Home Health & Hospice Week

When do therapists have time for patient care?

The frequent reassessment visits required by CMS’s proposed 14-day timeline for therapy aren’t just unnecessary — they are actually harmful to patient care. So contend multiple commenters on the 2015 prospective payment system proposed rule.

“In the vast majority of patients, you are taking an important interaction between the patient and the therapist that could be used to further progress a patient towards their goals by performing a rehabilitative therapy visit focused on skills progression, and instead using it to document that the goals are still appropriate and that the therapist has seen limited progress secondary to this only being the fourth visit,” stresses Brandon Douglas of Oklahoma in his comment letter on the rule issued in July (see story, this page).

Under the 14-day model, “the therapist will be spending more time doing paperwork and objective testing that doesn’t actually help the patient improve their condition,” says a rep from Signature Home Health in Oregon. “By having a reassessment every 2 weeks, there will be less continuity of care as a PTA will not be able to work with a patient on a regular basis to develop a good rapport,” the commenter says. “I hope you keep in mind what is best for the patient.”

With twice weekly visits, “performing and documenting a reassessment every 14 days will be ‘documentation overload,’” insists PT Cynthia Jarrett in Mississippi, who has been a practicing for more than 30 years. There will be “little relevant information to relate that is not included on each visit’s progress note,” she says.

The “14-day clock-watching” will lead to “a burdensome, chaotic mess,” warns PT Tom Pugh with Sacred Heart Home Health in Eugene, Ore.