RE: question on 3 hour rule

[Guest guest]

This is a great discussion. We have the same situation. My thoughts to

potentially solve this would be to plan the patients entire treatment days from

admission to discharge including the days that may be breaks. We typically know

anticipated DC date and could plan ahead all the days so that we are not caught

short. My opinion regarding the last week if it is short the 5 days is that we

should give 3 hours (12 UOS) each day including day of discharge. The

regulations as I remember do not indicate decrease in hours for anything other

than the exception days related to medical issues. What are others opinions or

interpretation?

Does anyone give the patients a schedule of all the days for LOS on a calendar

including breaks so they know ahead of time?

B. Stowers, Ed.D.

Clinical Manager Rehabilitation

CHRISTUS St. Regional Medical Center

455 St. s Dr.

Santa Fe, NM. 87505

> My question is about the intensity on the final days. here's the scenario:

>

> first 7 day period---patient received 15 hours (5/7 days)

> second 7 day period----same as above

> next period---patient discharges on the 4th day of this period. Is the patient

suppose to receive 3 hours a day for each of these days? To meet the 3 hour

rule?

> Even if you exclude the day of discharge, what about the other 3 days? If they

don't receive 3 hours each day in the final days, would you consider them as

meeting the 3 hour rule for the entire stay?

>

> I've been told that each of the final days must meet the 3 hour rule. That's

what we strive for it but sometimes get caught on this because we gave the

patient a day off (over the weekend).

> For example--The beginning of their cycle (7 day period) is a Saturday and

they discharge on Wednesday. My understanding is that they must receive 3 hours

on Saturday, Sunday, Monday, Tuesday, and Wednesday.

> We rarely provide therapy on day of d/c.

>

> I would really appreciate any insights, references, guidance you can provide.

>

> Lori Stoddart, OTR/L

> Inpatient Therapy Manager

> Physical Rehabilitation Services

> Henry Ford Wyandotte Hospital

> 2333 Biddle Avenue

> Wyandotte, MI 48192

> 734/246-8963

> lstodda1@...

>

> Be kinder than necessary because everyone you meet is fighting some kind of

battle

>

> ==============================================================================

>

[Guest guest]

This is a great discussion. We have the same situation. My thoughts to

potentially solve this would be to plan the patients entire treatment days from

admission to discharge including the days that may be breaks. We typically know

anticipated DC date and could plan ahead all the days so that we are not caught

short. My opinion regarding the last week if it is short the 5 days is that we

should give 3 hours (12 UOS) each day including day of discharge. The

regulations as I remember do not indicate decrease in hours for anything other

than the exception days related to medical issues. What are others opinions or

interpretation?

Does anyone give the patients a schedule of all the days for LOS on a calendar

including breaks so they know ahead of time?

B. Stowers, Ed.D.

Clinical Manager Rehabilitation

CHRISTUS St. Regional Medical Center

455 St. s Dr.

Santa Fe, NM. 87505

> My question is about the intensity on the final days. here's the scenario:

>

> first 7 day period---patient received 15 hours (5/7 days)

> second 7 day period----same as above

> next period---patient discharges on the 4th day of this period. Is the patient

suppose to receive 3 hours a day for each of these days? To meet the 3 hour

rule?

> Even if you exclude the day of discharge, what about the other 3 days? If they

don't receive 3 hours each day in the final days, would you consider them as

meeting the 3 hour rule for the entire stay?

>

> I've been told that each of the final days must meet the 3 hour rule. That's

what we strive for it but sometimes get caught on this because we gave the

patient a day off (over the weekend).

> For example--The beginning of their cycle (7 day period) is a Saturday and

they discharge on Wednesday. My understanding is that they must receive 3 hours

on Saturday, Sunday, Monday, Tuesday, and Wednesday.

> We rarely provide therapy on day of d/c.

>

> I would really appreciate any insights, references, guidance you can provide.

>

> Lori Stoddart, OTR/L

> Inpatient Therapy Manager

> Physical Rehabilitation Services

> Henry Ford Wyandotte Hospital

> 2333 Biddle Avenue

> Wyandotte, MI 48192

> 734/246-8963

> lstodda1@...

>

> Be kinder than necessary because everyone you meet is fighting some kind of

battle

>

> ==============================================================================

>

[Guest guest]

This is a great discussion. We have the same situation. My thoughts to

potentially solve this would be to plan the patients entire treatment days from

admission to discharge including the days that may be breaks. We typically know

anticipated DC date and could plan ahead all the days so that we are not caught

short. My opinion regarding the last week if it is short the 5 days is that we

should give 3 hours (12 UOS) each day including day of discharge. The

regulations as I remember do not indicate decrease in hours for anything other

than the exception days related to medical issues. What are others opinions or

interpretation?

Does anyone give the patients a schedule of all the days for LOS on a calendar

including breaks so they know ahead of time?

B. Stowers, Ed.D.

Clinical Manager Rehabilitation

CHRISTUS St. Regional Medical Center

455 St. s Dr.

Santa Fe, NM. 87505

> My question is about the intensity on the final days. here's the scenario:

>

> first 7 day period---patient received 15 hours (5/7 days)

> second 7 day period----same as above

> next period---patient discharges on the 4th day of this period. Is the patient

suppose to receive 3 hours a day for each of these days? To meet the 3 hour

rule?

> Even if you exclude the day of discharge, what about the other 3 days? If they

don't receive 3 hours each day in the final days, would you consider them as

meeting the 3 hour rule for the entire stay?

>

> I've been told that each of the final days must meet the 3 hour rule. That's

what we strive for it but sometimes get caught on this because we gave the

patient a day off (over the weekend).

> For example--The beginning of their cycle (7 day period) is a Saturday and

they discharge on Wednesday. My understanding is that they must receive 3 hours

on Saturday, Sunday, Monday, Tuesday, and Wednesday.

> We rarely provide therapy on day of d/c.

>

> I would really appreciate any insights, references, guidance you can provide.

>

> Lori Stoddart, OTR/L

> Inpatient Therapy Manager

> Physical Rehabilitation Services

> Henry Ford Wyandotte Hospital

> 2333 Biddle Avenue

> Wyandotte, MI 48192

> 734/246-8963

> lstodda1@...

>

> Be kinder than necessary because everyone you meet is fighting some kind of

battle

>

> ==============================================================================

>

[Guest guest]

We do not provide any therapy on day of d/c, unless absolutely necessary

due to family training needs or an unplanned d/c and the discharge eval

is not yet completed. We do follow the 7 day pattern for the last week

up until the d/c date. We target the d/c for 11:00 so that we can bring

a new patient in on the same day, if our beds are full. Nursing

provides some discharge teaching, review of going home instructions,

appts that have been scheduled, on the day of discharge.

Brownrigg

Inpatient Therapy Manager

Acute Care and Inpatient Physical Rehabilitation Therapies

PeaceHealth St. ph Medical Center

2901Squalicum Parkway

Bellingham, WA 98225

sbrownrigg@...

www.peacehealth.org

our success is in the being, not just the doing

From: PTManager [mailto:PTManager ] On

Behalf Of Stoddart, Lori

Sent: Wednesday, April 13, 2011 8:26 AM

To: PTManager

Subject: question on 3 hour rule

My question is about the intensity on the final days. here's the

scenario:

first 7 day period---patient received 15 hours (5/7 days)

second 7 day period----same as above

next period---patient discharges on the 4th day of this period. Is the

patient suppose to receive 3 hours a day for each of these days? To meet

the 3 hour rule?

Even if you exclude the day of discharge, what about the other 3 days?

If they don't receive 3 hours each day in the final days, would you

consider them as meeting the 3 hour rule for the entire stay?

I've been told that each of the final days must meet the 3 hour rule.

That's what we strive for it but sometimes get caught on this because we

gave the patient a day off (over the weekend).

For example--The beginning of their cycle (7 day period) is a Saturday

and they discharge on Wednesday. My understanding is that they must

receive 3 hours on Saturday, Sunday, Monday, Tuesday, and Wednesday.

We rarely provide therapy on day of d/c.

I would really appreciate any insights, references, guidance you can

provide.

Lori Stoddart, OTR/L

Inpatient Therapy Manager

Physical Rehabilitation Services

Henry Ford Wyandotte Hospital

2333 Biddle Avenue

Wyandotte, MI 48192

734/246-8963

lstodda1@... <mailto:lstodda1%40hfhs.org>

Be kinder than necessary because everyone you meet is fighting some kind

of battle

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