MDS Alert
Is CMS Going to Limit the Amount of Concurrent Therapy That Counts Toward a Rehab RUG?
Question: Has CMS already indicated that it plans to cap the amount of concurrent therapy or where does that stand? Answer: Consultant Elisa Bovee, OTR/L, in Topsfield, Mass., notes that the final SNF PPS rule for FY 2010 states the following: "At this time, we do not agree that CMS should impose a specific cap, similar to the one for group therapy, on the amount of concurrent therapy to be coded on the MDS. However, we are revising the MDS ... to capture therapy data by mode of therapy. We will then be able to analyze the data on therapy, including the delivery mode, and will be able to better understand the rates of provision and develop other requirements as deemed appropriate, including but not limited to a cap on concurrent therapy." How Would You Code C7 (Change in Communication/Hearing) for This Resident? "Upon admission two months ago, Mrs. T had difficulty hearing unless the speaker adjusted his or her tone of voice and spoke more distinctly," states the MDS 2.0 RAI User's Manual. Mrs. T "has worn hearing aids in the past but lost them during a hospital admission. Since admission to the nursing facility, Mrs. T was tested and fitted with new hearing aids. She hears much better with the aids though she is still trying to adjust to wearing them." Coding options: "0" for no change, "1" for improved, or "2" for deteriorated. Answer: Code "1" for improved. Rationale: The intent for C7 is "to document any change in the resident's ability to express, understand, or hear information compared to his or her status of 90 days ago (or since last assessment, if less than 90 days ago). This item asks for a snapshot of the resident's status in the current observation period as compared to 90 days ago (i.e., a comparison of two points in time). If the resident is a new admission to the facility, this item includes changes during the period prior to admission." Source: RAI User's Manual for the MDS 2.0, chapter 3.
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