Exam Preview for 4474: Getting Ready for PDPM: Group and Concurrent

Getting Ready for PDPM: Group and Concurrent Therapy

Please note: exam questions are subject to change.

1. Which of these offers the accurate definition of group therapy under PDPM as determined by CMS (Centers for Medicare and Medicaid Services): Group Therapy is defined as the provision of skilled rehabilitation services in a setting with a therapist(s) and 2-6 participants; the participants are simultaneously engaged in similar activities. Group Therapy is defined as the provision of skilled rehabilitation services in a setting with a therapist(s) and only 4 participants; the participants are simultaneously engaged in similar activities. Group Therapy is defined as the provision of skilled rehabilitation services in a setting with a therapist(s) and 2-6 participants; it does not matter what the participants are doing. Group Therapy is defined as the provision of skilled rehabilitation services in a setting with a therapist(s) and only 6 participants; the participants are simultaneously engaged in similar activities.
2. Which of these statements is true regarding group therapy in skilled nursing: Groups can exceed the ratio set by CMS providing that documentation supports the rationale. The “rules” for group are the same for Medicare Parts A and B Groups must be administered by a licensed therapist or therapist assistant under the supervision of the licensed therapist. Rehab Aides or techs cannot independently facilitate a group. The ratio for group therapy under Medicare Part A is 1:4.
3. Which of these is true regarding concurrent therapy: Concurrent therapy is defined as a treatment provided to more than one patient at the same time as another. No more than 2 patients can be seen concurrently. Under the definition of concurrent, patients are not performing the same or similar activities All of these are true.
4. Which of these is NOT demonstrative of clinical rationale for group therapy: Clinically, participants learn from one another, encourage one another, and motivate one another. Running groups is now required. Group therapy helps with overall productivity and profitability. In a group setting, multiple goals can be addressed for a particular participant. The group treatment may allow the participant to practice tasks in a practical, realistic setting, which further prepares the participant for discharge to a less-restrictive environment.
5. Which of the following would be considered clinically inappropriate for concurrent therapy: Wound care Bedside treatments Procedures requiring one-on-one intervention, such as advanced gait and balance training All of these are inappropriate clinically for concurrent therapy
6. Which of the following patients would be most appropriate for group and/or concurrent therapy? A patient who is cognitively impaired and has difficulty following directions A patient who is alert, able to follow directions, and has a goal for discharge to home A patient who is unable to be safely supervised without physical contact of another person A patient who has severe safety concerns
7. Which of the following elements is true to of skilled documentation for group therapy? Documentation for group treatments for the individual participants is to be incorporated into the daily documentation/weekly note as part of the medical record. Documentation must show that the group treatment is medically necessary. Documentation should detail the specific benefits of group therapy and how this mode of service delivery will assist the participant in achieving his or her individual goals. All of these should be incorporated.
8. When documenting/billing for group therapy, which of these statements is true? Participants may be billed for group treatment only if they are active participants in group functions. The logs do not need to show a clear distinction between individual treatments, concurrent, or co-treatment. Group therapy is coded using a CPT code that corresponds to the type of activity performed. For example, an exercise group would be coded using CPT 97110. Each individual in the group is credited with ¼ of the total time/duration of the group.
9. When documenting group therapy, which of these should be considered and included in the daily skilled note? Number of minutes individual participated in group therapy and the number of people participating in the group. Specific treatment technique(s) used in the group and how these provided therapeutic benefit to the patient. Any modifications that had to be made and the participant’s reactions to them. All of these should be included in the note.
10. In preparing for delivering group and/or concurrent therapy, which of the following is NOT a logistical consideration? Is there enough space, activities, and materials to meet the goals of the treatment session? How large should the group be so to maximize therapeutic benefit for all participants involved? How can the therapist schedule group and concurrent to maximize productivity? How long should the treatment session be based on the needs and abilities of the participants?