DAVE Tip Sheet  

Section P1, Therapies: Assessment Guidelines, March 2005

MDS Items:

P1bcB – Physical Therapy Total Number of Minutes

P1bbB – Occupational Therapy Total Number of Minutes

P1baB – Speech-Language Pathology, Audiology Services Total Number of Minutes

Common Reasons for Discrepancies: 

• Miscalculation of Therapy Minutes

• Including Initial Evaluation Time

• Treatment Time not Documented

 

The Intent of Section P is to identify any special treatments, therapies, or programs that the resident received in the specified time period. For P1b, Therapies, include only skilled and medically necessary therapies furnished after admission to the nursing facility.

 Errors in the coding of P1baB, P1bcB, and P1bbB, may be avoided if the following are taken into consideration:

 1. Count only therapies that occurred after admission/readmission to the nursing facility, whether delivered in the facility or at another location, that were ordered by a physician, were performed by a licensed/qualified therapist and were medically necessary.

2. Only therapy services provided or directly supervised by a licensed/qualified therapist should be included; line-of-sight supervision by the licensed/qualified therapist is required to count the therapy aide and therapy student minutes.

3. The time required to adjust equipment or otherwise prepare for the individualized therapy of a particular resident is the set-up time and may be included.

4. The therapist’s time spent on documentation may not be included.

5. Services provided at the request of the resident or family that are not medically necessary may not be counted.

6. Do not include group therapy minutes in excess of 25% of the total treatment time per discipline.

7. See page 3-188 of the RAI User’s Manual for information on concurrent therapy/dovetailing.

 To Calculate Group Therapy Minutes:

1. Individual Minutes divided by 3 = Maximum Group Minutes

2. Individual Minutes Delivered + Group Minutes Delivered (Do not exceed Maximum Group Minutes from above) = Allowable Minutes for P1b

 

Reason for Discrepancy	Coding Tips
Miscalculation of Therapy Minutes	a. Use a calculator to total the minutes. b. Double check your addition. c. Conversion from units to minutes is not appropriate. d. Do not round up or down. e. Do not count maintenance therapy once the program has been developed. f. Therapy minutes should only include actual, medically necessary minutes of skilled therapy received by the resident.
Including Initial Evaluation Time	a. Time spent on evaluations (including diagnostic audiology) may not be included. b. Include time spent on periodic medically necessary reevaluations during the course of ongoing treatment. c. Include set-up time.
Documentation that records the number of minutes is not provided or does not match the minutes coded on the MDS	a. Double check minutes documented in the clinical record (e.g. therapy log and treatment notes) against the MDS. b. Logs may be used to verify the provision of therapy services and to validate information reported on the MDS assessment. Logs are not an MDS requirement, but reflect a standard clinical practice expected of all therapy professionals.