Eli's Rehab Report

Question: In our facility, we ask our Medicare patients very detailed ADL questions on their first visit. Documenting the Q&As, as well as doing the evaluation to check some of these ADLs, takes a long time -- not to mention creating stumbling blocks since we don’t have a kitchen facility to test those ADLs. Would it be sufficient to give the patient a questionnaire to fill out and use that as documentation for the ADLs?

Answer:  Absolutely. Look at CMS’ recommended outpatient measurement tools, such as AM-PAC, Optimal, NOMS and FOTO. You’ll notice that the tools involve questionnaires that either the patient, the caregiver, their family -- or you as the therapist -- can complete, depending on the tool.

Good idea: Make sure your objective data agrees with the patient’s responses. For example, if the patient notes on your questionnaire that he "can’t do overhead tasks at home," but your range-of-motion test shows 170-180 degrees for flexion and abduction, and the muscle strength test shows 5/5 (normal), that’s not jibing with what the patient’s telling you -- and that could lead to payer scrutiny.