Free Fast Facts Webinar: Results of the Therapy STARS Projects Thursday, September 13, 2012 Cindy Krafft, PT, MS Director of Rehabilitation Consulting Services Fazzi Associates 243 King Street, Suite 246 Northampton, MA 01060 413-584-5300 fax: 413.584.0150 e-mail: info@fazzi.com www.fazzi.com
Instructions and Handouts for: Free Fast Facts Webinar: Results of the Therapy STARS Projects Thursday September 13, 2:00pm Eastern Time 11 12 10 9 8 7 6 1 5 2 3 4 Eastern Standard Time 2:00 PM to 2:45 PM 11 12 10 9 8 7 6 1 5 2 3 4 Central Standard Time 1:00 PM to 1:45 PM 11 12 10 9 8 7 6 1 5 2 3 4 Mountain Standard Time 12:00 PM to 12:45 PM 11 12 10 9 8 7 6 1 5 2 3 4 Pacific Standard Time 11:00 AM to 11:00 AM To participate in the webinar: 1. You may listen to this webinar via your computer speakers or over the telephone. If you wish to listen over the phone, dial 1-(702) 489-0002 at least 10 minutes prior to the start of the webinar. 2. When asked, enter Access Code 526-122-561#. 3. Give your agency s name. 4. At this time you will be entered into the call and in listen mode. 5. To view the visual part of this presentation, click on the link that was emailed to you by GoToWebinar. 6. If at any time you need assistance you may press *0 for the operator.
Speaker Introduction Cindy Krafft MS PT is the Director of Rehabilitation Consulting Services for Fazzi Associates, Inc. She has 17 years of home health experience ranging from PRN Clinician to the Director of Rehabilitation for a six agency home care system. She serves as the President of the Home Health Section of the American Physical Therapy Association and immediate past Chair of the NAHC Therapy Advisory Committee. She has authored two books focused on Therapy Documentation and Interdisciplinary Care Management as well as a variety of articles in Caring Magazine, The Remington Report, Success in Home Care, Home Healthcare Nurse, and the Home Health Section of APTA newsletter. As well as being an expert on therapy practice in home care she also assists agencies with achieving OASIS competency. She served as the Clinical Co-Director of the Delta National OASIS-C Best Practices Project and the Clinical Director of the Delta Excellence in Therapy Project. She is a well-received speaker at both the state and national levels on the topics of OASIS, therapy documentation, program development, therapy utilization, and recruitment.
Fazzi Fast Facts: Results of the Therapy STARS Project Cindy Krafft PT, MS Director of Rehabilitation Consulting Services Fazzi Associates Therapy STARS Project Standardized Assessment, Reassessment and Strategies August 2011 June 2012 60+ agencies completed the project Combined total of over 3000 records reviewed Representation of: Agency Size Rural / Urban Employed / Contract Goal = Sustainable Improvement Documentation concerns are not new. Expectations are not fundamentally Medicare or Home Health Specific. Agencies AND therapists want to move on from this issue. 1
Project Components Baseline Audit Webinars (3) Individual Calls (3) Therapy Roundtable Improvement Audit Baseline Audit Sept / Oct Recently discharged patients Represent PT, OT and SLP Utilization low to high If recerts present, focus will be on initial cert period Record Content SOC / ROC OASIS 485 / Plan of Care Therapy Evaluations Therapy Reassessments Therapy Orders Therapy Notes 2
Webinars Medical Necessity Utilization Management Reviewer Training Individual Consulting Calls Three one on one calls with assigned consultant over the course of the project Topics determined by agency needs within parameters of the project Therapy Roundtable Dynamic, highly interactive, monthly online discussions Focus on an array of critical home care issues specific to Therapy Live on-air interviews, and of course discussion and interaction with the membership 3
Improvement Audit Not the same charts as the initial review Final report provided to the agency and the group Measures the impact of the project Highest Risk Areas Measurement AND Analysis PT Gait OT ADLs SLP Function Measureable AND Meaningful Goals Reassessments Measuring Initial Risk Total Risk: $1.85 million Per Record Risk: $1570 Average size of audit: 20 records = $31,400 risk 4
Min / Mod / Max Independent, Supervision, SBA, CGA, Min A, Mod A, Max A, Total, Dependent quantifies assistance. It is the qualitativemeasure that requires further detail about WHY the level of assist is required and WHAT skill the therapist is providing to improve the functional limitation. Good / Fair / Poor Timed Up and Go (TUG) Tinetti Performance Oriented Mobility Assessment (Tinetti POMA) Berg Balance Test One Leg Stance Test Gait Velocity Dynamic Gait Index Balance confidence tests such as Activities Specific Balance Confidence Scale (ABC Test) Measureable Goals CONSIDER: ROM MMT Distances Level of assistance Environment Testing Scores Specific Equipment Caregiver role Specific Instructions Any Complicating Factors AVOID: fair/good/poor WFL LRAD household community safe increase improve min/mod Modified Independent 5
Meaningful Goals Connection to what is meaningful TO THE PATIENT Consider: to allow patient to so patient can to comply with Therapy Reassessments Audit results showing some issues with completion in the correct time frames Larger issues with content NOT meeting the standard to support continuing therapy Reassessment Documentation Focus is the PLAN OF CARE. Refer to clinical findings (objective assessments) and treatment plan revisions. Speak to the effectiveness of therapy in relation to the goals. Plans to continue or discontinue. Why you? Why now? 6
Overall Improvement 77% reduced risk by at least 20% 40% reduced risk by more than 50% Highest reduction was 96% Successful Strategies Use of Webinars Project Champion Self and Peer Audits Supervisory Visits Individualized Coaching Tool Revisions Creating Reminders Where Do We Go From Here? Issues with OASIS, Coding and Clinical Documentation are NOT new. Many resources used to try to correct with limited sustainable success. PPS 2013 has a large focus on compliance. 7
The SuperSTARS Quality Improvement Project Baseline Audit 3 Webinars OASIS / Coding Outcomes Medical Necessity 3 Conference Calls Full year of OASIS NP Final Audit Focus Areas OASIS Coding Outcomes Medical Necessity Cost Breakdown Original Participation Cost for Fee Educational = $1500 Services Alone: Includes all webinars, individual conference calls and membership to OASIS NP $4000+ Documentation Audit = $175 per record Completed at beginning AND end of process Includes a detailed report of findings Specifics not shared with the overall group Ideally 10% of the Medicare Census 8
Contact Information Website Fazzi.com E-Mail ckrafft@fazzi.com Twitter Account FazziRehab 9