Physical Therapists' Ethical Dilemmas in Treatment, Coding, and Billing for Rehabilitation Services in Skilled Nursing Facilities: A Mixed-Method Pilot Study

2019 ◽  
Vol 20 (11) ◽  
pp. 1458-1461
Author(s):  
Roberto Cantu
Keyword(s):  
Pilot Study ◽  
Mixed Method ◽  
Physical Therapists ◽  
Ethical Dilemmas ◽  
Skilled Nursing Facilities ◽  
Rehabilitation Services ◽  
Nursing Facilities ◽  
Skilled Nursing

scholarly journals Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study

2015 ◽  
Vol 63 (9) ◽  
pp. 1894-1899 ◽  
Author(s):  
Vineet Chopra ◽  
Ana Montoya ◽  
Darius Joshi ◽  
Carol Becker ◽  
Amy Brant ◽  
...  
Keyword(s):  
Pilot Study ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Skilled Nursing

scholarly journals The congressional mandate: standardised post-acute care quality measures

2019 ◽  
Vol 26 (8) ◽  
pp. 1-10
Author(s):  
Christine Kroll ◽  
Thomas Fisher
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Functional Outcomes ◽  
Care Quality ◽  
Skilled Nursing Facilities ◽  
Rehabilitation Services ◽  
Nursing Facilities ◽  
Data Set ◽  
Skilled Nursing ◽  
Post Acute Care

Background/Aims This study describes the relationships between rehabilitation services intensity, post-acute care measures of Functional Performance Change, and length of stay for episodes of care provided in 93 skilled nursing facilities in the US. Methods The study used a secondary analysis of existing data on Medicare beneficiaries admitted to skilled nursing facilities from acute hospitals (n=518) who subsequently returned to the community. Data were selected from Minimum Data Set Section GG items reported by therapists. Results Statistically significant correlations were identified between rehabilitation services intensity and functional outcomes (P<0.001); and between rehabilitation intensity, medical condition, and length of stay (P<0.001) for rehabilitation patients in skilled nursing facilities. Conclusions The intensity of occupational and physical rehabilitation therapy services correlate with patients achieving higher functional outcomes, specifically improvement in self-care and mobility.

Rehabilitation Intensity and Patient Outcomes in Skilled Nursing Facilities in the United States: A Systematic Review

2021 ◽  
Author(s):  
Rachel A Prusynski ◽  
Allison M Gustavson ◽  
Siddhi R Shrivastav ◽  
Tracy M Mroz
Keyword(s):  
United States ◽  
Systematic Review ◽  
Patient Outcomes ◽  
Hospital Readmissions ◽  
The United States ◽  
Skilled Nursing Facilities ◽  
Functional Improvement ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
The Relationship

Abstract Objective Exponential increases in rehabilitation intensity in skilled nursing facilities (SNFs) motivated recent changes in Medicare reimbursement policies, which remove financial incentives for providing more minutes of physical therapy, occupational therapy, and speech therapy. Yet there is concern that SNFs will reduce therapy provision and patients will experience worse outcomes. The purpose of this systematic review was to synthesize current evidence on the relationship between therapy intensity and patient outcomes in SNFs. Methods PubMed, Medline, Scopus, Embase, CINAHL, PEDro, and COCHRANE databases were searched. English-language studies published in the United States between 1998 and February 14, 2020, examining the relationship between therapy intensity and community discharge, hospital readmission, length of stay (LOS), and functional improvement for short-stay SNF patients were considered. Data extraction and risk of bias were performed using the American Academy of Neurology (AAN) Classification of Evidence scale for causation questions. AAN criteria were used to assess confidence in the evidence for each outcome. Results Eight observational studies met inclusion criteria. There was moderate evidence that higher intensity therapy was associated with higher rates of community discharge and shorter LOS. One study provided very low-level evidence of associations between higher intensity therapy and lower hospital readmissions after total hip and knee replacement. There was low-level evidence indicating higher intensity therapy is associated with improvements in function. Conclusions This systematic review concludes, with moderate confidence, that higher intensity therapy in SNFs leads to higher community discharge rates and shorter LOS. Future research should improve quality of evidence on functional improvement and hospital readmissions. Impact This systematic review demonstrates that patients in SNFs may benefit from higher intensity therapy. Because new policies no longer incentivize intensive therapy, patient outcomes should be closely monitored to ensure patients in SNFs receive high-quality care.

scholarly journals Carbapenemase-Producing, Carbapenem-Resistant Acinetobacter baumannii: Summary of CDC Consultations, 2017–2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s151-s152
Author(s):  
Lauren Epstein ◽  
Alicia Shugart ◽  
David Ham ◽  
Snigdha Vallabhaneni ◽  
Richard Brooks ◽  
...  
Keyword(s):  
Public Health ◽  
Acinetobacter Baumannii ◽  
Median Number ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Healthcare Facilities ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
Single Facility

Background: Carbapenemase-producing carbapenem-resistant Acinetobacter baumannii (CP-CRAB) are a public health threat due to potential for widespread dissemination and limited treatment options. We describe CDC consultations for CP-CRAB to better understand transmission and identify prevention opportunities. Methods: We defined CP-CRAB as CRAB isolates with a molecular test detecting KPC, NDM, VIM, or IMP carbapenemases or a plasmid-mediated oxacillinase (OXA-23, OXA-24/40, OXA-48, OXA-58, OXA-235/237). We reviewed the CDC database of CP-CRAB consultations with health departments from January 1, 2017, through June 1, 2019. Consultations were grouped into 3 categories: multifacility clusters, single-facility clusters, and single cases. We reviewed the size, setting, environmental culturing results, and identified infection control gaps for each consultation. Results: We identified 29 consultations involving 294 patients across 19 states. Among 9 multifacility clusters, the median number of patients was 12 (range, 2–87) and the median number of facilities was 2 (range, 2–6). Among 9 single-facility clusters, the median number of patients was 5 (range, 2–50). The most common carbapenemase was OXA-23 (Table 1). Moreover, 16 consultations involved short-stay acute-care hospitals, and 6 clusters involved ICUs and/or burn units. Also, 8 consultations involved skilled nursing facilities. Environmental sampling was performed in 3 consultations; CP-CRAB was recovered from surfaces of portable, shared equipment (3 consultations), inside patient rooms (3 consultations) and nursing stations (2 consultations). Lapses in environmental cleaning and interfacility communication were common across consultations. Among 11 consultations for single CP-CRAB cases, contact screening was performed in 7 consultations and no additional CP-CRAB was identified. All 4 patients with NDM-producing CRAB reported recent international travel. Conclusions: Consultations for clusters of oxacillinase-producing CP-CRAB were most often requested in hospitals and skilled nursing facilities. Healthcare facilities and public health authorities should be vigilant for possible spread of CP-CRAB via shared equipment and the potential for CP-CRAB spread to connected healthcare facilities.Funding: NoneDisclosures: None

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