With the newly implemented enhancements (10/01/18) to the assessment-based quality measures (Section GG) , it is imperative to take time to time to reflect on our practice patterns.  This new process will provide statistical analysis for CMS to determine the effectiveness of our skilled rehabilitation services. The data will allow functional outcomes to be measured as a part of the national SNF quality performance methodology.  Transparency will become available through the CMS Nursing Home Compare website as the new scores become available.  https://www.medicare.gov/nursinghomecompare/search.html

This standardized approach to care will also promote successful transition to the next level of care.  As a result, we should be preparing our clients to achieve functional improvement in addition to identifying role of family members/caregivers along with assisted devices and durable medical equipment needs.

As we continue to provide excellence in rehabilitation services, do we have the opportunity to further provide therapy in a better way?

Occupational therapy staff should be scheduling regular times for activities of daily living (ADLs).  In addition, late afternoons can be used for practicing reverse ADLs.  During our treatment time in the gym, work on specific impairments can help to move the dial.  First point, residents should be moved out of their wheelchair to promote posture and core strength. Interventions should iclude static and dynamic balancing activities at the edge of bed/mat or while sitting in standard chairs (with or without arms).  Emphasis is place to dynamic movements to mimic the required functional tasks – reaching out of based of support, crossing midline, weight-shifting and flexibility throughout the body.  Practice transfers everywhere – it’s the true key to functional toileting!

 

If you have a treatment mat, physical therapy should  have a line of clients ready to use it! Again,  residents should be moved out of their wheelchair to promote posture and core strength. Rolling, supine to sit, sit to stand and transfers can be fast tracked  using the support of the hard surface and positioning devices as need. Consider use of the Otago fall prevention exercises as a component of your care plan.  Evidenced-base care is the way to go! Consider setting up an area to work on stair stepping and the distances identified in the mobility items in Section GG.  Determine the best way to assess car transfers at your facility.

 

As Functional Pathways continues to meet the changes to our regulatory requirements, find out how your outcomes reflect your clinical excellence.  Check out your facility scores on the CMS Nursing Home Compare website.  The new RightTrack® enhancements, Functional Pathways innovative product, will be rolled out in March, 2019.   It’s time to elevate our clinical reasoning and creativity to meet the needs of our clients.

 

Our new partnership with MedBridge will allow our occupational and physical therapists to obtain Section GG certification through online courses and competency testing.  Get ready … change in on the way!

 

Beth Reigart
Clinical Operations Specialist