Learn

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 articleposted January 31. Today’s “Oppties” challenge is related to our culture of discipline. We seek to hire the “Right” people. The right people are deeply motivated by the inner drive to do GREAT work.

In our industry, great work means working with our patients to help them achieve their highest possible level of function so that, in many cases, they can return to their home or community living in a safe and effective manner. In other cases, some of our patients live with us in the long-term care portion of our Skilled Nursing Facilities and their highest possible level of function may be for them to complete their ADLs or walk to the dining room with assistance. In addition to providing great clinical care to our patients and residents, doing GREAT work means completing our work in a productive and thorough manner. To win an “OPPTIES” prize, share with us your secrets for completing each day in a productive and thorough manner. Thank you for participating in Learning “OPPTIES”.

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. On Tuesday, February 14 (Valentine’s Day), over 14 of our therapists wrote inspiring blogs, sharing stories from the heart. Take a moment to check out some of their writings.

Today’s Learning “Opptie” is related to the recording of time for patient’s receiving services therapy services in a Skilled Nursing Facility. We have spent time discussing the three primary modes of treatment defined by CMS in the RAI Manual for MDS 3.0, v1.07, Section O, Chapter 3. Remember, you can access this manual online at CMS.GOV. Did you know that, according to the RAI manual, a resident may receive therapy via different modes during the same day or even treatment session? When developing the plan of care, the therapist and assistant must determine which mode(s) of therapy and the amount of time the resident receives for each mode and record the minutes appropriately. The therapist and assistant should document the reason a specific mode of therapy was chosen as well as anticipated goals for that mode of therapy.

Here is the Learning “Oppties” 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. How would the therapist code each individual’s treatment? (Hint: Medicare Part B does not allow concurrent billing). Be sure to indicate the name of your facility so that you can be entered to win an “Opptie” prize! Thank you for your participation.

When:
April 14, 2012

Where:
South Texas College
Allied Health Campus
1103 E Vermont
McAllen, TX 78501

Ensign Facility Services hosts seminars in facilities that are ADA accessible. Please let Jon Anderson know if you need any special accommodation: jonanderson@ensigngroup.net

Kinesio Taping® Certification

KT3 Course, also called Kinesio Taping® Certification Course – The Kinesio Taping® Certification Course combines KT1 and KT2 coursework with extra lab time for attendees to practice their skills on a variety of clinical applications. KT3 can be designed to allow the instructor to cater towards specific practitioner protocols, clinical applications, and practitioner population and address specific professions (pediatrics, hand therapy, sports medicine, chiropractic, etc.) or clinical conditions (stroke, scoliosis, lymphedema, etc.). KT3 can also be set up as a general orthopedic course and may incorporate any or all of the following: unusual tapings, variations on standard tapings, problem solving, and “live patients”. This course is a minimum of 8 hours, but may be expanded by 2-8 additional hours depending on the instructor and/or the focus of the seminar. Upon completion of this course and prerequisite KT1, KT2 seminar, attendees will be eligible to request and take the exam to become a Certified Kinesio Taping® Practitioner (CKTP). Note: Students can request to take the exam but will not receive CKTP certificate until they graduate.

Prerequisite:

Completion of KTA approved KT1 and KT2 courses

Instructor:

‘Dee’ Virginia Ellis, PTA, CKTI

Dee is a Physical Therapist Assistant who has practiced in many different settings and states. Dee specializes in aquatic therapy, Pilates based spinal stabilization and orthopedic outpatient rehab. She has been a PTA for 15 years, graduating with her A.A.S. from Community Colleges of Southern Nevada in Las Vegas with a Gerontology Wellness Specialty. She also did undergraduate study at San Diego State University in California. Dee has a special interest in wellness and prevention.

Dee has been a Certified Kinesio® Taping Practitioner for 8 years and has been a Certified Kinesio® Taping Instructor since 2005. Dee has her American Physical Therapy Association (APTA) Advanced Proficiency in the musculoskeletal realm and was the recipient of the Texas Physical Therapy Association’s (TPTA) Joy Davenport award in 2008. She is an active volunteer in the APTA, the TPTA and the Aquatic Section of the APTA. Dee has presented continuing education on Electrical Modalities, Aquatic Physical Therapy and Kinesio® Taping: Fundamentals and Whole Body Techniques.

Dee currently works for as a PRN for local south Texas hospital systems and home health agencies.

Agenda:

Time	Mins	Application	Region	Symptom
8:00	20	Success Stories, Troubleshooting and Questions		Database, Instructor Lecture, Demonstration
8:20	20	Evaluation Questions, Assessments, & KT1 / 2 Review		Database, Instructor Lecture, Demonstration
8:40	15	Clinical Concepts: Shoulder Impingement	Shoulder	Database, Instructor Lecture, Demonstration
8:55	20	Shoulder Impingement Lab	Supraspinatus, Deltoid and Mechanical Correction	Shoulder Disfunction/Rotator Cuff Impingement
9:15	10	Clinical Concepts: Whiplash / Cervical Pain	Neck / Upper Back	Database, Instructor Lecture, Demonstration
9:25	15	Whiplash / Cervical Pain Lab	Cervical Paraspinals, Upper Trapezius, Ligament Correction	Cervical Pain (Whiplash)
9:40	10	Clinical Concepts: Chondromalacia Patella	Knee	Database, Instructor Lecture, Demonstration
9:50	15	Chondromalacia Patella Lab	Vastus Medialis Oblique Facilitation, Space Correction	Knee Effusion
10:05	15	Break
10:20	10	KT3 Advanced Concept: Fascial Correction: Manual Glide		Database, Instructor Lecture, Demonstration
10:30	15	Manual Fascial Glide Lab	Multiple Body Regions	Lab
10:45	10	KT3 Advanced Concept: “Basket Weave” Technique		Database, Instructor Lecture, Demonstration
10:55	15	Basket Weave (Closed Ended) Lab	Multiple Body Regions	Lab
11:10	15	Intro to Kinesio Scar Tapings		Database, Instructor Lecture, Demonstration
11:25	10	Scar Management “Directional Pull Application”
11:35	10	Scar Management “Pitting Scars Application”		Database, Instructor Lecture, Demonstration
11:45	15	Scar Management Lab	Multiple Body Regions	Lab
12:00	60	Lunch
1:00	15	Tension headache, TMJ, Sinus	Face	Instructor Lecture, Demostration
1:15	15	Lab		Lab Practice
1:30	15	Thoracic Outlet Syndrome, posture correction*	Neck/Chest	Instructor Lecture, Demostration
1:45	15	Lab		Lab Practice
2:00	40	Mallet Finger, UE edema	Wrist/Hand	Instructor Lecture, Demostration/Lab
2:40	20	Wrist Sprain (TFC)	Wrist/Forearm	Instructor Lecture, Demonstration/Lab
3:00	3:15	BREAK
3:15	15	External Oblique, Pregnant Belly, Lumbar Fascia**	Trunk	Instructor Lecture, Demonstration/Lab
3:30	15	Lab		Instructor Lecture, Demonstration/Lab
3:45	30	Knee Hyperextension, MCL, ACL	Knee	Instructor Lecture, Demonstration/Lab
4:15	30	Hallus Valgus, Hammer Toe	Foot	Instuctor Lecture, Demonstration/Lab
4:45	15	Lower GI Motility/ANS	Abdomen/CNS	Instructor Lecture, Demonstration/Lab
5:00	15	Contraindications & Precautions, Application Requests, Q&A		Mandatory

Who Should Attend?

PTs, OTs, ATs, DCs, LACs, MTs, PTAs, OTAs and other medical practitioners.
THIS COURSE IS INTENDED FOR LICENSED HEALTH CARE PRACTITIONERS ONLY

KT-3 Course Fees:

$279 – Professionals
$150 – Professionals who attended KT 1-2 on Jan 20/21 in McAllen
$125 – Ensign Supported Facility attendees
$100 – Students – Limited Slots Available

Enrollment:

Download Registration Form (PDF file)
Download Credit Card Payment Form (PDF file)

Send completed registration and payment forms to:

Kelly Wallerstedt
kwallerstedt@ensigngroup.net
602-538-6783

Valentine’s Day, 2012. 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.

Today is not just a regular day. Today is special and we are looking for today’s “Oppties” as a chance to create something rather extraordinary. According to Jim Collins in his book, Good to Great, “The right people don’t need to be tightly managed or fired up; they will be self-motivated by the inner drive to produce great results and be part of creating something great.” As therapy resources, we are constantly inspired by the beautiful work happening in our programs every single day. Share with us today, on Valentine’s Day 2012, some of your “Great” and inspiring stories, results, vision, programs, goals….the works of your heart. The first 14 respondents will receive an “Opptie” award for inspiring greatness through your stories and examples. Have a beautiful day. Deb Bielek, Therapy Resource

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.

I am so pleased to announce the Learning “Oppties” winners from Week 2. We had a number of challenging questions throughout the second week, asking for information regarding state licensing, as well as Medicare rules and regulations surrounding billing. Great attention to detail was noted in the responses and it was exciting to see continued growth in the amount of involvement. The TEAM WINNER for last week’s “Oppties” award is TEAM CLARION! Careage of Clarion is located in our newest company, Gateway. The Gateway Company is comprised of 9 Skilled Nursing Facilities across the states of Iowa and Nebraska. This home has 86 beds and saw its highest Skilled Census just recently when they hit 7. Our therapy team has successfully transitioned to an in-house program, led by Betsy Engelbarts, Director of Rehab and Speech-Language Pathologist. Karin Sande, SLP, Wendy Tireman, COTA, Jennifer Groen, PTA, and Sandra Fee, PT, combined for over 17 responses to our “Oppties” challenges last week! Way to go, Team Clarion. For your participation, you will be receiving an “I’m a Winner” T-Shirt and EnsignTherapy.com water can. We will also be coming to spend a lunch or breakfast with you to discuss the topic of “Passion in Healthcare”. We look forward to time with your team and are so grateful for the beautiful work you are doing for our residents and patients at Careage of Clarion.

Sam Baxter, PT, DOR at Orem Rehabilitation and Nursing in Orem, UT and Terry Martin, OT, DOR at Cloverdale Healthcare Center in Cloverdale, CA are our Individual Winners for week 2. They, too, will be receiving an “I’m a Winner” T-Shirt and watercan. Thank you, all, for your participation. Deb Bielek, Therapy Resource

 

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. Today’s Learning “Opptie” is related to the RAI Manual for MDS 3.0, v1.07, Chapter 3, Section O (manual can be found by going to cms.gov), rules on billing the different modes of treatment. As a reminder, the modes of treatment include Individual, Concurrent and group. Individual is defined as, “The treatment of one resident at a time.” Concurrent for Medicare Part A is defined as, “The treatment of 2 residents, who are not performing the same or similar activities, at the same time, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant.” And, Group for Medicare Part A 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.”

The Medicare Part B rules do NOT allow for recording at treatment as “Concurrent.” Instead, follow the Medicare Part B rule as such, “The treatment of 2 or more individuals regardless 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.”

Use the information above to answer the following “Opptie” challenge. Be sure to include your full name and facililty name on your response. Winners from this week will be posted on Monday, February 13. Good Luck!

• An OT provides therapies that are not the same or similar to Mr. P and Mr. R at the same time for 57 minutes. Mr. P’s stay is covered under the Medicare SNF PPS Part A benefit. Mr. R’s therapy is covered under Medicare Part B. Based on the information above, how would the therapist record each patient’s treatment on the service log? Be sure to include “mode” and minutes.

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. Today’s Learning “Opptie” is related to the RAI Manual for MDS 3.0, v1.07, Chapter 3, Section O (manual can be found by going to cms.gov), rules on billing the different modes of treatment. As a reminder, the modes of treatment include Individual, Concurrent and group. Individual is defined as, “The treatment of one resident at a time.” Concurrent for Medicare Part A is defined as, “The treatment of 2 residents, who are not performing the same or similar activities, at the same time, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant.” And, Group for Medicare Part A 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.”

Using the information above, answer the following “Oppties” challenge. Be sure to include your full name and facility name on your response so that you can be entered to win an “oppties” award. Winners for this week’s challenge will be posted on Monday, February 13.

• An Occupational Therapist provides similar therapies to Mr. W., Mr. X, Mrs. Y and Mr. Z at the same time, for 30 minutes. Mr. W. and Mr. X’s stays are covered under the Medicare SNF PPS Part A benefit. Mrs. Y.’s therapy is covered under a Medicare Advantage Plan, and Mr. Z has private insurance paying for therapy. Based on the information above, answer the following questions: 1. What treatment code would the OT use to indicate the “Mode” of treatment? 2. How many minutes would the OT record for each patient? Good luck!

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. Today’s Learning “Opptie” is related to the RAI Manual for MDS 3.0, v1.07, Chapter 3, Section O (manual can be found by going to cms.gov), rules on billing the different modes of treatment. As a reminder, the modes of treatment include Individual, Concurrent and group. Individual is defined as, “The treatment of one resident at a time.” Concurrent for Medicare Part A is defined as, “The treatment of 2 residents, who are not performing the same or similar activities, at the same time, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant.” And, Group for Medicare Part A 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.”

Using the information above, answer the following “Oppties” challenge. Please be sure to include your name and facility in your response so that you may be entered to win an “Oppties” prize. This week’s winners will be posted on Monday, February 13.

• A physical therapist provides therapies that are not the same or similar, to Mrs. Q and Mrs. R at the same time, for 30 minutes. Mrs. Q’s stay is covered under the Medicare SNF PPS Part A benefit. Mrs. R’s stay is also covered under the Medicare SNF PPS Part A benefit. Based on the information above, how would the therapist record each individual’s minutes for this day of treatment? Be sure to include the “mode” of treatment and the total treatment minutes recorded for each patient.

Football has a play book, but sometimes, the plays get changed. Troy Palamalu picks up on the quarterback’s audible at the line of scrimmage and calls for a blitz and “BAM,” down goes the quarterback. Troy got it right and made the play. Rehabilitation in the Skilled Nursing Facility has regulations. The therapist is comfortable with his understanding of a rule and “BAM,” the rule changes. But, unlike the quarterback in this story, the therapist doesn’t go down.

 

Let’s face it. We work in the most highly regulated, analyzed and scrutinized setting in America. Why do we hang in there? We hang in there for the love of it. That’s right, we LOVE what we do. We LOVE the people we serve. We LOVE our co-workers. We LOVE the difference we make every single day. We don’t go down.

As the regulations continue to change, we are finding ways to continue to deliver beautiful care and achieve tremendous outcomes with our patients and residents. We must celebrate those successes. Share those stories of progress and recovery. Show the outside world that we are capable and we will continue to evolve through changes thrust upon us.

With the ever-changing environment, taking care of the basics becomes paramount. For example, we must know and follow our state practice acts. Ask yourself – What is the responsibility I have as a supervising therapist? What obligations do I have as a therapist assistant? What is on the agenda with my licensing board? Will a new rule impact my practice? If you haven’t done so already, log onto your state board website today and read the announcements, review the rules governing your license.

Not only is it important to understand our practice acts, but we must also know the billing and service delivery rules governing inpatient skilled nursing and outpatient rehab. The Centers for Medicare and Medicaid Services publishes the online MDS 3.0 RAI Manual at cms.gov that guides us on the coding of the MDS. The MDS drives our reimbursement for Medicare Part A and many state Medicaid services. What constitutes a skilled service? How do I bill for the services I deliver? What do I need to document? These answers are available in your RAI Manual.

Your service center is working to create more tools to assist you with training your people and ensuring their understanding of these tremendous obligations toward our practices. It’s 2012 and the year of education and getting back to basics. We will be sharing an orientation curriculum through our organization’s learning management system called, Brainshark. Our www.ensigntherapy.com website is growing and providing Learning “Oppties” for you to gain further understanding of our industry, while allowing you to explore the site to gain new ideas for enhancing care.

Your therapy resources will be continuing to spend hands-on time in your department to provide education and training, as well as being available to hear about your ideas and suggestions for improving our support and educational programs. Several components of a new orientation manual is available on the portal to provide you with information on some of our basic practices. Policies and procedures are being written to help provide assistance in navigating our standards of practice.

We are all on the same side of the ball. We are strong. We are smart. We have each other’s backs and we won’t go down, even if the audible gets called. We’ve got our own playbook! Let’s make 2012 OUR Super Bowl and LET’S WIN!

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.