Group vs. Concurrent Therapy Part 2: Are You Documenting Accurately?

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In Part 2 of this two-part blog series “Group vs. Concurrent Therapy: Are You Documenting Accurately?” we will discuss actual documentation of examples that may not support group and concurrent therapy as skilled and reasonable. In Part 1, we reviewed the definitions of group and concurrent therapy. Both definitions can be found in the Resident Assessment Instrument (RAI) Manual, Pages O-23-O-25. To refresh your memory, the Centers for Medicare & Medicaid Services (CMS) currently defines…

Group vs. Concurrent Therapy Part 1: Are You Documenting Accurately?

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Since October 1, 2019, for Medicare A recipients, the Resource Utilization Groups (RUGS) IV is out and the Patient Driven Payment Model (PDPM) is in. The first two years of the transition were complicated by COVID and the PHE. But since May 2023 when the PHE ended, things have been getting back to normal. It is important to remember that although the reimbursement model has changed, the regulations outlined in the Centers for Medicare &…

Will Your Late Entry Process Withstand an Integrity Audit?

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In recent months, LW Consulting, Inc. (LWCI) has been assisting clients with responding to Safeguard Unified Program Integrity Contractors (UPICs) and Medicare Administrative Contractors (MACs). During this process, LWCI has observed an increase in denials purely based on delayed or late entries within the documentation submitted for review to the UPICs and MACs. Over the next few weeks, LWCI will be reviewing the Centers for Medicare & Medicaid Services’ (CMS) signature requirements and late entries…