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RESOURCES FOR YOU
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CASE LAW
The Jimmo v. Sebelius Settlement Agreement officially established OT's ability to provide maintenance therapy when appropriate (CMS, 2014). When appealing reimbursement denials related to maintenance therapy, it would be very helpful to cite this case law. In addition to citing case law, OT practitioners still have the responsibility to objectively document their justification for providing maintenance therapy. Click the button below to view the full CMS description of the changes brought about by Jimmo v. Sebelius.
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BECOME A MEMBER OF AOTA AND GAIN ACCESS TO FREE ONLINE RESOURCES!
The American Occupational Therapy Association is an essential resource for OT practitioners working in all settings. By becoming a member, you will gain access to a host of resources, including discounted continuing education opportunties and the American Journal of Occupational Therapy.
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MODELÂ
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CASE-SMITH, J. & EXNER, C. E. (2015). HAND FUNCTION EVALUATION AND INTERVENTION. IN J. CASE-SMITH & J. CLIFFORD O’BRIEN (EDS.), OCCUPATIONAL THERAPY FOR CHILDREN AND ADOLESCENTS, 7TH EDITION (PP. 220-257). ST. LOUIS, MO: MOSBY.
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COX, E., (2015). COACHING AND ADULT LEARNING: THEORY AND PRACTICE. NEW DIRECTIONS FOR ADULT AND CONTINUING EDUCATION. 148. 27-39. DOI: 10.1002/ACE.20149
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KNOWLES. M., HOLTON, E., & SWANSON, R. (2018). THE ADULT LEARNER: THE DEFINITIVE CLASSIC IN ADULT EDUCATION AND HUMAN RESOURCE DEVELOPMENT. EIGHTH EDS. NEW YORK, NY: ROUTLEDGE.
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PIZZI, M. A. & RICHARDS, L. G. (2017). GUEST EDITORIAL-PROMOTING HEALTH, WELL-BEING, AND QUALITY OF LIFE IN OCCUPATIONAL THERAPY: A COMMITMENT TO A PARADIGM SHIFT FOR THE NEXT 100 YEARS. AMERICAN JOURNAL OF OCCUPATIONAL THERAPY, 71, 7104170010. DOI:10.5014/AJOT.2017.028456
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​SABARI, J. S., CAPASSO, N., & FELD-GLAZMAN, R. (2014). OPTIMIZING MOTOR PLANNING AND PERFORMANCE IN CLIENTS WITH NEUROLOGICAL DISORDERS. IN M. VINING RADOMSKI & C. A. TROMBLY LATHAM (EDS.), OCCUPATIONAL THERAPY FOR PHYSICAL DYSFUNCTION, 7TH EDITION (PP. 614-680). BALTIMORE, MD: LIPPINCOTT WILLIAMS & WILKINS.
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LITERATURE
REFERENCES
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ASABA, E., NAKAMURA, M., ASABA, A., & KOTTORP, A. (2017). INTEGRATING OCCUPATIONAL THERAPY SPECIFIC ASSESSMENTS IN PRACTICE: EXPLORING PRACTITIONER EXPERIENCES. OCCUPATIONAL THERAPY INTERNATIONAL, 2017. DOI:10.1155/2017/7602805
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BEKHET, A. K., & ZAUSZNIEWSKI, J. A. (2014). CHRONIC CONDITIONS IN ELDERS IN ASSISTED LIVING FACILITIES: ASSOCIATIONS WITH DAILY FUNCTIONING, SELF-ASSESSED HEALTH, AND DEPRESSIVE SYMPTOMS. ARCHIVES OF PSYCHIATRIC NURSING, 28(6), 399-404. DOI:10.1016/J.APNU.2014.08.013
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BORTNICK, K. (2017). OCCUPATIONAL THERAPY ASSESSMENTS FOR OLDER ADULTS: 100 INSTRUMENTS FOR MEASURING OCCUPATIONAL PERFORMANCE. THOROFARE, NJ: SLACK INCORPORATED.
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CAUSEY-UPTON, R. (2015). A MODEL FOR QUALITY OF LIFE: OCCUPATIONAL JUSTICE AND LEISURE CONTINUITY FOR NURSING HOME RESIDENTS. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS, 33(3), 175–188. DOI:10.3109/02703181.2015.1024301
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CHE DAUD, A., JUDD, J., YAU, M., & BARNETT, F. (2016). BARRIERS OF OCCUPATION-BASED INTERVENTION. ASIA JOURNAL OF QUALITY OF LIFE, 1(4), 1-10. DOI:10.21834/AJQOL.V1I4.12
CHEN, S.-W., & CHIPPENDALE, T. (2018). THE ISSUE IS—LEISURE AS AN END, NOT JUST A MEANS, IN OCCUPATIONAL THERAPY INTERVENTION. AMERICAN JOURNAL OF OCCUPATIONAL THERAPY, 72, 7204347010. DOI:10.5014/AJOT.2018.028316
JANSSEN, S. & GRABANSKI, J. L. (2019). OCCUPATIONAL THERAPY. STATPEARLS. STATPEARLS PUBLISHING: TREASURE ISLAND, FL. RETRIEVED FROM HTTPS://WWW.NCBI.NLM.NIH.GOV/BOOKS/NBK537068/
JEWELL, V. D., PICKENS, N. D., HERSCH, G., & JENSEN, G. (2016). AN EXPLORATION INTO OCCUPATION-CENTERED PRACTICE IN SKILLED NURSING FACILITIES. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS, 34(1), 43-56. DOI:10.3109/02703181.2015.1114062
JUNG, J.-Y., PARK, S.-Y., & KIM, J.-K. (2018). THE EFFECTS OF A CLIENT-CENTERED LEISURE ACTIVITY PROGRAM ON SATISFACTION, SELF-ESTEEM, AND DEPRESSION IN ELDERLY RESIDENTS OF A LONG-TERM CARE FACILITY. JOURNAL OF PHYSICAL THERAPY SCIENCE, 30, 73-76. DOI:10.1589/JPTS.30.73
KUYKENDALL, L., TAY, L., & NG, V. (2015). LEISURE ENGAGEMENT AND SUBJECTIVE WELL-BEING: A META-ANALYSIS. PSYCHOLOGICAL BULLLETIN, 141(2), 364-403. DOI:10.1037/A0038508
LAMB, A. J. (2017). PRESIDENTIAL ADDRESS, 2017—UNLOCKING THE POTENTIAL OF EVERYDAY OPPORTUNITIES. AMERICAN JOURNAL OF OCCUPATIONAL THERAPY, 71, 7106140010. HTTPS://DOI.ORG/10.5014/AJOT.2017.716001
LEE, K. J. & HWANG, S. (2018). SERIOUS LEISURE QUALITIES AND SUBJECTIVE WELL-BEING. THE JOURNAL OF POSITIVE PSYCHOLOGY, 13(1), 48-56. DOI:10.1080/17439760.2017.1374437
LIPOVCAN, L. K., BRKLJACIC, T., LARSEN, Z. P., BRAJSA-ZGANEC, A., & FRANC, R. (2018). LEISURE ACTIVITIES AND THE SUBJECTIVE WELL-BEING OF OLDER ADULTS IN CROATIA. GEROPSYCH: THE JOURNAL OF GERONTOPSYCHOLOGY AND GERIATRIC PSYCHIATRY, 31(1), 31-39. DOI:10.1024/1662-9647/A000179
NEWMAN, D. B., TAY, L., & DIENER, E. (2014). LEISURE AND SUBJECTIVE WELL-BEING: A MODEL OF PSYCHOLOGICAL MECHANISMS AS MEDIATING FACTORS. JOURNAL OF HAPPINESS STUDIES, 15, 555-578. DOI:10.1007/S10902-013-9435-X
O’SULLIVAN, G., & HOCKING, C. (2013). TRANSLATING ACTION RESEARCH INTO PRACTICE: SEEKING OCCUPATIONAL JUSTICE FOR PEOPLE WITH DEMENTIA. OTJR: OCCUPATION, PARTICIPATION & HEALTH, 33(3), 168–176. DOI:10.3928/15394492-20130614-05
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ROUSSEAU, F. L. & VALLERAND, R. J. (2008). AN EXAMINATION OF THE RELATIONSHIP BETWEEN PASSION AND SUBJECTIVE WELL-BEING IN OLDER ADULTS. INTERNATIONAL JOURNAL OF AGING AND HUMAN DEVELOPMENT, 66(3), 195-211. DOI:10.2190/AG.66.3.B
SCHENK, L., MEYER, R., BEHR, A., KUHLMEY, A., & HOLZHAUSEN, M. (2013). QUALITY OF LIFE IN NURSING HOMES: RESULTS OF A QUALITATIVE RESIDENT SURVEY. QUALITY OF LIFE RESEARCH, 22, 2929-2938. DOI:10.1007/S11136-013-0400-2
SCHULZ, P., SCHULTE, J., RAUBE, S., DISOUKY, H., & KANDLER, C. (2018). THE ROLE OF LEISURE INTEREST AND ENGAGEMENT FOR SUBJECTIVE WELL-BEING. JOURNAL OF HAPPINESS STUDIES, 19, 1135-1150. DOI:10.1007/S10902-017-9863-0
SIMONE, P. A. & HAAS, A. L. (2013). FRAILTY, LEISURE ACTIVITY AND FUNCTIONAL STATUS IN OLDER ADULTS: RELATIONSHIP WITH SUBJECTIVE WELL BEING. CLINICAL GERONTOLOGIST, 36, 275-293. DOI:10.1080/07317115.2013.788114
VROMAN, K. & STEWART, E. (2014). OCCUPATIONAL THERAPY EVALUATION FOR ADULTS: A POCKET GUIDE. PHILADELPHIA, PA: LIPPINCOTT WILLIAMS & WILKINS.
WATTERS, A. M., PEARCE, C., BACKMAN, C. L., & SUTO, M. J. (2013). OCCUPATIONAL ENGAGEMENT AND MEANING: THE EXPERIENCE OF IKEBANA PRACTICE. JOURNAL OF OCCUPATIONAL SCIENCE, 20(3), 262-277. DOI:10.1080/14427591.2012.709954
WHITAKER, R., FOSSEY, J., BALLARD, C., ORRELL, M., MONIZ-COOK, E., WOODS, R. T., … KHAN, Z. (2014). IMPROVING WELL-BEING AND HEALTH FOR PEOPLE WITH DEMENTIA (WHELD): STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL. TRIALS, 15(1), 284. DOI:10.1186/1745-6215-15-284
WHITEFORD, G. (2000). OCCUPATIONAL DEPRIVATION: GLOBAL CHALLENGE IN THE NEW MILLENNIUM. BRITISH JOURNAL OF OCCUPATIONAL THERAPY, 63(5), 200–204. RETRIEVED FROM HTTPS://SEARCH-EBSCOHOST.COM.EZPROXYLR.MED.UND.EDU/LOGIN.ASPX?DIRECT=TRUE&DB=CCM&AN=104165856&SITE=EHOST-LIVE
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PROFESSIONAL
REFERENCES
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AMERICAN OCCUPATIONAL THERAPY ASSOCIATION. (2014). OCCUPATIONAL THERAPY PRACTICE FRAMEWORK: DOMAIN AND PROCESS (3RD ED.). AMERICAN JOURNAL OF OCCUPATIONAL THERAPY, 68, S1–S48. DOI:10.5014/AJOT.2014.682005
AMERICAN OCCUPATIONAL THERAPY ASSOCIATION. (2017). INAPPROPRIATE AND POTENTIALLY UNETHICAL PRACTICES IN SNFS. RETRIEVED FROM HTTPS://WWW.AOTA.ORG/PRACTICE/ETHICS/TOOLS-FOR-PRODUCTIVITY-REQUIREMENTS/INAPPROPRIATE-AND-POTENTIALLY-UNETHICAL-PRACTICES-IN-SNFS.ASPX
AMERICAN OCCUPATIONAL THERAPY ASSOCIATION. (2019A). 11 WAYS TO ADDRESS THE SKILLED NURSING FACILITIES PATIENT DRIVEN PAYMENT MODEL (PDPM). RETRIEVED JANUARY 14, 2020, FROM HTTPS://WWW.AOTA.ORG/PRACTICE/MANAGE/VALUE/SKILLED-NURSING-FACILITIES-PATIENT-DRIVEN-PAYMENT.ASPX
AMERICAN OCCUPATIONAL THERAPY ASSOCIATION. (2019B). ETHICAL CONSIDERATIONS FOR PRODUCTIVITY, BILLING, AND REIMBURSEMENT. RETRIEVED FROM HTTPS://WWW.AOTA.ORG/~/MEDIA/CORPORATE/FILES/PRACTICE/ETHICS/ADVISORY/REIMBURSEMENT-PRODUCTIVITY.PDF
AMERICAN OCCUPATIONAL THERAPY ASSOCIATION. (2019C). NEW COGNITIVE FUNCTION INTERVENTION CODE FOR 2020. RETRIEVED FROM HTTPS://WWW.AOTA.ORG/ADVOCACY-POLICY/FEDERAL-REG-AFFAIRS/NEWS/2019/COGNITIVE-FUNCTION-INTERVENTION-CODE-2020.ASPX
CENTERS FOR MEDICARE AND MEDICAID SERVICES, MEDICARE LEARNING NETWORK. (2014). MANUAL UPDATES TO CLARIFY SKILLED NURSING FACILITY (SNF), INPATIENT REHABILITATION FACILITY (IRF), HOME HEALTH (HH), AND OUTPATIENT (OPT) COVERAGE PURSUANT JIMMO V. SEBELIUS. RETRIEVED FROM HTTPS://WWW.CMS.GOV/OUTREACH-AND-EDUCATION/MEDICARE-LEARNING-NETWORK-MLN/MLNMATTERSARTICLES/DOWNLOADS/MM8458.PDF
CENTERS FOR MEDICARE AND MEDICAID SERVICES, MEDICARE LEARNING NETWORK. (2019). SNF PPS: PATIENT DRIVEN PAYMENT MODEL. RETRIEVED FROM HTTPS://WWW.CMS.GOV/OUTREACH-AND-EDUCATION/OUTREACH/NPC/DOWNLOADS/2018-12-11-SNF-PPS-PDPM.PDF
CENTERS FOR MEDICARE AND MEDICAID SERVICES, MEDICARE LEARNING NETWORK. (2020). 2020 ANNUAL UPDATE TO THE THERAPY CODE LIST (MM11501). RETRIEVED FROM CENTERS FOR MEDICARE AND MEDICAID SERVICES, MEDICAL LEARNING NETWORK WEBSITE: HTTPS://WWW.CMS.GOV/OUTREACH-AND-EDUCATION/MEDICARE-LEARNING-NETWORK-MLN/MLNMATTERSARTICLES/DOWNLOADS/MM11501.PDF
MAYASICH, O., TYCE, A., & JANSSEN, S. (2019). USING LEISURE AS A THERAPEUTIC ACTIVITY TO ENHANCE HEALTH, WELL-BEING, AND QUALITY OF LIFE AMONG LONG TERM CARE RESIDENTS. (MASTER’S THESIS). RETRIEVED FROM HTTPS://COMMONS.UND.EDU/OT-GRAD/425/
REYNOLDS, M., VOLKMER, K., JEWELL, V., & RUSSELL, M. (2019). CREATIVE SOLUTIONS FOR IMPLEMENTING OCCUPATION-CENTERED PRACTICE IN SKILLED NURSING FACILITIES. AOTA CONTINUING EDUCATION ARTICLE (ARTICLE CODE: CEA0619). RETRIEVED FROM HTTPS://WWW.AOTA.ORG/~/MEDIA/CORPORATE/FILES/PUBLICATIONS/CE-ARTICLES/CEA-JUNE-2019.PDF
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