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
ACHIEVING CLINICAL EXCELLENCE
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
Functional Reporting and Manual Medical Review
I hope you have a wonderful holiday season! It’s a new year and Medicare Part B therapy changes continue. As you are aware, Functional Reporting went into effect January 1, 2013 with a testing period through June 30th. Claims submitted July
American Taxpayer Relief Act: Therapy Impact
President Obama has signed into legislation the American Taxpayer Relief Act and I want to share with you the relevant therapy provisions: No 2% sequester cut to Medicare providers The SGR fix is extended through December 31, 2013 The legislation does not preclude
COMMUNICATE – STAYING IN TOUCH AFTER DISCHARGE
For the last two months the theme has been communication. I have attempted to break down this all important topic into different phases. The first was the Initial Phase where communication early and often was stressed. The second phase discussed
OIG 2013 Work Plan: Nursing Home Areas Of Focus
While we all anxiously await the coming of a new year and what actions Congress will take related to impact on Medicare, Nursing Homes and Therapy Services, there is one thing we can prepare for now. Each year the U.S.
RESTORATIVE NURSING AND QUALITY OF LIFE
Restorative Nursing programs are vital to long term care. These traditional nursing home programs, if not well managed and organized may leave long term care residents with an overall poorer quality of life lower and declines in function that impact
Preparing for Medicare Implementation
As you may be aware, there will be new reporting requirements for outpatient therapy services beginning 1/1/13. The Middle Class Tax Relief and Jobs Creating Act of 2012 section 3005(g) amended section 1833(g) of the Social Security Act to require
COMPLIANCE DEPARTMENT AND RESOURCES
Compliance is defined as the act of adhering to, and demonstrating adherence to, a standard or regulation. As you know, in the medical field, there are numerous regulations and they are constantly changing. Functional Pathways is passionate and committed to
Prevent Readmissions by Identifying Causes of Acute Change
Causes of acute change of condition in a resident residing in a skilled nursing facility can be categorized into either reasons that relate primarily to the resident’s current status or condition or reasons less directly related to the resident’s current