RE: Re: Short Term Goals (STG's)

[Guest guest]

Before dismissing the issue of short-term goals altogether, you might want to

read carefully your discipline-specific LCD from your Medicare Administrative

Contractor (MAC). Many of these LCDs do include the requirement for " short and

long term goals stated in objective measurable terms, and their expected date of

accomplishment " . Some MACs are now denying coverage (via ADR review) based on

not meeting this requirement.

[cid:image001.jpg@...]

Jean-Michel Geoffriau, PT | Director of Rehabilitation | Sta-Home Health &

Hospice | JGEOFFRIAU@...

406 Briarwood Drive, Bldg. 200 | , MS 39206 | Office: | Fax:

| Mobile:

From: PTManager [mailto:PTManager ] On Behalf Of

Jerry

Sent: Monday, June 04, 2012 2:46 PM

To: PTManager

Subject: Re: Short Term Goals (STG's)

Hi Ron

Great point. Terminology here is all over the map and there is a lot of

confusion about this. My two cents:

* You're right, there is no requirement for both short term and long term goals

to be included in your Plan of Care, only long term goals.

* But, there is a requirement in the documentation requirements section of the

Medicare Benefits Policy Manual that " Documentation should establish through

objective measurements (my emphasis) that the patient is making progress toward

goals. (I think one can assume that CMS is referring to long term goals here.)

So, it would seem to be ideal if there is an explicit linkage of your important

clinical findings with progression toward long term goals. These clinical

measurements may be " classic " clinical tests like ROM and strength or other

reproducible tests of patient's function.

I think it makes all of this easier if we think of the terms " short term goals "

and " long term goals " as " Clinical Goals " and " Functional Goals " . These terms

just add to the confusion.

Jerry , PT

VP, Clinical Community | Clinicient, Inc.

1515 SW Fifth Street, Suite 950 | Portland, OR 97205

Direct Line: x.115 | Cell: | Fax:

www.Clinicient.com<http://www.clinicient.com/>

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[Guest guest]

I believe the discussion on " short term goals " has been oversimplified. It

is true that the CMS " minimum requirement for payment " for therapy services

is that documentation include:

.. Diagnoses

.. Long term treatment goals

.. Type, amount, duration and frequency of therapy services

However, on the following page of the Medicare Benefits Policy Manual

(Revised 11-18-2011), Section 220.1, page 160 also includes the following

significant paragraph referring to " good therapy practices "

" The above policy describes the minimum requirements for payment. It is

anticipated that clinicians may choose to make their plans more specific, in

accordance with good practice. For example, they may include these optional

elements: short term goals, goals and duration for the current episode of

care, specific treatment interventions, procedures, modalities or techniques

and the amount of each. "

If we want to be considered professionals, limiting our documentation to

only " long term goals " is a shortcut we can't afford to take. Including STG

in our documentation demonstrates our consideration of early specific

outcomes we expect to see, rather than the long range goals which may be

several weeks away. Adding STG's adds justification to the patient's

record.

Jerry 's comment to label " STG " as " clinical goals " is well taken,

but may not be understand by those reviewing our records. The future of

documentation lies in EMRs and standardization of labels. There needs to be

a consensus in naming of labels.

Let's think like the professionals we are.

Echert, MPT

Monroe, WA

From: PTManager [mailto:PTManager ] On Behalf

Of Jerry

Sent: Monday, June 04, 2012 12:46 PM

To: PTManager

Subject: Re: Short Term Goals (STG's)

Hi Ron

Great point. Terminology here is all over the map and there is a lot of

confusion about this. My two cents:

* You're right, there is no requirement for both short term and long term

goals to be included in your Plan of Care, only long term goals.

* But, there is a requirement in the documentation requirements section of

the Medicare Benefits Policy Manual that " Documentation should establish

through objective measurements (my emphasis) that the patient is making

progress toward goals. (I think one can assume that CMS is referring to long

term goals here.)

So, it would seem to be ideal if there is an explicit linkage of your

important clinical findings with progression toward long term goals. These

clinical measurements may be " classic " clinical tests like ROM and strength

or other reproducible tests of patient's function.

I think it makes all of this easier if we think of the terms " short term

goals " and " long term goals " as " Clinical Goals " and " Functional Goals " .

These terms just add to the confusion.

Jerry , PT

VP, Clinical Community | Clinicient, Inc.

1515 SW Fifth Street, Suite 950 | Portland, OR 97205

Direct Line: x.115 | Cell: | Fax:

www.Clinicient.com<http://www.clinicient.com/>

Follow Us:

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