Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 29

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 32

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::load() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 161

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 138

Strict Standards: Non-static method JRequest::clean() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 33

Strict Standards: Non-static method JRequest::_cleanArray() should not be called statically in /home/content/44/4033044/html/libraries/joomla/environment/request.php on line 463

Strict Standards: Non-static method JRequest::_cleanArray() should not be called statically in /home/content/44/4033044/html/libraries/joomla/environment/request.php on line 464

Strict Standards: Non-static method JRequest::_cleanArray() should not be called statically in /home/content/44/4033044/html/libraries/joomla/environment/request.php on line 465

Strict Standards: Non-static method JRequest::_cleanArray() should not be called statically in /home/content/44/4033044/html/libraries/joomla/environment/request.php on line 466

Strict Standards: Non-static method JRequest::_cleanArray() should not be called statically in /home/content/44/4033044/html/libraries/joomla/environment/request.php on line 467

Strict Standards: Non-static method JRequest::_cleanArray() should not be called statically in /home/content/44/4033044/html/libraries/joomla/environment/request.php on line 468

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 35

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 38

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 39

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::load() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 161

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 138

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 46

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 47

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 50

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 53

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 54

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 57

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/content/44/4033044/html/libraries/joomla/import.php on line 58

Warning: session_start(): Cannot send session cookie - headers already sent by (output started at /home/content/44/4033044/html/libraries/joomla/import.php:29) in /home/content/44/4033044/html/libraries/joomla/session/session.php on line 423

Warning: session_start(): Cannot send session cache limiter - headers already sent (output started at /home/content/44/4033044/html/libraries/joomla/import.php:29) in /home/content/44/4033044/html/libraries/joomla/session/session.php on line 423

Warning: Cannot modify header information - headers already sent by (output started at /home/content/44/4033044/html/libraries/joomla/import.php:29) in /home/content/44/4033044/html/libraries/joomla/session/session.php on line 426
Dementia FAQs - Dementia FAQs

Warning: Parameter 1 to modMainMenuHelper::buildXML() expected to be a reference, value given in /home/content/44/4033044/html/libraries/joomla/cache/handler/callback.php on line 99

Create PDF Email Print

Dementia FAQs

Avoiding Denials Due To Poor Documentation

Answer

AVOIDING F-TAGS & DENIALS DUE TO POOR DOCUMENTATION

Skilled vs. unskilled intervention

-Clarify need for the expertise of a skilled therapist to treat the patient, vs. unskilled staff. Your evaluation and subsequent daily/weekly notes will determine whether you have been precise enough in your documentation for reimbursement.

Unreasonable amount of time for setting up the Functional Maintenance Plan

-It should not take more than 2 - 3 sessions to complete caregiver training of compensatory strategies, whether these are for mobility, communication, socialization, behavior or dysphagia (swallowing).          

Missing documentation

-Example: Therapist states on evaluation that the patient's gait has become unsteady, however, the nursing notes do not mention this.  Perhaps nursing meant to document, but forgot. It is the therapists duty to check and be sure nursing has documented on the patient's chart before proceeding.

Insufficient documentation

-'Patient receiving physical therapy 5 x's week, tolerating well'.  This is not enough anymore.  Medicare reviewers are wanting specifics relating to functional status.  Provide more information in your note.  Tolerating well relating to what functional improvement?  Provide details regarding standing balance, transfers, gait, or whatever your goals state that you are working on.

Conflicting documentation

-Nurses note: 'patient able to walk to bathroom unassisted daily'.

-Therapist's note: 'patient requires mod assist of 1 for toileting ADL's.

This is a problem for the Medicare surveyor and raises a red flag.  Do your best to make sure nurses notes are documented on the patient's chart that coincide with yours before proceeding with your evaluation and treatment.  If you check this before your evaluation, you can use the nurses documentation on your evaluation for prior level of function and reason for referral.

*Documentation is the key to opening up reimursement for our deserving patients with dementia. Medicare reviewers will deny reimbursement if your documentation is not properly written. Our book reviews appropriate documentation and, if you are unsure about this, may be useful by providing the protocols for placing a patient on therapy.

Patient is inappropriate for skilled intervention

-This happens when  documentation does not support expectation that the patient will achieve stated goals.  It is incumbent on the therapist to make sure the patient is a good candidate for therapy before ever starting therapy.  Understand the protocols for placing a dementia patient on your caseload. 

Our book covers this and may be a good resource for you if you are unsure about whether a patient is a good candidate for therapy.

Goals are not functional

-Goals should be functional for the patient as it relates to their staging, spared capabilities and expectations related to their living environment. 

-Goals should be skilled, measurable, attainable, reasonable and necessary.

This is a huge area.  Medicare reviewers are looking for reasons to deny reimbursement.  Make sure your goals meet the above criteria and do not fall short.  After writing your goals, ask yourself , 'If I were a reviewer, would I deny or reimburse based on what I wrote?'.             

Our book spends a lot of time on appropriate goal writing and provides several pages of suggested goals relating to mobility, communication, socialization, behavior and dysphagia.  If you are needing information on goals, interventions, activities and strategies that are relevent to therapeutic intervention for patients with dementia, you might  find our book useful.  A broader description of topics covered within our book Dementia Therapy and Program Development, can be found in the 'Our Services' link.

               

 

Category