SpeechPathology.com Phone: 800-242-5183


Presence Learning Therapy Tools Suite - November 2019

When to Evaluate a Patient in a SNF

Rachel Wynn, MS, CCC-SLP

February 23, 2015

Share:

Question

Does Medicare require that evaluations be medically necessary? 

Answer

You should only evaluate if you believe that the patient has a need.  When I approach evaluation and treatment, I usually screen everyone who comes in.  I find that my nurses are not the best referral sources because they may not see something in the chart that I do.  I usually review all of the charts of our patients who are coming in for a SNF stay.  Essentially, I am screening everyone.  I do an evaluation if I see things in the chart that make me wonder if the patient has had a decline or if the patient has the right supervision or assistance set up at home.  Maybe I need to help identify what deficits are present so when the patient returns home, everything will be in place.  A good example is a person who has fallen and has a hip fracture.   They may not need extensive cognitive rehabilitation, but I might do an evaluation and brief treatment to help the physical therapist and occupational therapist understand what is appropriate in terms of communication and their ability to learn.  An evaluation should be medically necessary based on your review of the chart and based on your screening.  You should not evaluate everyone.  That is a complaint that I have heard a lot -- that therapists are being required to evaluate everyone.  I think that is unnecessary.  

Rachel Wynn, MS, CCC-SLP is the owner of Gray Matter Therapy, a website dedicated to providing information about ethics in the SNF setting, functional treatment ideas, and recent research related to cognitive-communication disorders, including dementia. 


rachel wynn

Rachel Wynn, MS, CCC-SLP

Rachel Wynn, MS, CCC-SLP is the owner of Gray Matter Therapy, a website dedicated to providing information about ethics in the SNF setting, functional treatment ideas, and recent research related to cognitive-communication disorders, including dementia. Rachel Wynn started the November 2013 letter writing campaign to ASHA regarding ethical concerns in the prevailing model of SNF therapy service delivery. Since then she has been featured in the ASHA Leader, spoken to graduate student groups, and spoke at the 2014 ASHA Convention regarding ethics in the SNF setting. 


Related Courses

End-of-Life Care for the SLP Part 2: Roles, responsibilities, and ethics
Presented by Amanda Stead, PhD, CCC-SLP
Video

Presenter

Amanda Stead, PhD, CCC-SLP
Course: #8861Level: Introductory1 Hour
  'Course content was clearly presented'   Read Reviews
This is Part 2 of a three-part series. This course will provide an introduction to the important role that SLPs can play in caring for people near the end of life, and the application of ethical principles to end-of-life situations. Several case studies will be presented.

End-of-Life Care for the SLP
Presented by Amanda Stead, PhD, CCC-SLP
Video

Presenter

Amanda Stead, PhD, CCC-SLP
Course: #8885Level: Introductory3 Hours
  'So much of the information was new to me'   Read Reviews
This 3-part course will introduce SLPs to topics related to end-of-life care, including how and where people die, the role of SLPs and the application of ethical principles in end-of-life situations, and the issues of grief, spirituality and the "good death."

Behavioral Frameworks for Dementia Management
Presented by Mary Beth Mason, PhD, CCC-SLP, Robert W. Serianni, MS, CCC-SLP, FNAP
Video

Presenters

Mary Beth Mason, PhD, CCC-SLPRobert W. Serianni, MS, CCC-SLP, FNAP
Course: #9473Level: Intermediate1 Hour
  'Very practical, functional information that I can use to help my patients!'   Read Reviews
This course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.

Dysphagia in Neurodegenerative Disease
Presented by Debra M. Suiter, PhD, CCC-SLP, BCS-S
Video

Presenter

Debra M. Suiter, PhD, CCC-SLP, BCS-S
Course: #9732Level: Intermediate1 Hour
  'Variety of treatment options instead of just “giving up” because of the prognosis of the disease'   Read Reviews
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.

Social Isolation and COVID-19 Cognitive Decline: From Zero to Hero!
Presented by Amber B. Heape, ClinScD, CCC-SLP, FNAP, CMD, CMDCP
Video

Presenter

Amber B. Heape, ClinScD, CCC-SLP, FNAP, CMD, CMDCP
Course: #9514Level: Intermediate1 Hour
  'It was thorough and gave various ideas for tasks to include in therapy'   Read Reviews
Social distancing and isolation associated with the COVID-10 pandemic have begun to take a toll on patients in residential settings, but SLPs can help mitigate the long-term consequences. This course will discuss the risk factors for and effects of isolation, as well as potential strategies to prevent or reverse pandemic-related cognitive decline.