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  • Final IRF, SNF Rules for 2018 Vary Little From Proposed Rules Calling for 1% Increases, Quality Reporting Changes

    The final 2018 rules for inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) released by the US Centers for Medicare and Medicaid Services (CMS) don't vary much from the proposed versions issued this spring, following through with proposals for an overall 1% payment increase, changes to reporting requirements, and updates to the list of ICD-10-CM codes the agency uses to evaluate facility compliance with the so-called “60% rule.” That rule states that 60% of an IRF's patients must require treatment for 1 or more specified conditions.

    As in the proposed rules, payment increases amounting to $80 million for IRFs and $390 million for SNFs are included, as are increased quality-reporting requirements—and consequences for noncompliance. More detail on the proposed rules appears in a PT in Motion News story published in May. CMS has published fact sheets on both the SNF and IRF final rules.

    In its comments to CMS on the proposed rules (SNF comments here, IRF comments here), APTA supported several provisions, including a plan to revamp the existing "pressure ulcer quality" measure and remove the "all-cause unplanned readmission" measures. Additionally, the association agreed with CMS on its plan to update the list of codes on the "presumptive compliance list," the list on which the 60% rule is based. Those proposed changes remain in the final rules.

    APTA regulatory affairs staff members are reviewing both final rules and will publish highlights in the coming weeks. PT in Motion News will share links to those highlights when they become available.

    From PT in Motion Magazine: The PT as Inventor

    Sometimes, clichés exist because they're true.

    Take "necessity is the mother of invention." Physical therapists (PTs) know all about the necessity part: patients need to regain, increase, or maintain mobility, and PTs constantly need to be on the lookout for ways to help make that happen. And when none of the usual ways seems to work? That's when some PTs become inventors.

    "Inventional Thinking," a feature article in the August issue of PT in Motion magazine, recounts the efforts of several PTs who've developed products or technologies that have helped to fill gaps in rehabilitation. The inspiring PTs profiled include:

    • Romina Bello, PT, DPT, who led a team of PTs and occupational therapists at the Henry Ford Health System in the creation of a high-acuity walker that makes it easier to get patients in intensive care units up and walking while minimizing risk of falls or loss of lines to the patient—and with the assistance of only a PT and respiratory therapist
    • Thubi Kolobe, PT, PhD, who worked with an engineering professor to develop the Self-Initiated Progressive Prone Crawler, a skateboard-like device that allows babies with physical limitations to crawl, an important developmental milestone
    • Daniel J. Lee, PT, DPT, whose prototype limbWISE app is designed to make it easier for patients adjusting to use of a prosthesis to manage fitting issues
    • Scott Rogoff, PT, DPT, ATC, developer of the dynamic ankle rehabilitation trainer (DART), a device—now in its fourth iteration—that aids recovery from ankle injuries by helping to strengthen anterior ankle muscles
    • Bryce Taylor, PT, MSPT, the inventor of the Halo Trainer, a device that gives PTs the ability to put handlebars on stability balls

    In addition to the inventors' own accounts of how they birthed their ideas into reality, the article features tips and advice for PTs thinking about inventing—including possible funding sources.

    "Inventional Thinking" is featured in the August issue of PT in Motion and is open to all viewers—pass it along to nonmember colleagues to show them 1 of the benefits of belonging to APTA. Printed editions of the magazine are mailed to all members who have not opted out; digital versions are available online to members.