The Long Goodbye

Saying goodbye to a loved one usually involves a nice long bear hug, followed by a warm statement of, “I’ll see you soon.” This is not the case when leaving a loved one afflicted with Alzheimer’s disease. Goodbye is repeated over and over again, in hopes that the person remembers who we are, why we are leaving, and will they remember any glimpse of us when we return. Many families, friends, and caregivers express a deep sadness when saying
goodbye. This June is Alzheimer’s and Brain Awareness Month. Alzheimer’s dementia is a devastating disease that slowly destroys the brains and lives of those diagnosed. The impact is broad-reaching as it pillages family and friends. This disease is often referred to as “The Long Goodbye,” reflecting how families and friends must watch their loved ones slowly fade away. The word dementia encompasses a range

Arthritis Awareness Month – Understanding Who Physical Therapy Can Help

While there are over 100 types of arthritis, one of the things almost all types have in common is that those who are suffering can benefit from physical therapy. Because there are different types of arthritis, the methods used in physical therapy will be different, as will the potential outcomes of the physical therapy. The goals of the patients will be different too. In this article, we will look at the most common types of arthritis, the types of physical therapy that might help, and the possible outcomes of receiving physical therapy.

The Two Most Common Types of Arthritis

Rheumatoid arthritis and osteoarthritis are the two most common types of arthritis. Both types can initially be similar in their symptoms, but their causes are dramatically different.

Osteoarthritis is caused by wear and tear on the joints of the body. It often takes years for the symptoms to build and it gradually gets worse. Obesity has a strong correlation with arthritis, particularly in the knees. Previous injury can also contribute to the onset of osteoarthritis.

Rheumatoid arthritis is an autoimmune disease. Its cause isn’t known, but it is thought to affect about 0.2% of the population. Rheumatoid arthritis has a much more sudden onset than osteoarthritis. Symptoms can get much worse over the course of weeks, and they often include swelling of the joints.

What Types of Physical Therapy are there?

Physical therapy can be broadly divided into two categories: passive treatments, and active treatments.

Passive treatments are often helpful with severe cases of osteoarthritis and early cases of rheumatoid arthritis. Passive treatments include hydrotherapy, massage, heat and cold therapy, or ultrasound. For those who are in too much pain to begin active therapy, these options can help get them ready to start becoming more active.

Active therapy can be used to prevent osteoarthritis from becoming worse, and can also be used once sufferers of rheumatoid arthritis are able to increase their range of motion and activity. Active therapy includes flexibility and strength training, aerobic exercise, and some forms of hydrotherapy.

Active therapy will help you to reduce pain, gain strength, and increase your flexibility and range of motion. It can also help you to lose weight which can be a main contributing factor to the pain caused by arthritis.

The Outcome of Physical Therapy
When starting physical therapy patients should clearly specify the goals they want to achieve. Telling your trainer what you want to achieve will help them to craft a specific training plan for you. You might have a goal as simple as getting out of your car without feeling pain, or it might be a bigger one like running a 5km race as you used to. Whatever it is, a physical therapist can set you on the right path to achieve it.

If you are suffering from arthritis, or even want to prevent its onset, talk to the professionals at Preferred Therapy Outpatient and Wellness about therapy options offered and how our experienced team can help you or your loved ones.

Celebrate National Skilled Nursing Care Week

May 8-14 celebrates National Skilled Nursing Care Week. It’s a true honor and privilege to partner with skilled nursing establishments. The dedication and commitment to providing care for their residents are to be celebrated not just this week – but every day throughout the year. #itsallaboutthepatient #celebratenationalskillednursingweek #PreferredTherapySolutionspartnershipswithskillednursingfacilities #NSNCW


CMS to End Certain COVID-19 Waivers


The Center for Medicare and Medicaid Services released a memorandum on April 7th  to state agencies announcing the ending of specific Public Health Emergency (PHE) waivers in two different time frames: May 7th and June 7th.

The following waivers related to SNF’s will end on May 7th:

  • Resident Groups: This waiver permitted the facility to restrict in-person meetings during the PHE
  • Physician Visits: CMS waived the requirement for physicians and non-physician practitioners to perform in-person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options
  • Physician Delegation of Tasks in SNFs: CMS waived the requirement that prevents a physician from delegating a task when the regulations specify that the physician must perform it personally
  • Quality Assurance & Performance Improvement (QAPI): CMS modified certain requirements which require long-term care facilities to develop, implement, evaluate, and maintain an effective, comprehensive, data-driven QAPI program
  • Detailed Information Sharing for Discharge Planning for LTC Facilities: CMS modified the requirement that LTC facilities are to assist residents and their representatives in selecting a post-acute care provider
  • Medical Records: CMS modified the requirement which requires long-term care (LTC) facilities to provide a resident a copy of their records within two working days

The following waivers related to SNF’s will end on June 7th:

  • Physical Environment: CMS waived requirements to allow for a non-SNF building to be temporarily certified and available for use by a SNF in the event there were needs for isolation processes for COVID-19 positive residents
  • Facility & Medical Equipment Inspection, Testing & Maintenance: CMS waived ITM requirements for facility and medical equipment to reduce exposure to COVID-19
  • Life Safety Code (LSC) and Health Care Facilities Code (HCFC) ITM: CMS waived ITM required by the LSC and HCFC, with specified exceptions, which permitted facilities to adjust scheduled ITM frequencies and activities
  • Outside Windows and Doors: CMS waived the requirement to have an outside window or outside door in every sleeping room. This permitted spaces not normally used for patient care to be utilized for patient care and quarantine.
  • Paid Feeding Assistants for LTC Facilities: CMS modified the requirements regarding required training of paid feeding assistants to allow that training can be a minimum of one hour in length
  • In-Service Training for LTC Facilities: CMS modified the nurse aide training requirements for SNFs, which required the nursing assistant to receive at least 12 hours of in-service training annually
  • Training and Certification of Nurse Aides: CMS waived the requirements which require that a SNF  may not employ anyone for longer than four months unless they met the training and certification requirements

Source:  CMS’ Memorandum: QSO-22-15-NH & NLTC & LSC

Preferred Therapy Solutions continues to provide vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported by compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, please contact Maria Maggi, Vice President of Quality, Outcomes, and Compliance:


Older Americans Month: Age My Way

May is a special time of year, all the buds start to bloom and a colorful landscape comes to life. This May, as we take in the sights and sounds of spring, May also celebrates Older American Month. The theme for 2022 is Age My Way with a focus on how older adults can age independently and participate in activities they choose. While your spring unfolds, remember to reach out to the older adults in your lives and in the community, and engage with them in their favorite activity or two. Whether it be gardening, music events, bike riding, or baking get involved, participate, and stay connected with our older population. #OlderAmericansMonth #stayconnected #AgeMyWay

May Celebrates Speech and Better Hearing Month

Preferred Therapy Solutions would like to thank everyone in the Speech Pathology discipline for all of your hard work in supporting our most vulnerable population. This May we celebrate Better Hearing & Speech Month and the people that work with those affected by communication and hearing disorders. #itsallaboutthepatient #celebratespeechpathologist #nationalbetterspeechandhearing

National Healthcare Month and World Immunization Week—What Is Their Significance?

In the United States, April is considered the National Interprofessional Healthcare Month. Globally, the last week of April is World Immunization Week. If you’re wondering why they’re important, read on to learn more.

National Healthcare Month and World Immunization Week

Interdisciplinary healthcare is what keeps the public healthy at large. Multiple disciplines of medicine often have to come together and work in unison to diagnose, treat, cure, and even prevent illnesses. Based on this principle, NAP declared April as Interprofessional Healthcare Month at the 2016 Forum in Baltimore, Maryland.

Immunization has helped humankind reduce and even eradicate some preventable diseases. With the COVID-19 pandemic reminding the world of the importance of vaccination, there is no time better than now to inform and increase awareness of immunization. It is incredibly important for the public to be aware of the recommended vaccination schedules for children and adults and adhere to them in a timely fashion.

Let us also discuss a few other health observances happening in April and their significance.

Stress Awareness Month

The American Psychological Association estimates that 34% of Gen Z adults, 21% of millennials, 19% of boomers, and 8% of older adults felt extremely restless from the stress they were experiencing. These numbers have also gone up steadily over the years. From this, it wouldn’t be an overstatement to say that the average American is stressed. Stress causes various mental health issues that, if left untreated, may also manifest as physical issues. If you are a mental health provider that is looking to help your patients better, Preferred Therapy Solutions is here to help with its unique plans that are tailor-made with the end-user in mind.

Parkinson’s Disease Awareness Month

April is deemed Parkinson’s Disease Awareness Month as it is the birth month of James Parkinson, the first physician to describe the disease. Every year, it serves as an opportunity to raise awareness about the disease and its symptoms, and provide support to those who have been affected by it. Parkinson’s disease is a long-term ailment in which the central nervous system degenerates, and the motor system suffers as a result. The symptoms include tremors, loss of balance, stiffness, etc. If you are a caregiving facility or a provider with patients suffering from PD, you could greatly benefit from the expertise offered by our team.

Autism Awareness Month

Anybody who works with ASD (Autism Spectrum Disorder) knows how serious of a developmental disorder it is. It can put its patients on a spectrum of behavioral and communicative problems, ranging from mild to severe. Although campaigns like #CelebrateDifferences by the Autism Society of America are working towards the goal, autism acceptance is still far from being achieved at this point.

To learn more about Preferred Therapy Solutions and how our clinical model can assist your facility contact Jim MacManus, Director of Business Development at #itsallaboutthepatient.

About Preferred Therapy Solutions

Preferred Therapy Solutions is a full-service rehabilitation management organization dedicated to providing state-of-the-art clinical, management, billing, and information technology solutions to the post-acute and long-term care industry. Preferred Therapy Solutions is able to assist in developing a strategic road map designed to increase SNFs market share by identifying potential referral targets and providing useful information on competitors’ performance. Preferred Therapy Solutions’ abilities significantly enhance the quality, productivity, scope, and efficiency of any facility’s rehabilitation department while maintaining a focus on achieving high levels of patient satisfaction and providing excellent customer service.

EDUCATIONAL WEBINAR: FY 2023 SNF PPS Proposed Rule – What’s Ahead for PDPM, QRP & VBP!

The FY 2023 Proposed Rule is out and CMS is following through on the recalibration of PDPM, adding new measures for quality and value-based care, and building upon the Biden-Harris Administration’s commitment to advance health equity, drive person-centered care and promote sustainability of the program. Register below to join this informative webinar.

FY 2023 SNF PPS Proposed Rule: What’s Ahead for PDPM, QRP & VBP!

Attendees of this session will gain insight on:

  • Understand the proposed changes to Medicare PPS reimbursement and quality reporting
  • Identify the potential impact of the proposed changes and begin strategic planning initiatives
  • Learn how to submit comments and provide feedback to CMS on the proposed changes

This program has been approved for Continuing Education for 0.50 total participant hours by NAB/NCERS—Approval #20230516-0.50-A83943-DL

CMS Releases FY 2023 Proposed Rule


The Centers for Medicare and Medicaid Services (CMS) are legally required to update the Medicare payment rates and quality programs on an annual basis. Each April, CMS publishes a proposed rule for the upcoming fiscal year (FY) and opens a comment period for stakeholders to review and provide comments to CMS before releasing the final rule.


On April 11th CMS issued proposed rule CMS-1765-P for FY 2023. This proposed rule contains many areas of importance and significance for SNF providers specifically as it relates to payment, quality, staffing, and more.

Preferred Therapy Solutions is thoroughly reviewing the proposed rule and has planned an in-depth webinar for May 17th, which has already received program approval from the National Association of Long Term Care Administrators Board (NAB).

Key elements of the proposed rule include:

    CMS estimates the aggregate impact of payment policies would result in a decrease of approximately $320 million in Medicare Part A payments to SNFs in FY 2023
  • The actual payment update for FY 2023 is a 3.9% increase based on SNF market basket and forecast error adjustments but this increase is offset by a 4.6% decrease in SNF PPS rates as a result of a proposed recalibrated parity adjustment
  • An additional $186 million in reductions is estimated based on the SNF VBP program



  •  Recalibrating the PDPM Parity Adjustment
    • The purpose of the parity adjustment is to ensure budget neutrality between RUG-IV and PDPM
    • In last year’s proposed and final rules, CMS shared that the transition from RUG-IV to PDPM was not budget neutral with a 5% increase in Medicare Part A payments to SNFs under PDPM. They sought feedback from stakeholders regarding how and when to recalibrate the PDPM parity adjustment, but never proposed an actual parity adjustment
    • In this year’s proposed rule, CMS improved its methodology to determine the necessary parity adjustment and is proposing a 4.6% decrease in PDPM payments
    • CMS is proposing to accomplish the parity adjustment by recalibrating all PDPM CMI’s equally (PT, OT, SLP, Nursing, and NTA)
    • CMS is proposing to implement the entire recalibration all at once, without delay or phase-in
  • CMS is proposing several changes to the PDPM ICD-10 code mappings and lists


  • CMS is proposing to adopt one new quality measure to become part of the SNF QRP for FY 2025: Influenza Vaccination Coverage among Healthcare Personnel (HCP) measure
  • CMS is proposing to revise the compliance dates for specific SNF QRP requirements
  • CMS is seeking comments on 3 subjects
    • Future measures for SNF QRP
    • Overarching principles for measuring equity and healthcare disparities
    • Inclusion of CoreQ: Short Stay Discharge Measure in the SNF QRP


  • CMS is proposing to suppress the SNF 30-day All-Cause Readmission Measure for the FY 2023 SNF VBP due to the COVID-19 PHE
    • In order to maintain compliance with the statutory requirements of the SNF VBP program, CMS is proposing to do the same process implemented last year as it relates to the SNF VBP
      • CMS will continue to withhold 2% of Medicare Part A FFS payments per statute
      • CMS will “award” SNF’s 60% of the withhold, resulting in a 1.2% payback
      • The proposal will result in 0.8% decrease in Medicare Part A FFS payments for all SNF’s except those that are subject to the Low Volume Adjustment policy
  • CMS is proposing to add two new measures to the FY 2026 SNF VBP and one new measure to the FY 2027 SNF VBP
    • FY 2026: addition of SNF Healthcare-Associated Infections Requiring Hospitalization and Total Nursing Hours per Resident Day measures
    • FY 2027: addition of Discharge to Community – Post-Acute Care Measure for SNFs
  • CMS is seeking feedback on the following for the SNF VBP
    • Implementing a Nursing Home Staff Turnover measure
    • Scoring methodology and how it converts to incentive payments
    • Incorporating adjustments related to health equity

Finally, Preferred Therapy Solutions will be submitting comments and feedback to CMS to advocate for therapy services, SNF providers, and most importantly, the residents we are privileged to serve. We encourage all providers to do the same!

Join our webinar on May 17th to learn more about the proposed rule and how to advocate for our industry and patients. Details and links to join this webinar will be provided at a later date.

Preferred Therapy Solutions continues to provide vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported by compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, please contact Matt Nash, Vice President of Strategy and Business Development:


April showers bring May flowers, which may be true, but during the month of April, a significant celebration is in order, it’s Occupational Therapy (OT) Month. The contributions of the OT profession are paramount to healthcare by helping people reach their goals through rehabilitative therapy programs. Celebrate this April by implementing a strong Transition to the Community program. Preferred Therapy Solutions’ experienced occupational therapy unit can assist your facility in growing your customized Transition to the Community program and assist in the reduction of hospital readmissions. Click on the below link to learn how Preferred Therapy Solutions’ clinical model enhances the improvement of patients’ conditions allowing patients to remain functional, and therefore, aids in a seamless transition to their next level of care with a concentration on avoiding hospital readmission.

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