Communicate-Early and Often

How many times in your life, either private or professional, do you look back and wish you had communicated better or differently? I think we all can agree that many times this would be true. If it were not important

Settlement Reached: Medicare’s “Improvement Standard”

Attorneys from the Center for Medicare Advocacy, Vermont Legal Aid and the Centers for Medicare & Medicaid Services (CMS) have agreed to settle the “Improvement Standard” case, Jimmo v. Sebelius. A proposed settlement agreement was filed in federal District Court


Phase 2 providers are approaching their debut for submitting their pre-approval requests for part B therapy residents who have met or will meet the $3700 threshold for OT and $3700 threshold for PT/ST.  You may have already submitted your pre-approval

Cardiac Recovery

Currently, more than two million Americans have heart failure and about 700 thousand new cases are diagnosed each year. The five year survival rate is approximately 50%, but varies depending on the cause of heart failure and the ability of

Part B Therapy: More Stormy Weather Ahead!

The final mandated report on “Improving Medicare’s Payment System for Outpatient Therapy Services” is due on June 15, 2013.  However, Congress has asked MedPAC to forward the recommendations in early- November so they are relevant to the discussion that will

What’s In Store for Quarter Four?

The manual medical review of therapy claims is well on its way for phase 1 providers.  I am going to take a break from the Manual Medical Review this week and talk about our focus for the fourth quarter—coding and


There has been a tremendous amount of information lately discussing the changes that are taking place in the world of healthcare. The biggest leader of change has been the government by way of CMS. Cost is what is driving the

Prevent Hospital Readmissions by Educating Caregiving Staff

A key component in any skilled nursing facility that is working towards preventing hospital readmissions is education of the caregiving staff on their roles and responsibilities related to the ability to identify acute changes in resident’s conditions.   Before the education

Leading Age Annual Convention

Leading Age Annual Convention Denver, Colorado October 21st-24th, 2012 JOIN US October 22nd, 2012 at 3:30PM Ensuring Therapy Compliance Presented By: Sheila Capitosti Vice President of Clinical & Compliance Services Functional Pathways Candace McMullen Senior Vice President of Operations/Chief Operating

AHCA 63rd Annual Convention & Expo

AHCA 63rd Annual Convention & Expo Tampa, Florida October 7th-10th, 2012 JOIN US October 8th, 2012 at 7:30AM  Strategies for Documenting Medical Necessity Presented By: Sheila Capitosti Vice President of Clinical & Compliance Services Functional Pathways Candace McMullen Senior Vice