The 100 Day Therapy Schedule
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- Malcolm Parks
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1 The 100 Day Therapy Schedule 100 Day Therapy Schedule programs assist you in scheduling therapy and MDS records to manage RUG scores and reimbursement. These programs will help you: Schedule and provide the therapy that your residents need. Verify that scheduled therapy has been performed. Verify that actual therapy has been recorded. Schedule MDS records to capture therapy minutes. Release added the following new features to 100-day Therapy Scheduling Schedule Profile: Ability to: o Identify holidays so therapy will not be scheduled on those days. o Build templates for specific types of therapy, i.e. after a knee-replacement o New format for the Therapist schedule, including the ability to print just unassigned therapy so it can be completed. IMPORTANT: You must have a Manager s status to do scheduling. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 1
2 Contents Schedule Profile... 3 Templates... 4 Default Assessment Reference Date... 5 Holiday Scheduling... 5 Scheduling... 6 Edit 100 Day Schedule... 7 Project RUG Scores... 9 Scheduled Therapy Actual Therapy Day Lookback RUG Stats ADL Assessment (***) and ARD Individual Resident s Therapy Schedule Print Weekly Schedule Print Therapist Schedule Print 30 Day Review Update Rollover Minutes G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 2
3 Therapy System > Rehab Therapy > Libraries > Schedule Profile TH44 Use this program to build up to 99 Templates that define a typical therapy schedule for specific RUG or the rehab protocols, such as rehab for after a knee-replacement. When you schedule therapy for a resident, select the template that will meet this resident s therapy needs. Override this default schedule at the resident level when necessary. Define the Day of Stay that you will want to use as the Assessment Referance Date (ARD) for the MDS 3.0 records. Identify holidays on which therapy should not be scheduled. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 3
4 Templates Assign a two digit code to the template and build the minutes of therapy for that template. You can select this template when you create a resident s therapy schedule. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 4
5 Default Assessment Reference Date Default Assessment Reference Date: Define the default ARD day for each type of assessment. You will be able to change the ARD at the resident level to use an ARD that allows you to report the most therapy time. NOTE: You can leave this blank if you would always like to choose the ARD. Holiday Scheduling Enter the dates and a description of days on which no therapy will be scheduled. IMPORTANT: All the therapy minutes that would have been scheduled on one of these days will be scheduled for the next day. You must manually update your holidays every year. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 5
6 Therapy System > Rehab Therapy > Scheduling Scheduling 100 Day Schedule: Schedule, review and revise a resident s therapy. Page 7 Weekly Schedule: Display/print PT, OT and ST scheduled for each resident the seven days following the Start Date used. Page 18. Therapist Schedule: Sorted by therapist, lists the residents scheduled for therapy. Includes unassigned therapy. Page Day Review: Prints 30 days of therapy that has been completed (Actual) or on the Schedule. Page 21. Update Rollover Minutes: Reschedule therapy that was not completed as scheduled to future days. RECOMMENDATION: Run Update Rollover Minutes in the morning before printing other therapy reports. Page 22. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 6
7 Edit 100 Day Schedule TH40 Use this program to: Select a therapy template for a new resident, i.e. a certain type of therapy or RUG. Schedule therapy to meet the target RUG. View a resident s Scheduled and Actual Therapy and the resulting RUG. Select a target MDS ARD for reporting the most therapy. View amount of therapy required to qualify for the projected or a higher RUG group. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 7
8 Resident ID: Enter/look up the resident ID to display that resident s 100 Day therapy schedule. Start Date: After you select the resident, the resident s Admit Date will be displayed, and the schedule will begin with Day 1 of the resident s stay. You can change the Start Date to anactual therapy start date if therapy does not start on the admit date, as with Part B therapy. This will reset the 100 day schedule. Therapy Posted Thru will default to yesterday. You can change it to a different posted thru date. Posted Therapy will display in the Actual Therapy columns. Enter actual therapy through Rehab Therapy > Daily Procedures > Enter Daily Time. Day: days 1 through 100. Date: dates for Day 1 through 100. DoW: day of the week. Sample: Actual Therapy that has been reported (see more on Page 12): Start Date Sample: Dates for which therapy has been scheduled (see more on Page 10): G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 8
9 Project RUG Scores IMPORTANT: This will erase any previous manual scheduling that you have entered. On the Edit 100 Day Therapy screen, click Project RUG to set up the resident s therapy schedule from the Start Date through the No of Days to be scheduled. Start Date defaults to the latter of 1) Start Date from the previous screen, or 2) one day after last scheduled therapy. You can change it. Enter the Start Date from which you want to start scheduling through the No of Days specified. No of Days defaults to 14. You can change it to schedule fewer or more days. Select the Therapists who will perform each type of Therapy for this resident. You can leave this blank to indicate UNASSIGNED therapy. Knowing the resident s needs, select the target RUG Template or type of therapy template. Template are built through the Schedule Profile (see page 3). Click OK. This will create a schedule under Scheduled Therapy. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 9
10 Scheduled Therapy Scheduled Therapy schedule enough therapy for a resident to qualify for the Target RUG. Will be blank if these days cannot be used as ARDs, or the resident does not have Medicare. Will be blank after the Therapy Posted Thru date. Therapist: (above) will display as follows: UNASSIGNED if a therapist was not identified. VARIOUS if more than one therapist provides this type of therapy on this day. If a single therapist was identified, the User ID as established in the User ID profile. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 10
11 Click in the Therapist column to display and edit the therapy schedule. See the Assign Therapy Time screen (on right). View and/or edit the therapy details for that day. Add up to eight occurrences of therapy time. If you select a Therapist from the lookup, you must select the type of Therapist for that type of therapy; for example, you must select a Physical Therapist for PT. The screen will keep a running total of the different types of minutes and use that total to update the Therapy Schedule. Click OK to save your entries. This will update the Scheduled Therapy for that day and also the 7 Day Look Back Therapy amounts. NOTE: You will not be able to edit assigned therapy for a day that actual therapy has been posted. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 11
12 Actual Therapy Therapy recorded from Day 1 through the Therapy Posted Thru date. Therapist and therapy minutes recorded for Individual, Concurrent, and Group (Grp) therapy. If only one therapist provided this type of therapy, that therapist is identified. Multiple therapists are identified as VARIOUS. Sample 1: Actual Posted Therapy that would be used to determine the RUG if that day is the ARD. Default ARD Sample 2: Days that cannot be used as ARDs: Cannot be used as ARDs Sample 3: Actual Therapy has not been posted: Therapy not yet posted (see Posted Thru date). G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 12
13 Click in the Therapist column to display Actual Therapy Time details for a specific day (see screen on right). You cannot edit the details on this screen. Actual Therapy and Scheduled Therapy will be used to calculate therapy totals under the 7 Day Look Back. KCOWAN KCOWAN The Eval column will list evaluation minutes that are separate from treatment time to assure that evaluation time is not included with treatment time. 45 G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 13
14 7 Day Lookback 7 Day Lookback: Totals the Scheduled and Actual therapy minutes for the 7-day lookback. These minutes will be used to calculate RUG groups and can also be reported on the MDS. The therapy amounts are cumulative for each type of therapy. For example, the screen below shows Actual Therapy minutes for OT for 4 different days: 60, 30, 55 and 15 minutes. Under 7 Day Lookback Ind these minutes accumulate from 60 to 90 to 145 to 160. The 7-Day Lookback will only use Actual minutes as of the Posted Thru Date. Therapy is displayed as Individual, Concurrent and Group minutes. The program will do the required calculations to add Individual minutes, ½ the Concurrent minutes, and the usable Group minutes. It will apply the 25% Group minute limitation to convert Group minutes to Usable minutes. G% (Group minutes percentage) will display the Group minutes that are Usable minutes to be considered in determining the RUG. Click in any RUG field to display the stats for that day. See RUG Stats on the next page. NOTE: The screen above shows (R)efused therapy. Refused therapy is one of the Session codes available when when you enter therapy minutes through Enter Daily Time. Refused minutes are displayed as a reminder. If you notice that a resident frequently refuses therapy, so you can make adjustments to the schedule. The Update Rollover Minutes program will recognize Refused minutes and add them to the next available therapy day. See Page 22. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 14
15 RUG Stats Click in any RUG column to display the RUG stats for that day. Stats are based on the 7-day Lookback that used both scheduled and actual therapy minutes. Usable: usable Individual, Concurrent and Group minutes. 5 Day Therapy: number of Therapy types provided for 5 or more days in the 7-day look back. 3 Day Therapy: number of therapy types provided for 3 or more days in the 7-day look back (includes the 5 day therapies). Rate: Comes from the Facility Rate file. ADL ADL scores are not automatically provided to the program, therefore the RUG group will default to the classification A within each therapy group. You can provide the resident s ADL score to calculate a more accurate RUG. Click in the ADL entry box to display the Edit ADLs screen. Currently in development. Select valid responses for each ADL. Click OK to save the information. View the recalculated RUG. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 15
16 Assessment (***) and ARD In the far right ARD column, you will notice a checked checkbox for specific days. The program will select this day based on the Default Assessment Reference Date schedule in the Schedule Profile (see Page 3). It will use the day to determine which therapy in the 7 Day Look Back will be used to calculate the RUG. Check a different ARD to select a different Assessment Reference Date date to capture therapy from different days. This will override the facility default for this resident. The days used to calculate the RUG will be identified with three asterisks *** in the Asm column. These same days will also be identified by asterisks on the Weekly Schedule and the Therapist Schedule. Click Print at the bottom of the screen to display the 100 Day Therapy Schedule for the resident. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 16
17 Individual Resident s Therapy Schedule 25 days per 4 pages with recap at the end. Legend: ARD the selected ARD date. *** the therapy days used to calculate the RUG for the selected ARD -A- Actual Therapy Minutes -S- Scheduled Therapy Minutes Recap for Day 1-25: G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 17
18 Rehab Therapy > Scheduling Print Weekly Schedule TH41 The report results will be sorted by Medicare A, Medicare C and All Residents. The program will look at the Stay Tables for the payer recap. If there is not one, it will use the primary payer. * Indicates Therapies within an ARD G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 18
19 Rehab Therapy > Scheduling Print Therapist Schedule TH42 List the scheduled therapies to be done to meet the resident s needs and target RUG group. NOTE: You can print separate pages of Unassigned Therapy and distribute them to available therapists for completetion. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 19
20 Therapist Schedule: * Indicates Therapies within an ARD Therapist Worksheet: Document completed procedures and codes for billing. Use paper form as an audit trail. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 20
21 Rehab Therapy > Scheduling Print 30 Day Review TH43 Accept or change the Review Date. This will calculate: Therapy From Date = 16 days before the Review Date Therapy Thru Date = 14 days after the Review Date. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 21
22 Rehab Therapy > Scheduling Update Rollover Minutes TH45 Recommendation: Run this program each morning before printing the schedules for the day. If your staff does not complete scheduled therapy days and minutes to achieve the targeted RUG group, you can use this program to re-schedule, or Rollover, those minutes to the next available therapy day. IMPORTANT: Verify that you have recorded all actual therapy time. Suggestion: Look at today s or tomorrow s schedule. Last Post Date: defaults to the day after the previous date used to rollover minutes. Rollover Lookback Days will default to 7 days the first time you run the program. After that it will default to the entry made the last time it was run. This is how many days the program will use, including the post date, to determine all the rollover minutes for that time frame. What the program will do: Each time you run the program, it will remove previous Rollover items. The minutes will be accumulated by Individual, Concurrent and Group and then be translated to usable minutes for the entire lookback period. All minutes will be added to the next day of therapy: Example: If 30 minutes of scheduled therapy time was not completed in the look back period (7 days back from current date), the Rollover will add those minutes to the next available therapy day. So if the next day has 30 minutes scheduled, you will now complete 60 minutes. NOTE: Lookbacks other than 7 days may cause a slight variation in the amount of usable Group minutes. Completing more than the scheduled minutes on a day does not deduct from the next day s scheduled minutes. You must manually adjust future minutes though Edit 100 Day Schedule. G:\HITECH\Documentation\100 DayTherapySchedule11.09.doc Page 22
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