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WE LOVE OUR THERAPISTS! AND, WE ARE PASSIONATE ABOUT LEARNING! Throughout the month of February, we are providing Learning “Oppties”. To learn more about the February Learning “Oppties” program, please read the introductory article posted January 31. Hopefully, you’ve had a chance to take a look at last week’s “Oppties” winners. It’s awesome to see companies like the Northern Pioneers have so much representation from a wide array of facilities. Way to go, team! Today’s Learning “Opptie” is designed to encourage us to take a close look at our Ethics and Values, relative to the provision of therapy services in the skilled nursing environment. As one of the most highly regulated environments, we must embody and uphold a set of ethical standards. Ethics is defined in the dictonary as the set of “obligations and duties a society requires of its members.” With that in mind, we must put first things first and get back to the basics of truly understanding the rules surrounding our practice, as well as adopt and support them fully. This is the essence of our foundation. There are many rules, so deciding where to start can feel somewhat overwhelming. First, as a therapist or therapist assistant, you are bound by a set of rules governing your practice. This set of rules for your specific discipline can be found by going to the state licensing board for your discipline and within the state in which you are providing skilled services. How do you find the state licensing board? If you are unsure about your state licensing board’s web site, ask your supervisor or check out the quick guide to “State Practice Acts” on the portal under therapy. In a culture of discipline, all therapists and all assistants must be very well aware of the licensing rules governing the practice of therapy. This information will clearly define what responsibilities an assistant, therapist and/or supervising therapist each has to uphold the law.

TODAY’S OPPTIE CHALLENGE IS THIS: Post the website URL or Web Address for your STATE LICENSING BOARD. Be sure to include your name, contact information and the name of your facility to receive credit toward your OPPTIE prize. Thank you for participating.

WE LOVE OUR THERAPISTS! To learn more about the February Learning “Oppties” program, please read the introductory articleposted January 31. Today’s Learning “Opptie” is related to billing the proper mode of treatment. There are 3 modes of treatment defined in the RAI Manual: Individual, Concurrent and Group. Individual treatment is defined as the treatment of one resident at a time. The resident has the full attention of the therapist or therapist assistant for the treatment. Concurrent treatment for a Medicare Part A patient is defined as the treatment of two residents, who are not performing the same or similar activities, at the same time, both of whom must be in the line of sight of the treating therapist or assistant, regardless of payer. For Medicare Part B, however, the treatment of two or more residents who may or may not be performing the same or similar activity, regardless of payer source, at the same time is documented as group treatment. While group treatment for a Medicare Part A resident is defined as the treatment of 4 residents, regardless of payer source, who are performing the same or similar activities, and are supervised by a therapist or assistant who is not supervising any other individuals.

Whew! Did you get all of that information? Well, let’s put it into application with the following challenge:

Mrs. V, whose stay is covered by SNF PPS Part A benefit, begins therapy in an individual session. After 13 minutes the therapist begins working with Mr. S., whose therapy is covered by Medicare Part B, while Mrs. V. continues with her skilled intervention and is in line-of-sight of the treating therapist. The therapist provides treatment during the same time period to Mrs. V. and Mr. S. for 24 minutes who are not performing the same or similar activities, at which time Mrs. V.’s therapy session ends. The therapist continues to treat Mr. S. individually for 10 minutes. Based on the information above, what is the answer to the following questions?

—For how many minutes did Mrs. V. receive individual therapy? For how many minutes did she receive concurrent therapy?

— For which mode of treatment did Mr. S. receive 24 minutes? And, for which mode did he receive 10 minutes? (HINT: Use the Medicare Part B definition).

WE LOVE OUR THERAPISTS! To learn more about the February Learning “Oppties” program, please read the introductory article posted January 31. Today’s learning opptie is related to guidelines for recording minutes. According to the RAI Manual for MDS 3.0, v1.07, Co-Treatment minutes for a Medicare Part A patient should be recorded using the following rule: When two clinicians, each from a different discipline, treat one resident at the same time (with different treatments), both disciplines may code the treatment session in full. All policies regarding mode, modalities and student supervision must be followed. The decision to co-treat should be made on a case by case basis and the need for co-treatment should be well documented for each patient.

Describe a scenario with a Medicare Part A patient where co-treatment might be clinically indicated. Be sure to include the therapist or therapist assistants discipline(s), the total treatment time and how each discipline would record minutes. Have you ever participated in a co-treatment session with a patient?

Please be sure to blog your answer in the reply space below. Include your first and last name, your facility and your e-mail address (your e-mail address will not be visible on the website), to be entered to win your “Opptie”. THIS WEEK’S “OPPTIES” AWARD WINNERS WILL BE POSTED ON MONDAY, FEBRUARY 6. Be sure to check back.

WE LOVE OUR THERAPISTS! To learn more about the February Learning “Oppties” program, please read the introductory articleposted January 31. Today’s learning opptie is related to a tool used in Skilled Nursing Facilities to report the assessment of care and services required. It’s called the Minimum Data Set or MDS. The purpose of this manual is to offer guidance on how to code and use the Minimum Data Set Version 3.0 (MDS 3.0) correctly and effectively. The Centers for Medicare and Medicaid Services (CMS) has an electronic version of the MDS 3.0 RAI manual available on the website at cms.gov. Your MDS Nurse also uses an RAI Manual and will know the answers (or at least how to find the answers) to questions you may have regarding the MDS. Did you know that, according to the RAI Manual, the time required to adjust equipment or otherwise prepare the treatment area for skilled rehabilitation service is the set-up time and is to be included in the count of minutes of therapy delivered to the resident? Set-up may be performed by the therapist, therapy assistant, or therapy aide.

In Chapter 3, Section O, on page 18, the manual talks about recording minutes for set-up time and gives specific instructions on HOW to record set-up time. Use these instructions to answer the following question: Under which mode of treatment (individual, concurrent or group) should set-up time be recorded? Please be sure to blog your answer in the reply space below. Include your first and last name, your facility and your e-mail address (your e-mail address will not be visible on the website), to be entered to win your “Opptie”. Also, if you have any suggestions regarding some continuing education courses you’d like to see us bring to your area, please include those ideas in your blog, as well. Thank you for participating and HAVE FUN!

WE LOVE OUR THERAPISTS! To learn more about the February Learning “Oppties” program, please read the introductory article posted January 31. Today’s Learning “Opptie” is designed to inspire you to explore! On the front page of the www.ensigntherapy.com website under our knowledge tab, you will find a splinting workshop scheduled for sometime next month. What is the date of the workshop and where is it scheduled to be held? What are the names of the workshop instructors? What is the fee for therapists who work in facilities supported by Ensign Facility Services, Inc.? Please fill out the reply information below to be entered to win your “opptie”. Don’t forget to include your first and last name, your facility and your email address. Your e-mail address will not be published! Thank you for participating and don’t forget to check back tomorrow.

WE LOVE OUR THERAPISTS! And, to CELEBRATE our PASSION FOR LEARNING, therapists, assistants and therapy techs working in facilities supported by Ensign Facility Services, Inc., will have the opportunity to LEARN AND WIN. In the July 2010 issue of Spirit Magazine (Southwest Airlines), Jay Heinrichs authored an article about a concept of giving back to employees by rewarding them with something that can help make them a little better. Heinrichs termed these rewards, “oppties”. We loved the idea and WE LOVE OUR THERAPISTS! So, for each day during the month of love (yes, February), a new learning opportunity related to various topics will be posted to the “LEARNING OPPTIES” page on www.ensigntherapy.com. Read the message, review the question and blog your response by hitting the “Discuss” link. You can also fill out the “reply” section located just below the question. Timely and correct responses will be entered to win “Oppties”. In addition to individual winners, there will also be other “Oppties” awarded, such as highest number of participants from a facility therapy department over a period of time and teams with the most consistent participation throughout a period of time. Winners will be posted. Don’t forget to check us out at www.ensigntherapy.com each day, beginning February 1, 2012, for your opportunity to LEARN AND WIN!