let you know if hear something definitive.

imkaren2 · Nov 10, 2011

My feeling is the eval counts as a day, and the next 2 days make 3 days without therapy.

The person who said this rule doesn't apply to the 5 day, not so, if there is no therapy for 3 days, including weekends regardless if you are a facility with/out rehab on weekends an EOT needs to be done unless the previous RUG was a nursing RUG. However, in this case, you may look at doing a SOT if able before resorting to the EOT.

I'm not sure if an EOT-r would be useful at this point. My understanding of that type of assessment is to resume rehab where you left off within the past 5 days at the same RUG. If the pt. never got rehab, I can't see how that would apply. Just my thoughts..