Medicare Extends 5-Star Ratings to Home Health Agencies

Home health agencies are now part of the Centers for Medicare and Medicaid Services (CMS) 5-star rating system, which incorporates evaluations of patient mobility in its assessment of an agency’s overall effectiveness.

Released through its Home Health Compare website, the star ratings are based on 9 of the 27 quality measures included in that program. The measures included are patient wait for a first visit, thoroughness of explanations of drugs to a patient or caretaker, administration of a flu shot, hospital stays, and improvements in walking, getting in and out of bed, breathing, and movement with less pain.

Of the 9,359 agencies rated (out of 12,261 total agencies), only 239 received 5 stars, while 2,218 received 4 or 4.5 stars. Nearly half of all agencies—46%—landed in the middle of the pack, receiving 3 or 3.5 stars, with 28% receiving lower ratings of 1.5 to 2.5 stars. Of all agencies rated, 6 received a single star.

Full story of 5-star ratings on home health agencies at APTA

Study: Concussed College Athletes Almost Twice as Likely to Experience Later Lower Extremity Injuries

A study of Division I college athletes has reinforced the idea that there’s a connection between concussion and later musculoskeletal injury, with an estimate that for as much as a year after the initial head injury, concussed athletes are nearly twice as likely to suffer an acute lower extremity injury than they were prior to the concussion.

Researchers analyzed electronic medical records of 44 concussed and 58 nonconcussed college athletes for a 2-year period that extended 1 year before and after the concussion (the nonconcussed athletes were matched with the concussed athletes over the same time period). Records were retrieved at 365 days, 180 days, and 90 days before and after the concussion, with researchers focusing on reports of acute lower extremity musculoskeletal injury that included sprains, strains, contusions, and fractures, but didn’t include chronic and overuse injuries.

Full story of concussions and lower extremity injuries at APTA

Additional Day-Per-Week of Physical, Occupational Rehab Therapy Results in Cost-Savings

What a difference a day makes.

Researchers in Australia say that a study of inpatient rehabilitation there has revealed that adding Saturday physical and occupational therapy sessions to a weedays-only schedule can lower overall health care costs after 1 year while it increases functional independence.

For the study, researchers tracked public and private health care costs of 996 patients admitted to 2 inpatient rehabilitation facilities. The patients were divided into 2 groups: 1 group of 500 that received 1 hour each of physical therapy and occupational therapy Monday through Friday, and a second group of 496 patients who received the therapy sessions on Saturdays, too. Authors of the study were interested in finding whether the cost of the additional day of rehab therapies was offset by patient gains that resulted in lower health care expenditures after 1 year.

Full story of additional days to therapy at APTA

Blogs and Tweets and Posts Oh, My: Support for Therapy Cap Repeal Gets Creative

APTA members and supporters are keeping the pressure on the US Senate to consider an amendment that would end the therapy cap, and, true to the profession, doing it with plenty of energy and creativity.

In addition to APTA’s own grassroots efforts to ensure that a therapy cap repeal amendment is included in legislation to end the sustainable growth rate (SGR),Joseph Brence, PT, DPT, FAAOMPT, used his “Forward Thinking PT” blog to urge physical therapists (PTs) to contact their senators, and he compiled a list of social media handles that makes it easy to post to legislators’ and staffers’ Twitter accounts. The list also includes links to each senator’s Facebook page.

Many PT and physical therapist assistant (PTA) students are answering APTA’s request for phone calls, but with a twist: yesterday, they began answering a challenge from APTA to document their phone calls to senators by posting photos on Twitter. You can check out the photos through this Storify page. Great stuff.

Full story of support or therapy cap repeal at APTA

‘Bionic Reconstruction’ Restores Hand Function in 3 Patients

Researchers in Austria say that they’ve successfully completed “bionic reconstruction” procedures that allow individuals to use their minds to control a prosthetic hand that can engage in complicated motor control activities such as unfastening buttons, picking up coins, and pouring water from a cardboard carton. All 3 patients who received the prosthesis suffered brachial plexus avulsion injuries and elected to have the injured hand amputated.

The prostheses are controlled through 2 “cognitively separate” electromyographic signals in the forearm—one from nerves and muscles already present in the patient’s damaged forearm, and another surgically transferred into the affected arm from the leg. After the signal sites were established, the patients underwent cognitive training by, at first, controlling a graph on a computer screen via electrodes attached to the sites, and then through the operation of a “virtual hand” on the screen.

Full story of bionic reconstruction at APTA

What’s Your Advice? Check Out This PTNow Blog Case for ‘Wear Red Day’

You’re a physical therapist (PT) at Anytown Physical Therapy, Anytown, USA. Say hello to Ms LZ.

As part of February 6 “National Wear Red Day” to raise awareness about women’s heart health, APTA’s PTNow blog features a quick case scenario about a 44-year-old woman who has a few questions for you, based on some recent results from her primary care physician.

Read the vignette, think about what you’d say to Ms LZ, then read on for comments on the case from Dan Malone, PT, PhD, CCS, president of the APTA Cardiovascular and Pulmonary Section. Finally, check out some additional resources that look at the PT’s role in cardiopulmonary health.

For more information on the PTNow blog case, visit APTA

CMS Adjusts Manual Medical Review Process for Claims Made in 2014

The US Centers for Medicare and Medicaid Services (CMS) is using a revised manual medical review process that takes a stepped approach to Additional Documentation Requests (ADRs) for outpatient therapy claims over $3700. The new postpayment review system will allow Recovery Audit Contractors (RACs) to request documentation for increasing percentages of claims over time, beginning with 1 claim and advancing to 100% of remaining eligible claims by the fifth ADR issued, according to CMS.

The review process applies to outpatient physical therapy, occupational therapy, and speech language pathology claims that exceeded $3700 from March 1-December 31, 2014. The review of these claims had been temporarily halted due to delays in the transition to new RACs.

Full story of CMS changes to processing claims at APTA

Children With Mystery Polio-Like Illness Still Not Recovered; Link to Enterovirus Still Uncertain

The children who suffered a mysterious polio-like illness in Colorado last year have yet to fully recover, and what gains they have made have been achieved largely through physical therapy. Meanwhile, while no definitive conclusion has been reached on a cause for the illnesses, researchers in Colorado are finding support for a possible link to enterovirus D-68 (EV-D68), which was at the center of an outbreak of respiratory illnesses in children during the last half of 2014.

In an article published in the January 29 edition of The Lancet, physicians from the Colorado Children’s Hospital recount the development and treatment of 12 cases of acute flaccid paralysis and cranial nerve dysfunction among children (median age: 11.5 years). Ten of the 12 children experienced limb weakness, and 11 had extensive spinal cord lesions. Additionally, cranial nerve dysfunction—defective speech, facial droop, trouble swallowing, double vision—was observed in 10 of the children.

Full story of children with polio like symptoms at APTA

Rise in Fall Prevalence ‘Exceeds What Would be Expected’

The prevalence of self-reported falls among adults 65 and older is on the rise, and it’s not just because of an aging American population, according to researchers who analyzed data collected from 1998 to 2010.

Researchers anticipated that if increases in falls prevalence were found, they would be largely due to “changes in age structure of the population”—that is, more and more people getting older and older. What they found surprised them: while prevalence did increase across the board for adults 65 and older from 1998 to 2010, from 28.2% to 36.3%, the largest jumps in prevalence occurred in the lower age brackets.

Full story of rise in falls at APTA

SC Supreme Court Ready to Weigh in on Physician-Owned Physical Therapy Services

Amid increased national attention on the issue of physician self-referral—and some high-profile support for tightening restrictions on the practice—the South Carolina Supreme Court is scheduled to hear arguments in a case that challenges a prohibition on physician-owned physical therapy services (POPTS) in that state.

The Joseph case, scheduled to be heard by the high court on February 19, is an appeal of a decision made by the state circuit court last year that ruled in favor of the South Carolina Board of Physical Therapy Examiners (SCBPTE) and the South Carolina Chapter of APTA (SCAPTA). The case was brought against SCBPTE by 2 medical doctors and a physical therapist (PT) who sought to extend the state’s ban on PTs working for physician-owned groups to PTs working in PT-owned group practices.

Full story of physician-owned PT services at APTA