July 25, 2023

Prior Level of Function: Reconsiderations in Today’s Healthcare Arena

When physical therapists (PT), occupational therapists (OT), or speech therapists (ST) evaluate a patient in a skilled nursing facility (SNF), they document the patient’s prior level of function (PLOF). The status and timeframe to describe PLOF can vary from therapist to therapist. However, usual and customary is the patient’s level of function just prior to the last qualifying hospital stay that supports the SNF admission. Considerations Regarding Prior Level of Function Typically, Medicare and other…

F-Tags in Review: F757 and F758 Freedom from Unnecessary Drugs and Psychotropic Medications

F-Tag 757, freedom from unnecessary drugs, and F-Tag 758, freedom from unnecessary psychotropic medications, are closely affiliated and are often cited together during a survey. Regulation 758 defines a psychotropic medication as one that affects the brain with mental processes and behaviors. These medications fall into one of 4 categories: Use of anti-psychotic medications requires participation from multiple levels of staff and consultants before the administration can begin. Decision makers include, but are not limited to: …

Understanding PDPM and the PT/OT Components

As you may know, issues with the current Resource Utilization Groups, Version IV (RUG-IV) Prospective Payment System (PPS), were identified by The Centers for Medicare & Medicaid Services (CMS), Office of Inspector General (OIG), MedPAC, and others. Therapy payments under the current SNF PPS Case Mix System is based primarily on the amount of therapy provided to a patient, without consideration for the patient’s individualized characteristics, needs or goals. The Patient Driven Payment Model (PDPM),…