[Dysphagia] Medicare holidays

[connorswa at ph.upmc.edu (Connors, William A.)]

I believe there are three distinct issues brewing here.  

One is insurance reimbursement be it Medicare or other.

Two is regulatory factors.

The third relates to patient care: quality of patient care/gold standards for patient care/evidence-based medical practice/ethical factors in patient care.

The patient care centered bottom line call for all three to be important.  While I appreciate the pragmatics of reimbursement and staff satisfaction/recruitment, if we omit number three from discussions are we sufficiently patient-focused?

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On Behalf Of v.cooper
Sent: Saturday, December 04, 2004 6:19 PM
To: Casper219@aol.com; dysphagiadude@mailcan.com; Dysphagia@b9.com
Subject: Re: [Dysphagia] Medicare holidays

  The medicare week as I understand it is the day of the week of admission
for a Part A thru the following7 days. Thats how we count the number of min
in a week. Sunday thru Saturday for the other pts. I have never found a
problem in all my years (20) of SNF tx with a day off for a holiday, before
or after PPS....as long as the holiday is documented in the med record and
the number of min for a week are met.




  ----- Original Message -----
  From: <Casper219@aol.com>
  To: <dysphagiadude@mailcan.com>; <Dysphagia@b9.com>
  Sent: Saturday, December 04, 2004 2:34 PM
  Subject: Re: [Dysphagia] Medicare holidays


  > There is no such thing as a "Medicare holiday" according to CMS.  Just
as
  > there is no such thing as a "Medicare week".  Your facility / company
should
  > probably have policies for how to handle holiday coverage.  In the
scenario you
  > presented where Thanksgiving and the day after are just time "off" for
the
  > therapist, that would present a risk for the facility in terms of anyone
in an
  > assessment period for Medicare, and in general if there were an audit
(like DAVE
  > or post payment review) the entire stay for that patient could be
jeopardized.
  > My company's policy is that there can never be 3 consecutive days
without
  > treatment for those who have orders 5 days per week.  This year while
the
  > Christmas holiday is on a Saturday, the official holiday at the office
is Friday.
  > However, services will need to be provided by therapy either Friday,
Saturday,
  > or Sunday.  If we vary from the order for 5 times per week we have to
document
  > why - and that there was no adverse outcome.  As another person
suggested, we
  > might increase the minutes on the other days that week, but then I'd
have to
  > question why those patients can't tolerate more treatment all the time
... oh I
  > digress.
  > Bottom line is you have to follow your company's policies for handling
the
  > holidays - the policies are what the surveyors will be looking at.
  > Good luck.
  > Mary
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