The Post-acute Care Guide to Maintenance Therapy
Description:
Medicare coverage for maintenance therapy in the post-acute world has been unclear, causing improper documentation and reimbursement for home health agencies, skilled nursing facilities (SNF), outpatient therapy, and rehabilitation facilities.
This guide contains both regulatory information and analysis as well as hands-on, practical advice for care and documentation. Advice given is specific to each post-acute care setting. The guide also features tips from consultants, tools from the Center of Medicare Advocacy and information from CMS, downloadable materials, and sample forms and worksheets for easy comprehension of information.
This book ensures Medicare coverage by:
- Guiding providers through the documentation process related to maintenance therapy
- Explaining how to document at key instances
- Tips for defending medical necessity
- Providing practical advice and information on how to identify patients who require maintenance therapy, conduct patient assessments, and write goals
After reading this book, readers will be able to:
- Understand the proper use of maintenance therapy
- Identify when and how to document care as maintenance therapy
- Determine which patients qualify as needing maintenance therapy
- Plan and assess care of maintenance therapy patients
- Document maintenance therapy with confidence
- Use the tools provided to help with comprehension and documentation
Table of Contents
Foreword
Chapter 1: Are We Providing Maintenance Therapy?
Chapter 2: Defining Key Terms
Chapter 3: Understanding the Regulations
Chapter 4: Identifying Maintenance Patients
Chapter 5: Assessments and the Maintenance Patient
Chapter 6: Goals Capturing the Impact of Therapy
Chapter 7: Care Planning With a Maintenance Focus
Chapter 8: Defending Medical Necessity on Routine Visits
Chapter 9: Reassessments in Maintenance Cases Mandatory and Clinically Driven
Chapter 10: Tips for Identifying Maintenance Patients
Chapter 11: Tips for Qualified Therapists
Chapter 12: Tips for the Quality Review Process
Appendices
This book contains tips, tools, and resources on:
- Identification of maintenance candidates
- Goal writing strategies
- Compliance with reassessment expectations
- Care planning for the maintenance patient
Also included:
- Documentation auditing tool
Judith Stein, a lead attorney on the Jimmo v. Sebelius case and executive director for the Center for Medicare Advocacy, has provided tools to help agencies better use maintenance therapy in their practice, including a Self-Help Packets for Home Health Care/Outpatient/Nursing Appeals, Including 'Improvement Standard' Denials.
A specific scenario is used throughout to demonstrate key concepts. To enhance knowledge application, a practice scenario is provided as well.
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