Archive for December, 2011


December 15, 2011

Therapy Center Student News: Spotlight on Jennifer Champagne

Filed under: Blog,Physical Therapy,Therapy Center Student News — Tags: , — Kristi Fredieu @ 9:32 am

Jennifer Champagne, PTA student from Our Lady of the Lake tells about her experience at Therapy Center’s partner skilled nursing facility, Maison Teche, in Jeanerette & what she’s learned! Stay tuned for more student interviews and news updates…

 

 

Read more Therapy Center News student spotlights…


December 13, 2011

Therapy Center Student News: Spotlight on Teela Faircloth

Teela Faircloth, from Lafayette, Louisiana is currently studying Speech Language Pathology at the University of Louisiana at Lafayette. Teela is completing a student rotation with the Therapy Center team at Jeff Davis Living Center in Jennings, Louisiana and told us a little bit about herself and what she has learned during her rotation.

Why did you choose to be a speech therapist?
To be perfectly honest, I have always enjoyed helping others. I know this sounds cliché for one to say; however it is what describes me the best. Speech therapists help individuals from many different populations improve quality of life and regain the ability to communicate. They possess the ability each and every day to make a positive difference in the life of a patient, whether it is regaining speech after a stroke or speaking for the first time with a speaking valve after a tracheotomy or eating foods by mouth following return of a functional swallow with elimination of tube feeding. This career I have chosen will benefit me just as much as the people I will treat. There is no better feeling than knowing you have made a positive impact on another person’s life. My grandmother would always tell me the way to lead a fulfilling and meaningful life is created through service to others in need and as a future Speech Language Pathologist, I intend to keep this in perspective.

What is the biggest thing that you learned while on rotation with us?
This past semester I had the honor of completing my rotation with the Therapy Center at Jeff Davis Living Center. As a student, working with the elderly and older adults has taught me many things. Foremost, the greatest thing I have learned from this rewarding experience is my dedication to this population. Daily life becomes a challenge as people age and I want to help alleviate their burdens.

Favorite part of working with Therapy Center staff?
The Therapy Center staff provides meaning to the old saying “respect your elders” as it is demonstrated in their admirable delivery of services to each and every resident. I had the privilege to shadow the facility’s Speech Therapist, Candice Cooley, who in my eyes possesses all the positive qualities a future clinician should strive to acquire. Her knowledge about the field, dedication, and empathy for others is communicated through her work. Her willingness to take the time and talk to patients to find out what is bothering them is admirable. Often times I watched as she would peek her head in a resident’s room just to say hi, providing the idea that yes someone cares and hasn’t forgotten about them. She listens and asks questions to understand each individual’s concerns. She has shown me to always implement laughter and love as an objective in each therapy session. Not only will this improve the quality of life in others, but I too have felt in just a short period of time the fulfillment in life that is created through service to others. I will follow in the footsteps of this great clinician.

What are your hobbies and other areas of interest?
I am very interested in observing and learning more about Modified Barium Swallow Studies. These studies are designed to test the safety of different foods and liquid consistencies.  I enjoy viewing the anatomic structures, the motions of these structures, and passage of the food through the oral cavity, pharynx and esophagus. The results of an MBS help determine the safest foods/liquids that patients can consume orally as well as appropriate exercises to be utilized in therapy.  I am also fascinated by individuals with memory loss and overall cognitive impairments. I look forward to helping those with dementia use strategies to preserve communication and cognitive functioning for as long as possible.  Below is a beautiful poem I found online and wanted to share with the Therapy Center.

Anything interesting about yourself that you want others to know?
I am the first person in my family to attend, graduate, and further my education in college. I have held a full time job since I was old enough to work and have paid my way through college while obtaining some debt along the way. I have experienced hardship and struggle; however the experience I obtained while working has taught me responsibility, courage, compassion, appreciation, teamwork, and humility. These are qualities I will demonstrate in my future career as a Speech Language Pathologist.

Dedicated to every family whose parent is suffering with dementia or Alzheimer’s disease.

Living With Dementia
© Annabel Sheila

She’s trapped inside the prison walls
That used to be her mind.
The woman that she used to be,
Has long been left behind.

There are times she’s quite alert,
Her memory’s still intact.
Then there are days when she disappears,
And we know it’s not an act.

No longer able to care for herself,
We couldn’t leave her alone.
Her safety had to be assured,
So we placed her in a home.

Good days are when we visit her,
And she calls us by our name.
She’s grateful for the company,
And thankful that we came.

Most of the time it’s difficult,
To see our Mom that way.
All we can do is love her now,
As we take life day by day.

Source: Living With Dementia, Aging Poem, 5 Stories http://www.familyfriendpoems.com/poem/living-with-dementia#ixzz1fBUOL42m
Family Friend Poems

Other related Articles:
- The Truth Behind Speech Therapy

- Check out other student blogs here


December 8, 2011

Is Your Facility Ready if Targeted for a RAC Audit?

Filed under: Blog,Compliance — Tags: , — Kristi Fredieu @ 8:30 am

Article posted by RACMONITOR.com (visit their site here...)

CMS Announces New Demonstrations to Help Curb Improper Medicare, Medicaid Payments

The Centers for Medicare & Medicaid Services (CMS) has announced it will launch demonstration programs beginning in January 2012 targeting some of the most common factors that lead to improper payments. The cost saving projects will help protect Medicare and Medicaid, according to a news release posted on its site yesterday.

Beginning on January 1, 2012, CMS will conduct demonstration projects that will strengthen Medicare by aiming at eliminating fraud, waste, and abuse.  Reductions in improper payments will help ensure the sound future of the Medicare Trust Fund and protect Medicare beneficiaries who depend upon it, CMS said.  Additionally, noted the agency:

•    Recovery Audit Prepayment Review: The Recovery Audit Prepayment Review demonstration will allow Medicare Recovery Auditors (RACs) to review claims before they are paid to ensure that the provider complied with all Medicare payment rules.  The RACs will conduct prepayment reviews on certain types of claims that historically result in high rates of improper payments.   These reviews will focus on  seven states with high populations of fraud- and error-prone providers (FL, CA, MI, TX, NY, LA, IL) and four states with high claims volumes of short inpatient hospital stays (PA, OH, NC, MO) for a total of 11 states. This demonstration will also help lower the error rate by preventing improper payments rather than the traditional “pay and chase” methods of looking for improper payments after they have been made.

•    Prior Authorization for Certain Medical Equipment: The second demonstration announced yesterday will require Prior Authorization for certain medical equipment for all people with Medicare who reside in seven states with high populations of fraud- and error-prone providers (CA, FL, IL, MI, NY, NC and TX).  This is an important step toward paying appropriately for certain medical equipment that has a high error rate.  This demonstration will help ensure that a beneficiary’s medical condition warrants their medical equipment under existing coverage guidelines. Moreover, the program will assist in preserving a Medicare beneficiary’s right to receive quality products from accredited suppliers.

CMS said the Prior Authorization demonstration would be implemented in two phases. During the first phase (the first three to nine months), the Medicare Administrative Contractors will conduct prepayment reviews on certain medical equipment claims. The second phase, for the remainder of this three-year demonstration, will implement prior authorization, a tool utilized by private-sector health care payers to prevent improper payments and deter the fraudulent provision of items or services.

•    Part A to Part B Rebilling: The third initiative will allow hospitals to re bill for 90 percent of the Part B payment when a Medicare contractor denies a Part A inpatient short stay claim as not reasonable and necessary due to the hospital billing for the wrong setting.  Currently, when outpatient services are billed as inpatient services, the entire claim is denied in full.

This demonstration will be limited to a representative sample of 380 hospitals nationwide that volunteer to be part of the program. This demonstration will allow hospitals to resubmit claims for 90 percent of the allowable Part B payment when a Medicare Administrative Contractor, Recovery Auditor, or the Comprehensive Error Rate Testing Contractor finds that a Medicare patient met the requirements for Part B services but did not meet the requirements for a Part A inpatient stay.  In addition, this demonstration is expected to lower the appeals rate which will protect the trust fund and reduce hospital burden. Beneficiaries will be held harmless with respect to changes in hospital coinsurance liability.

New Projects Build on 2011 Savings

The 2012 projects announced yesterday will build on accomplishments in 2011 to reduce Medicare and Medicaid improper payment rates.
For example, the Medicare fee-for-service improper payment rate dropped to 8.6 percent, or $28.8 billion in estimated improper claims payments.  This rate was calculated using a refined methodology, after consulting with the Office of the Inspector General, that reflects the impact of late documentation and the results of appeal activities that typically occur after the cut-off date.  For consistency and comparison purposes, CMS adjusted the 2010 error rate to 9.1 percent or $29.7 billion. When comparing the adjusted rates, the 8.6 percent error rate for 2011 represents a 0.5 percentage point reduction in the improper payment rate from 2010.

In addition, for 2011, CMS noted the following:
•    The Medicare Advantage (Part C) improper payment rate, based on the 2009 payment year, is 11.0 percent, or $12.4 billion, a reduction from last year’s rate of 14.1 percent, or $13.6 billion.  The Part C improper payment rate dropped 3.1 percentage points (or 21 percent) from 2010, a result of the Administration’s aggressive corrective actions, including ongoing audits – with an emphasis on contract-level risk adjustment data validation audits – designed to recover over payments to Part C plans.

•    The Medicaid improper payment rate is 8.1 percent, or $21.9 billion in estimated improper payments.  This rate reflects a three-year average of the 2009, 2010, and 2011 cycle rates.  The Medicaid improper payment rate declined by 1.3 percentage points, reflecting ongoing efforts by the States and the Department of Health and Human Services (HHS) to educate providers on the root causes of improper payments.
CMS also reported for the first time a composite improper payment rate for the Medicare Part D prescription drug program.  Based on payment year 2009, the improper payment rate is 3.2 percent, or $1.7 billion.  The Part D payment improper payment rate combines five component payment error measures: Medicare Advantage prescription drug payment system error; payment error related to low income subsidy status; payment error related to incorrect Medicaid status; payment error related to prescription drug event data validation; and payment error related to direct and indirect remuneration.

The improper payment rate for the Children’s Health Insurance Program (CHIP) will not be published until 2012, CMS stated.  The agency said it was prohibited from calculating or publishing a rate until six months after the August 2010 Payment Error Rate Measurement (PERM) program rules went into effect.  Due to the timing, HHS began measuring CHIP improper payments under the new program rules in 2011, and will publish the results in 2012, CMS said.

While improper payment rates are not necessarily an indicator of fraud in Medicare, Medicaid or CHIP, they do provide HHS, CMS and states with a more complete assessment of factors leading to error rates and new ways to help prevent them, noted CMS.
The CMS announcement coincided with a news release from the White House yesterday reporting that the Office of Management and Budget (OMB) announced that the Administration had cut improper payments by $17.6 billion dollars in 2011 as part of the Obama Administration’s Campaign to Cut Waste, fueled by decreases in payment errors in Medicare, Medicaid, Pell Grants, and Food Stamps.

Read other related blogs here…


December 6, 2011

Occupational Therapists… Hmm, what exactly do they do?

Article written by Ava Hebert, Recruitment Manager for Therapy Center

After being surrounded by the world of therapy lately, I realized something… Growing up in a small town, I was simply not exposed to many professions and completely unaware of occupational therapy, for one. From that, I have drawn the conclusion that it is simply unfair to make an 18 year old choose what profession they should pursue and study in college as they begin a life of their own. Looking back, maybe I would have chosen a career as an occupational therapist (Nah, too much science involved; anatomy, physiology, kinesiology, oh my! That’s why I stuck with a good ole business degree).

Until recently, I’d never had any personal dealings with an occupational therapist. That all changed on June 19th, when my husband decided to stick his hand under the lawn mower while it was running.  After a trip to the emergency room, several x-rays and doctor visits, surgery to repair a nail bed and tendon, many stitches, three pins, and a husband with injured pride, we met an occupational therapist. My husband tells me that the therapy has been very challenging due to the amount of pain and loss of motion. After exercising his right ring finger for 30 minutes of attempting to write, type, and make a fist, he is dripping with sweat as though he were attempting to run a marathon. But I’m here to say that after a couple of visits to his therapist, several at-home exercises and a lot of determination, he is now using that finger as though the accident never happened. This is why occupational therapists are so very important.

The Difference Between an Occupational Therapist and a Physical Therapist

Many people struggle to understand the difference between an occupational therapist and a physical therapist. I sat down with Lauren Lemoine McCraine, an occupational therapist and Mentor with Therapy Center. She has been with Therapy Center for over seven years and she was very informative regarding the difference between the two professions. “The best way to describe the difference between occupational therapist and physical therapist is that PTs will teach you to walk to the kitchen, but OTs will teach you what to do once you get there. OTs are considered “holistic” therapists, in that we not only treat physical ailments, but we also address the social and psychological aspects of one’s life. We wear many hats on any given day– from OT to social worker, patient advocate to nurse, friend, or family.”

Where and How Occupational Therapists Treat

Occupational therapy is defined as the therapeutic practice of everyday actions in order to establish, recover, or maintain a person’s typical daily living activities. Occupational therapists help others to improve their basic motor functions and/or compensate for permanent loss of function. They are especially helpful to people who have a disabling condition or those recovering from an injury, as they can work with them to regain skills. Occupational therapists can also make the smallest adaptations, and with simple training techniques can give your loved ones the independence they need. For example, OTs can provide assistance for school aged children who suffer from disabilities by helping them to fully participate in school or social situations. In a skilled nursing facility, an OT is well known for providing support to the elderly population who may be experiencing physical or cognitive changes. Activities such as self-feeding, picking out clothes for dressing themselves, and performing grooming/hygiene tasks are all ways occupational therapists help to improve the patient’s quality of life and maintain a sense of dignity.  In all clinical settings, the main goal of an OT is to provide a better quality of life for the patient by helping them to achieve independent and productive daily functions.

Common Conditions Occupational Therapists Treat

Within her 7+ years of skilled nursing experience, Lauren tells me that the most common conditions she has worked with include strokes, osteoarthritis, Alzheimer’s disease, Parkinson’s disease, fractures, poor vision, COPD, depression, and age related decline. I wanted to know what types of exercises are commonly incorporated into an OT treatment plan, and what purpose these exercises serve. Just like other therapists, an occupational therapist will conduct assessments and evaluations to determine the areas in which a person may need help. But from there, how does an OT treat these conditions if they aren’t all physical? As Lauren explains it, “The thought behind this is that if an OT can discover an activity that is purposeful and meaningful to someone through conversations or evaluations, then there is more commitment to the task, it’s useful and familiar to the patient in regards to returning to prior level of function, and it can help build rapport between the therapist and patient. A simple task such as folding clothes while standing is something familiar, yet purposeful to the patient and can help to build motor skills, balance, and range of motion, among other things.”

Through my time with Therapy Center, my knowledge about occupational therapy has grown tremendously. I’ve learned that therapists in this field can develop a treatment plan out of almost any daily task; whether it be sweeping a room, putting a golf ball, painting, fishing, writing letters, brushing teeth,  and even making coffee, all of these activities are purposeful and meaningful to someone. Occupational therapy truly helps patients, young and old alike, maintain dignity and develop skills that help them live more independently.

To learn more about occupational therapy as a career, see the following articles.

•    Check out the following link to learn why occupational therapy was named one of the best careers of 2009: http://money.usnews.com/money/careers/articles/2008/12/11/best-careers-2009-occupational-therapist

•    To learn more about occupational therapy and find a school program near you, visit this link: http://www.aota.org/

•    And, if you’re an occupational therapist who is looking to expand your career and learn from the best, please visit this link:  http://therapyctr.com/employment-opportunities/current-job-openings


December 2, 2011

Who is Appropriate for Women’s Health Physical Therapy?

In continuation of our focus on women’s health PT, the article, “Physical Therapy for Your Lady Parts“, discusses what situations may warrant intervention from a women’s health physical therapist …

Here are six situations where a women’s health PT might be able to help you.

Incontinence

“Fifty percent of adult women will have incontinence at some point,” says Jennifer Klestinski, MPT, communications director for the Section on Women’s Health of the American Physical Therapy Association, who has a private practice in Madison, Wisconsin. “Because of anatomic differences, the effects of pregnancy and childbirth, and the effects of decreasing estrogen, women leak far more often than men. But with proper strengthening, the data shows there’s an 85-percent chance of complete resolution.”

The regimen: Weak pelvic muscles are a major factor in incontinence, so in addition to Kegel exercises, Klestinski recommends doubling up: “Engage the pelvic floor muscles while doing other daily core exercises—like Pilates—to strengthen the abs, back and hips.” Another surprising cause is osteoporosis, because a rounded back causes our thoracic cavity and abdomen to press on the bladder. A WHPT would recognize this during an evaluation and could prescribe appropriate exercises for bone density loss.

Organ Prolapse

Think of prolapse as a hernia that mostly affects women. When the muscles that hold the pelvic organs become weak or stretched, the organs—the bladder, uterus, small bowel, rectum—can drop from their normal spot and push against the wall of the vagina. As many new mothers know, pregnancy is the most common cause of prolapse. However, it’s not just the trauma of the childbirth that’s a factor—it’s also the extra pounds. “There could be 15 to 25 pounds plus the weight of a baby pushing on the perineum,” says Klestinski. This means that excessive weight gain (no baby necessary) can also put you at risk. Weight maintenance is key to avoid risk of prolapse.

The regimen: Klestinski explains how a WHPT would take a holistic approach to address organ prolapse. “We work from the top down and from the bottom up. From above you may have extra body weight and extra downward pressure from poor posture, dysfunctional bladder habits or from adhesions due to prior surgeries or injuries. From the bottom up, we have the pelvic floor muscles, which act as a supportive hammock to the pelvic organs.” Many WHPTs can help women work on weight management through exercise. To further improve the “top down” issues, the therapist would use manual techniques, patient education and posture training. At the other end of the, um, spectrum, she’d put the patient through workouts to strengthen and tone the pelvic muscles. This gives us yet another reason to do those darn Kegels.

Pregnancy and Recovery

Pregnancy causes profound anatomical and hormonal changes to our bodies. “Some women’s bodies accommodate those changes quite well, and some women require a fair amount of work and assistance,” says Jill Boissonnault, WCS, PT, PhD, past president and founder of the International Organization of Physical Therapists in Women’s Health.

The prenatal regimen: Pushing out a baby is never going to be easy, but some WHPTs say that massaging the perineum with a lubricant, as well as stretching the hip and pelvic muscles, can help a woman “open up” during delivery, which could make her less likely to tear. There’s also evidence that pregnant women can be taught how to bulge and flex their pelvic muscles correctly during labor, which can help avoid C-sections.

The postpartum regimen: “There are things a woman can do to mitigate some of the risk for future dysfunction, like strengthening her pelvic floor with Kegels throughout her pregnancy and after she delivers,” says Boissonnault. She adds that in France, where postpartum wellness visits are included under national health coverage, new mothers are likely to be advised by a WHPT about strengthening their pelvic floor muscles, their abs and their posture.

Pelvic Pain

Because many women avoid talking about this with their friends, family members and even their sexual partners, pelvic pain can be emotionally exhausting as well as physically unbearable.

Vulvodynia: An excruciating affliction of the vulva which affects an estimated 16 percent of women at some point in their lives, vulvodynia is described in this video from the Dr. Oz show as feeling like “acid burning the skin” or a “constant, knife-like pain.” It can be caused by trauma to the pelvis, which may result from chronic yeast or bacterial infections, physical force, accidents, surgery, or physical or sexual abuse.

I know a woman in her mid-20s who has suffered from vulvodynia since childhood. She suspects the cause may have had something to do with an ill-fitting waist harness on a forceful carnival ride. In her quest for relief, she was referred to gynecologists, dermatologists and psychologists, and tried topical anesthesia, antidepressants, talk therapy and the patronizing advice to “have a glass of wine and you’ll be fine.” She was finally told that pain-free sex would require surgery, and her doctor advised her to visit a women’s health physical therapist to prepare for the procedure.

“Many doctors assume that women’s health physical therapy can only take you to a certain point,” says my friend’s therapist, Gopi Jhaveri, PT, DPT, co-owner of Brooklyn Health Physical Therapy, “but we know it can take you all the way to recovery.” Jhaveri discouraged the surgery and instead worked with my friend to develop a rehab program. Four months later, my friend joyfully credits Jhaveri with her “cure.”

The regimen: This varies depending on the patient’s anatomy and type and severity of symptoms, but treatment often includes regular in-office manual therapy, at-home stretching using dilators, exercising daily to strengthen the pelvic muscles, avoiding harsh cleansers like soap in favor of sweet almond oil, and using a local anesthetic like lidocaine during sex.

Vaginismus: A 2010 episode of MTV’s True Life featured three women in their 20s whose pelvic conditions prevented them from having intercourse. Tali, an aspiring singer, had a condition called vaginismus, which involves painful, involuntary spasms and tightening of the vagina. As part of Tali’s treatment, Isa Herrera, MSPT, clinical director of Renew Physical Therapy in Manhattan, showed Tali and her boyfriend how to manually stretch Tali’s vagina (it was more clinical than kinky).

Herrera specializes in intra-vaginal massages to release tight or uncooperative muscles, and also in teaching patients and their partners to do this as home. “One out of three women has some sort of pelvic pain,” says Herrera, who is also the author of Ending Female Pain: A Woman’s Manual. However, she says, many women don’t admit it. “I’ve heard excuses like ‘it hurts unless I keep changing positions’ or ‘it hurts because my partner is so big.’ But the vagina is a wonderful thing and should be able to accommodate just about any man.” Herrera says WHPTs empower women to recognize and alleviate their physical discomfort.

The regimen: Techniques vary, but Herrera says she often follows a full pelvic muscle evaluation with manual massage, including trigger-point release technique to “release knots.” Herrera stressed that although the pain may occur in the pelvic area, the most successful approaches are holistic and involve the entire body. “Pain during sex can cause enormous anxiety, which results in the tensing up of different muscles groups, from the pelvis and the legs to the neck and back.” An important aspect of treatment includes diaphragmatic breathing and relaxation techniques to help the patient deal with the anxiety as well as the pain.


Contact one of our clinics today if you are interested in talking with one of our women’s health professionals.

Visit our Women’s Health section on our blog…click here