Yesterday, officials from the Centers for Medicare and Medicaid Services (CMS) held a call with therapy stakeholder groups to describe their plans to implement the manual medical review process for the therapy cap exceptions that exceed $3,700 effective October 1. CMS has provided a fact sheet and question-and-answer document regarding the process and will issue a transmittal in the coming days. The therapy cap is an annual per-beneficiary limitation on services that applies to all outpatient therapy settings except critical-access hospitals.
Highlights regarding manual medical review include these:
A special open door forum (ODF) teleconference on the manual medical review of therapy claims will be held August 7, 2 pm-3:30 pm, ET. Special open door participation instructions are below:
The Sitting Balance Scale is comparable to the Trunk Impairment Scale for measuring sitting balance in older adults who are nonambulatory or have limited mobility, say authors of an article published in Clinical Rehabilitation.
The authors conducted this prospective study in acute care, inpatient rehabilitation, skilled nursing facility, and home health settings. Participants included 98 patients, with a mean age of 80.5 (SD 7.9) years, who received physical therapy (n = 20 acute care, n = 18 inpatient rehabilitation, n = 30 skilled nursing facility, n = 30 home setting). Nineteen patients were nonambulatory, and 79 had limited functional mobility with Timed Up and Go scores ≥20 seconds. The main measures were the Sitting Balance Scale, Trunk Impairment Scale, Timed Up and Go, length of stay, and setting-specific clinical measures of sitting balance (OASIS-C M1850; MDS G-3b).
A moderate association between ambulatory status and sitting balance measures was found (Sitting Balance Scale r = 0.67, Trunk Impairment Scale r = 0.61). Moderate to strong relationships between Sitting Balance Scale, Trunk Impairment Scale, and clinical outcomes varied by setting. Multivariate analysis of variance results revealed differences between ambulators and nonambulators and among diagnostic categories for both instruments.
APTA member Mary Thompson, PT, PhD, GCS, is lead author of the article. APTA members Ann Medley, PT, PhD, CEEAA, and Steve Teran, PT, are coauthors.
Interdisciplinary collaboration and coordination is vital to facilitate early mobility and rehabilitation in the intensive care unit (ICU) setting. A recent stakeholders' conference aimed at improving long-term outcomes for ICU survivors identified important silos among critical care and rehabilitation clinicians working in the ICU, with these silos acting as a barrier to collaboratively advancing the field and improving patient outcomes. While clinical trials support the benefits of early rehabilitation for mechanically ventilated patients, implementing these interventions requires creating a new ICU culture based on proactive rehabilitation and interdisciplinary collaboration between all critical care and rehabilitation clinicians.
Critical Care Rehabilitation Conference 2012: Creating and Sustaining a Physical Rehabilitation Program in the ICU, hosted by Johns Hopkins University School of Medicine September 21-22, will bridge the interdisciplinary gap from research to clinical implementation at the bedside.
APTA members Jennifer Zanni, PT, Michelle Kho, PT, PhD, and Michael Friedman, PT, MBA, will participate in panel discussions and present several sessions at the conference.
For course objectives and registration information, visit the conference's webpage.
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