Rehabilitation Management Program (RMP)
Med-Net Healthcare Consulting, LLC utilizes its signature 7-Elements Blueprint© Program to assist our clients in meeting healthcare Compliance and Ethics requirements. The Rehabilitation Management Program (RMP) addresses regulatory and legal requirements from the Office of Inspector General (OIG), the Department of Justice (DOJ), and the Centers for Medicare & Medicaid Services (CMS) to identify and address potential risks and vulnerabilities affecting rehabilitation reimbursement in the long-term post-acute care (LTPAC) setting. The RMP helps facilities discover and mitigate potential compliance and ethics concerns that can compromise reimbursement and maintain a focus on federal compliance.
The RMP focuses on numerous factors that can affect reimbursement within the skilled nursing environment. These factors have the potential of positively or negatively affecting residents, the skilled nursing facility (SNF) staff responsible for maintaining resident quality of life, as well as the facility’s fiscal performance. If left unaddressed, these factors can quickly translate into federal audits, legal action, and financial instability. Med-Net’s RMP incorporates components that can help identify and mitigate these scenarios, hopefully before they occur, or at the very least before they are identified by outside sources.
Key components of the RMP include:
- Verification of Rehabilitation staff licensure
- Monitoring the OIG exclusion list
- Reviewing billing documents for technical accuracy, billing accuracy, and PDPM criteria
- Conducting chart audits for therapy documentation supporting skilled services
- Auditing of the pre-admission process and screening
- Verification and/or education of the Triple Check Process
- Staffing
- Productivity and Efficiency
- PDPM Education
- Diagnosis Selection
- Restorative Programming
- Survey Readiness
- Maintenance Therapy Options
- Programming per Functional Status
- Documentation Auditing
- Triple Check Involvement
- Role in Admissions
- Updates on current therapy regulations – Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and coding
Audit results can be tracked to the facility QAPI program for trending and demonstrated improvements through reports provided by the RMP.
For more information on this program, please visit the contact page.