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201 exam 2
Professional issues - SNF and HH
| Question | Answer |
|---|---|
| when does discharge planning begin in SNF? | at admission |
| what does discharge planning in SNF depend on? | type of admission (rehab or skilled bed, long term placement) |
| what are goals based on? | d/c plan |
| when does discharge planning begin in home health? | Begins at OASIS (medicare home health documentation/ data collection) Start of Care visit |
| how long is certification period for Medicare HH? (new goals) | 60 days |
| home health requires constant assessment of ____ | safety (lives alone vs independent) |
| consider need for... in home health | Caregiver support Hospice support Higher level of care |
| SNF billing period with medicare | 30 days |
| MAR (meds) update how often? | monthly and prn |
| how often are goals updates in SNF? | monthly and PRN |
| weights are captures how often in SNF? | monthly if stable or weekly for CHF |
| cert period for home health (new goals) | 60 days |
| billing window for home health | 30 days |
| LUPA | Low Utilization Payment Adjustment - means you have not seen them for at least 5 visits |
| try to avoid ___ if possible | LUPA |
| what is LUPA based on? | HHRG score generated by SOC OASIS |
| what do PTA's document in home health? | document visit notes, incident reports, communication w/ provider & clinical team |
| what do you need an order for before doing in HH? | for EVERYTHING, if you don't have an order you cannot bill |
| what is violated when you provide care without Dr orders? | Medicare’s COP’s (Conditions of Participation) and renders the entire visit nonbillable |
| when is the PT required to treat in HH | eval, discharge, resumption of care |
| are co-treats possible in HH? | yes |
| Most nonbillable visits from audits result from no ____ being documented | skill Gait training” vs “Patient ambulated”, “Instructed” vs “Reminded” or “Encouraged” Ask yourself, “What did I do?” and “Why did my license need to be in the room?” |
| Medicare does an in-person audit every ____ ____ in each individual facility | 3 years |
| SNFs and Home Health required to do ____ internal audit monthly | 10% |
| Audits result in ____ & _____ plans | Quality Assurance, Performance Improvement |
| what is done with quality assurance and performance improvement plans | shared with clinical staff w/ new recommendations or requirements for documentation Clinicians are expected to implement these into their clinical documentation |
| If audit score meets low threshold, monthly audit requirement increases to ____ for a period of time determined by the Medicare auditor | 100% |
| skilled vs unskilled documentation | "ambulated 100 ft CGA" vs "gait training 100' CGA with VC for step length" |
| instead of "reminded" use: | instructed, reinforced |
| can PTA's write d/c summary in HH? | no, also cannot do any OASIS documenting |
Created by:
bdavis53102
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