From the desk of our CEO Kris Mastrangelo:
What is CMS Saying About the EOT OMRA
January 27, 2011 CMS stated during their ODF that it is expected that an EOT will be completed anytime there is a break of three consecutive days or more in the provision of therapy services. The MDS 3.0 RAI Manual defines the EOT OMRA as: "Required when the resident was classified in a RUG-IV Rehabilitation Plus Extensive Services or Rehabilitation group and continues to need Part A SNF-level services after the discontinuation of all rehabilitation therapies."
CMS clarified that if a patient did not receive therapy from any one of the three disciplines an EOT is necessary. If the patient continues to require skilled therapy then CMS will mandate that a new therapy evaluation and SOT OMRA will be required to re-set the PPS RUG rate to a Rehab classification.
Additionally, CMS commented if a facility only provides therapy M-F they are not held to this guideline. If the facility only provides therapy on Saturday or Sunday on a very rare basis, for example to manage a holiday this is not considered a 6 or 7 day a week program.
Harmony recommends facilities take the following measures to prevent financial loss related to the reduction in reimbursement associated with completion of an EOT OMRA:
- Investigate, Define and Document any time there is a refusal of therapy. Determine if any minutes were provided (even 5-10) for education, assessment for participation, and/or treatment program modification.
- If Friday therapy is missed, schedule the patient on Saturday or Sunday to make up for the missed treatment.
- If Monday therapy is missed and the patient did not have therapy on the preceding Saturday or Sunday, schedule the patient for the following Saturday or Sunday.
- Develop a strong Restorative Nursing Program and review patients on Medicare Part A for utilization of the Rehab Low program.
Harmony is available to answer any questions related to specific patient case scenarios.
NEW Program: Jen Pettis, RN, WCC, RAC-MT, Program Development Manager and Regional Consultant for Harmony Healthcare is pleased to present the Quality Indicator Survey Preparedness Program. This is an educational program designed for all levels of facility leadership. We are currently seeking facilities to host this program. Contact us at 800-530-4413 x21 and ask for Sue Pellegrini.
Winter Webinars
February 3, 2011
MDS 3.0 FAQs
February 10, 2011 Pain Assessment and Coding February 17, 2011 [1/2 Day Seminar] 9:00AM - 12:00PM, Topsfield, MA Medicare Nursing/Therapy Documentation in a SNF and MDS 3.0 Documentation for the CNA
|
