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frequency order in SNF

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Question posted for a friend.

In a SNF who defines the work week Start on Sun and End on Sat. (not a

written policy on this, just the way they do it)

They had a patient with 3xwk clarification order who missed on Friday and

therapist came in on Sunday and saw them. The manager wants the patient

seen 3x again this week. This all has to do with Medicare A or B patients.

The facility is in Tenn and I don’t know if they have direct access in that

state. The facility is not JCAHO.

1. Does CMS define a week or does they expect a written policy

2. Would seeing this patient Sun/Mon/Wed/Fri for this week be a

problem if the work week policy is not defined by written policy

3. Finally, if a patient is seen late week… that facility tends to

write order for 3xwk/5xwk and assume their normal operations are M-F and the

first week is a given for not completing the full order. Has anyone had

actual problems with this from CMS review. I know some agencies write

orders as “1 week 1, 3 week 4” to handle the first week but has anyone

actually had problems with CMS by assuming the first week will be short.

Steve Passmore PT

CEO Healthy Recruiting Tools

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