Eli's Rehab Report

Question: My team is struggling over the definition of "long-term functional goals" for therapy. More specifically, we're wondering if we should set these goals for patients to achieve while having therapy, or if we should consider them truly long-term goals, where patients may take the tools and home exercise program, with the expectation that they'll gain additional function after they are discharged.

Pennsylvania Subscriber

Answer: The definition of long-term therapy goals depends on whom you're asking. If you're asking a peer for a clinical definition, she may say that a true long-term goal is the maximum outcome patients will gain after discharge with the tools you've given them. But if you ask a payer, it's focusing more on the timeframe in which you're administering the plan of care.

The Centers for Medicare & Medicaid Services, as well as most non-Medicare payers, requires long-term goals be established for patients. CMS Pub 100-02, Chapter 15, Section 220.1.2, states that long-term goals should be developed for the entire episode of care and not only for the services provided under a plan for one interval of care.

This is true in all settings where therapy is provided, not just outpatient.

Your long-term goals are what you expect the patient to achieve at the conclusion of therapy, regardless of the setting (i.e., SNF Part A, IRF, home health).

-- Reader Questions were answered by Rick Gawenda, PT, director of PM&R at Detroit Receiving Hospital and owner of Gawenda Seminars.