News: CMS responds regarding MMR & Therapy

CMS posted updated information about the agency’s Manual Medical Review process. The annual Medicare Part B therapy benefit for each Medicare beneficiary is $1,900 for Occupational Therapy and $1,900 for Physical Therapy/Speech Therapy combined.  There are exceptions to the these therapy caps for reasonable and necessary


Functional Pathways will be hosting Functional Limitation Reporting Webinars for all of our partners beginning this week.  The invitations have been sent out to all Administrators for all nine currently scheduled webinars.  Administrators can foward the invitation to the Business Office Managers

QAPI: Approach To Teamwork

Teamwork is a core component of Quality Assurance and Performance Improvement (QAPI).  Leadership must convey that it is everyone’ job to contribute to the organization’s Performance Improvement initiatives through clear guidelines identified in job descriptions.  Responsibility rests with the leadership

“Triple Check? Why? We Don’t Get Denials!”

Functional Pathways is committed to ensuring that the therapy treatment we provide is skilled in nature as well as reasonable and necessary.  We strongly recommend and encourage our partners to include us in their triple check process.  Why?  Because we


The Frazier Water Protocol (FWP) allows residents with dysphagia free access to water with little to no incidence of aspiration pneumonia. It was developed by Kathy Panther, MS, CCC-SLP, inpatient rehabilitation director at the Frazier Rehab Institute in Louisville, KY

QAPI: Leadership Responsibility

I do not think that anybody would disagree that creating a culture to support QAPI efforts begins with leadership. Support from the top is essential, and that support should foster the active participation of every caregiver.   The administrator and senior


Life is about change, right?  Well we certainly have been seeing change again with part B therapy. Therapy Cap and Manual Medical Review:  The exceptions process was extended through December 31st of this year which also extends the manual medical


Are Accountable Care Organizations going to become a driving force in the American healthcare scene? The jury is still out on that question but there are some signs that would lead one to believe that they just might.  To begin

I’ll Take A Bowl Of That Alphabet Soup Please!

The evolution of quality improvement philosophies in health care includes such models as MBO, Theory X, Theory Y, QA, QA&A, TQM, CQI, PI and the newest philosophy—QAPI.  Under the Affordable Care Act, Medicare and Medicaid certified nursing homes are required


In a time of change……………maintaining our ability as therapy  providers to ensure adequate  patient care can be a challenge.  As Physical, Occupational and Speech Language Pathologists our focus is on restoring function and improving quality of life. As reimbursement requirements