Therapy Systems Assessment. For each Reporting Period, the IRO shall assess the effectiveness, reliability, and thoroughness of Ensign Group’s oversight of its therapy services at a randomly selected subset of eight of the Subject Facilities, as outlined in Appendix C to this CIA, which is incorporated by reference.
Therapy Systems Assessment. For each Reporting Period, the IRO shall assess the effectiveness of Signature’s rehabilitation therapy systems as outlined in Appendix C to this CIA, which is incorporated by reference.
Therapy Systems Assessment. For each Reporting Period, the IRO shall assess the effectiveness, reliability, and thoroughness of FHS’s oversight of therapy services as outlined in Appendix C to this CIA, which is incorporated by reference.
Therapy Systems Assessment.
1. For each Reporting Period, the IRO shall assess the effectiveness, reliability, and thoroughness of NAHC’s rehabilitative therapy systems and NAHC’s oversight of rehabilitative therapy staff at the Subject Facilities. The systems assessment shall include, but is not limited to, ensuring that NAHC:
a. provides only skilled rehabilitation therapy that is:
i. delivered pursuant to an individualized plan of care;
ii. consistent with the nature and severity of the resident’s and/or patient’s individual illness or injury;
iii. in compliance with accepted standards of medical practice;
iv. reasonable and necessary given the resident’s and/or patient’s condition and plan of care to improve his or her condition, prevent or slow deterioration of his or her condition, or restore the his or her prior levels of function; and
v. limited to services that are inherently complex and require the skills of physical, speech, or occupational therapists, among other types of professionals;
b. complies with Medicare program requirements relating to the tracking of therapy minutes (e.g., only includes services that are inherently complex and require the skills of physical, speech, or occupational therapists, among other types of professionals; appropriately accounts for group and concurrent therapy);
c. complies with all Medicare and NAHC requirements relating to the documentation of medical records;
d. obtains an assessment, by a physician, of the resident’s and/or patient’s need for skilled therapy and that the skilled services will improve his or her condition, prevent or slow deterioration of his or her condition, or restore his or her prior levels of function;
e. receives appropriate and effective training that, at a minimum, includes the subject matters set forth in Section III.C.1 of the CIA; and
f. communicates and interacts effectively among the corporate, regional, and facility level employees who provide, manage, or oversee the delivery of skilled rehabilitative therapy services to NAHC’s residents and/or patients.
2. If, at any time during the term of the CIA, NAHC contracts for the provision of therapy services to its residents and/or patients or provides therapy services through an arrangement other than employment, the IRO shall assess the effectiveness, reliability, and thoroughness of NAHC’s oversight of those therapy services, including, but not limited to, the areas described in Section A.1 of this Appendix C.
3. In conducting the Therapy Systems Asses...
Therapy Systems Assessment.
1. For each Reporting Period, the IRO shall assess the effectiveness of LCCA’s rehabilitative therapy systems and its oversight of therapy staff at each of the Subject Facilities (Therapy Systems Assessment). Keeping in mind the findings and observations from the Rehab Review, the IRO shall examine whether the Subject Facility considers and incorporates the following:
a. best practices in patient management including examination, evaluation, diagnosis, prognosis and intervention;
b. use of effective tests and measures to quantify a patient’s impairments and functional limitations;
c. provides only therapy that is consistent with the nature and severity of the patient’s individual illness or injury and in compliance with accepted standards of practice for rehabilitation therapy;
d. setting of goals consistent with a patient’s diagnosis and prognosis;
e. use of appropriate interventions targeted to a patient’s specific impairments and functional limitations;
f. utilization of evidence-based practice patterns;
g. consideration of issues specific to gerontology;
h. early assessment of a patient’s cognitive capacity and whether the patient’s mental abilities or impairments are appropriately incorporated into the patient’s plan of care;
i. effective coordination between therapy staff and nursing staff;
j. appropriate monitoring of a patient’s response to skilled therapy, which includes measuring changes in functional status and making corresponding adjustments in the plan of care;
k. billing as therapy only those services that that can safely and effectively be performed only by, or under the supervision of, a qualified therapist and the service, or the condition of the beneficiary is of a nature that requires the judgment,
l. appropriate use of supporting personnel, such as aides or nursing personnel, to provide services that do not require the skills of a qualified therapist or can be performed without the supervision of a therapist;
m. interaction between multidisciplinary therapy team members, effectiveness of interdisciplinary team work and rehabilitation goal setting where patient requires more than one type of rehabilitation;
n. ability of therapists to assess and treat patients according to their independent clinical judgment for appropriate patient care based on ethical and professional standards;
o. effective communication among the corporate, regional, and facility level employees who provide, manage, or oversee the delivery of skilled rehabilita...
Therapy Systems Assessment. The IRO shall assess the effectiveness, reliability, and thoroughness of Xxxxxxx Lutheran’s oversight of its therapy services, as outlined in Appendix C to this CIA, which is incorporated by reference.
Therapy Systems Assessment. 1. For each Reporting Period, the IRO shall assess the effectiveness, reliability, and thoroughness of Xxxxxxx Lutheran’s oversight of its therapy contractor, including, but not limited to, ensuring the contractor:
a. provides only skilled rehabilitation therapy that is: (1) pursuant to an individualized plan of care; (2) consistent with the nature and severity of the resident’s individual illness or injury; (3) in compliance with accepted standards of medical practice; (4) reasonable in terms of in terms of duration and quantity; and (5) reasonable and necessary given the resident’s condition, prior level of function, and expected outcomes.
b. complies with Medicare program requirements relating to the tracking of therapy minutes (e.g., only includes services that are inherently complex and require the skills of physical, speech, or occupational therapists, among other types of professionals; appropriately accounts for group and concurrent therapy);
c. complies with all Medicare and Xxxxxxx Lutheran requirements relating to the documentation of medical records;
d. obtains an assessment, by a physician, of the resident’s restoration potential and that the condition of the resident will improve materially in a reasonable and generally predictable period of time or that the services are necessary for the establishment of a safe and effective maintenance program; and
e. receives appropriate and effective training that, at a minimum, includes the subject matters set forth in Section III.C.2.b of the CIA.
2. If, at any time during the term of the CIA, Xxxxxxx Lutheran no longer contracts for the provision of therapy services to its residents and, instead, provides therapy services through its own employees or other arrangement, the IRO shall assess the effectiveness, reliability, and thoroughness of Xxxxxxx Lutheran’s oversight of those therapy services, including, but not limited to, the areas described in Section A.1.
3. In conducting the Therapy Systems Assessments, the IRO shall, at a minimum, review policies and procedures, medical records, and other therapy-related documentation, observe the provision of therapy services at Xxxxxxx Lutheran, observe therapy-related care planning meetings, and interview key employees and contractors. Xxxxxxx Lutheran shall take all necessary steps to ensure the IRO has access to Xxxxxxx Lutheran’s facilities, documents, employees, and contractors to perform the activities set forth in this Section A.3 in a legally and clin...
Therapy Systems Assessment.
1. For each Reporting Period, the IRO shall assess the effectiveness, reliability, and thoroughness of Signature’s rehabilitative therapy systems and its oversight of therapy staff at each of the Subject Facilities (Therapy Systems Assessment). Keeping in mind the findings and observations from the Rehab Review, the IRO shall examine whether the Subject Facility considers and incorporates the following:
a. best practices in patient management including examination, evaluation, diagnosis, prognosis and intervention;
b. use of effective tests and measures to quantify a patient’s impairments and functional limitations;
c. provides only therapy that is consistent with the nature and severity of the patient’s individual illness or injury and in compliance with accepted standards of practice for rehabilitation therapy;
d. setting of goals consistent with a patient’s diagnosis and prognosis;
e. use of appropriate interventions targeted to a patient’s specific impairments and functional limitations;
f. utilization of evidence-based practice patterns;
g. consideration of issues specific to gerontology;
h. early assessment of a patient’s cognitive capacity and whether the patient’s mental abilities or impairments are appropriately incorporated into the patient’s plan of care;
i. effective coordination between therapy staff and nursing staff;
j. appropriate monitoring of a patient’s response to skilled therapy, which includes measuring changes in functional status and making corresponding adjustments in the plan of care;
k. bill as therapy only those services that that can safely and effectively performed only by, or under the supervision of, a qualified therapist and the service, or the condition of the beneficiary is of a nature that requires the judgment, knowledge, and skills of physical, speech, or occupational therapists, among other types of medical professionals;
l. appropriate use of supporting personnel, such as aides or nursing personnel, to provide services that do not require the skills of a qualified therapist or can be performed without the supervision of a therapist;
m. interaction between multidisciplinary therapy team members, effectiveness of interdisciplinary team work and rehabilitation goal setting where patient requires more than one type of rehabilitation;
n. ability of therapists to assess and treat patients according to their independent clinical judgment for appropriate patient care based on ethical and professional standard...
Therapy Systems Assessment. 1. For each Reporting Period, the IRO shall assess the effectiveness, reliability, and thoroughness of Ensign Group’s rehabilitative therapy systems and Ensign Group’s oversight of its rehabilitative therapy staff at the randomly selected subset of eight of the Subject Facilities. The systems assessment shall include, but is not limited to, ensuring that Ensign Group:
a. provides only skilled rehabilitation therapy that is:
i. delivered pursuant to an individualized plan of care;
ii. consistent with the nature and severity of the resident’s and/or patient’s individual illness or injury;
iii. in compliance with accepted standards of medical practice;
iv. reasonable and necessary given the resident’s and/or patient’s condition and plan of care to improve his or her condition, prevent or slow deterioration of his or her condition, or restore the his or her prior levels of function; and
v. limited to services that are inherently complex and require the skills of physical, speech, or occupational therapists, among other types of professionals;
b. complies with Medicare program requirements relating to the tracking of therapy minutes (e.g., only includes services that are inherently complex and require the skills of physical, speech, or occupational therapists, among other types of professionals; appropriately accounts for group and concurrent therapy);
c. complies with all Medicare and Ensign Group requirements relating to the documentation of medical records;
d. obtains an assessment, by a physician, of the resident’s and/or patient’s need for skilled therapy and that the skilled services will improve his or her condition, prevent or slow deterioration of his or her condition, or restore his or her prior levels of function; Corporate Integrity Agreement – Appendix C
e. receives appropriate and effective training that, at a minimum, includes the subject matters set forth in Section III.C.2.b of the CIA; and
f. communicates and interacts effectively among the corporate, regional, and facility level employees who provide, manage, or oversee the delivery of skilled rehabilitative therapy services to Ensign Group’s residents and/or patients.
2. If, at any time during the term of the CIA, Ensign Group contracts for the provision of therapy services to its residents and/or patients or provides therapy services through an arrangement other than employment, the IRO shall assess the effectiveness, reliability, and thoroughness of Ensign Group’s oversight of those therap...
