Kroll Christine, Fisher Thomas
Christine Kroll, OTD, MS, OTR, FAOTA, is Clinical Assistant Professor, School of Health and Rehabilitation Sciences, Department of Occupational Therapy, Indiana University at Indianapolis (IUPUI);
Thomas Fisher, PhD, OT, CCM, FAOTA, is Dean, Vera Z. Dwyer College of Health Sciences, Indiana University South Bend;
Am J Occup Ther. 2018 Jan/Feb;72(1):7201090010p1-7201090010p6. doi: 10.5014/ajot.2018.721002.
The Centers for Medicare and Medicaid Services (CMS) has scrutinized the provision of rehabilitation services in skilled nursing facilities (SNFs) for some time. Little research guidance exists on appropriate dosage or rehabilitation intensity (RI) among SNF patients or patients in other postacute care (PAC) settings. CMS developed a PAC assessment, the Continuity Assessment Record and Evaluation (CARE) Tool, in response to questions about what issues drive placement in various PAC settings under Medicare. The ability to adequately assess functional outcomes and correlate them to the RI provided by using the CARE Tool is promising. However, further research, policy advocacy, and practice analysis must be undertaken to promote and protect adequate access to occupational therapy and physical therapy in SNFs and other PAC settings. Individual practitioners must participate in data gathering to ensure that the data for analysis are fully informed by the occupational therapy perspective.
医疗保险和医疗补助服务中心（CMS）对专业护理机构（SNFs）提供的康复服务进行审查已有一段时间。对于SNF患者或其他急性后护理（PAC）环境中的患者，关于适当剂量或康复强度（RI）的研究指导很少。CMS开发了一种PAC评估工具，即连续性评估记录与评价（CARE）工具，以回应有关在医疗保险下哪些问题推动患者安置在各种PAC环境中的疑问。使用CARE工具充分评估功能结果并将其与所提供的RI相关联的能力很有前景。然而，必须进行进一步的研究、政策倡导和实践分析，以促进和保障在SNFs和其他PAC环境中充分获得职业治疗和物理治疗的机会。个体从业者必须参与数据收集，以确保分析数据能充分体现职业治疗的观点。
