Tricks or Treats?Home Health

Physical Therapy Practice in 2013 and Beyond

Discuss clinical decision making that is patient

driven and fiscally responsible

Interpret the operational challenges and opportunities for therapy leadership in home health

Recognize the impact of regulation and payment on therapy referrals and care planning

Objectives

Kristin Mattson - PT Director of Rehabilitation Development,

Masonic Health Systems / Overlook Visiting Nurse Association

Dee Kornetti - PT CEO, Co-owner, Integrity Home Health Care,

Inc. Sherry Teague - PTA

CFO, Co-Owner, Integrity Home health Care, Inc

Roshunda Drummond-Dye – JD Director of Regulatory Affairs APTA

Moderator: Cindy Krafft - PT President, Home Health Section APTA

Our Panel

After reading an article examining therapy visit distribution, the manager compares the included table to her own agency. She notices that her percentage of patients in the 0 – 5 tier is higher by 5%. She is concerned that the therapists are not doing enough visits per patient.

Data Management

Despite significant time and resources being spent on monitoring therapy reassessments, Andy PT did not complete one on a patient until visit #15. Looking at the schedule, Andy had made a visit to the home on #13. The supervisor wants to “correct” the error and now asks him to “fix it” by changing the documentation for visit #13.

Rules and Regulations

Mary works as a PT for a home health agency that utilized PTAs. She has been told that her focus will be evaluations, admissions and reassessments as well as supervisory visits per the state requirements. All follow up visits will be given to a PTA and assigned by the scheduler based on geographic location.

Use of Assistants

Mr. Walters is a “frequent flier” to the home health agency. He has CHF and Diabetes. He has had therapy involved in his last 3 admissions. This time the PT is upset about the referral stating “there is nothing we can do since he gets worse after every discharge and just comes back”

Care Planning

When answering OASIS M2200 – Therapy Need, the nurses rely on the therapists to supply a number of visits. The billing department is frustrated by the number of “downcodes” they are seeing each month because the number is “incorrect”.

Data Management

During a training on medication management, the PT staff assert that they are not able to complete drug regimen review as it is outside their “scope of practice”.

Rules and Regulations

The supervisor is frustrated due to the waiting list for PT evaluations. In addition, the PT department productivity number is below target. When reviewing schedules, the PTs are consistently booked full but the PTAs are not.

Use of Assistants

Melissa is a part time PT and typically works on Tuesdays and Thursdays. The agency has been discussing the idea of “frontloading” visits for certain patients but Melissa is resisting the idea. She insists it would be “too much” therapy and implies that this concept is motivated by the intent to increase therapy visits.

Care Planning

Kristin Matteson: kmattson@overlook-vna.org

Dee Kornetti: dkornetti@homewithintegrity.com

Sherry Teague: steague@homewithintegrity.com

Roshunda Drummond-Dye: roshundadrummond-dye@apta.org

Cindy Krafft: krafft@valuebeyondthevisit.com

Contact Information

References

www.apta.org

www.homehealthsection.org

www.valuebeyondthevisit.com