Encore Keynote - September 2021

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- Encore Rehabilitation’s monthly publication, designed to give you updates on trends we are seeing in the SNF/LTC industry. - 

Therapy is Essential


Therapy is Essential

Pandemic Reality: COVID-19 patients, upon discharge from the hospital, are showing significant declines that are best addressed by therapy…we will be the champions of their recovery...improving cognition, improving mobility and self-care deficits, improving activity tolerance and respiratory function.

Pandemic Reality: Therapy is essential to improve function to a level that patients can then safely transition to home or lesser level of care as quickly as possible and minimize exposure in the SNFs and continue the cycle to free up beds for more admits from hospitals

Pandemic Reality: Our long-term care residents have been impacted by the ripple effect of COVID-19.  Whether they have had COVID-19, or have had to be in social isolation for infection control reasons, their typical daily routines have been disrupted by the pandemic

Things to Consider with the Long-Term Care Population

Room isolation – Emotional Impact
• Signs and symptoms of or worsening of depression, anxiety, PTSD, and trauma.
• Lack of interest in tasks, people, and previously enjoyed activities.
• Vocalization of suicide idealization or self-harming behaviors.
• Increased reports of hallucinations and delusions.
• Increased behaviors with and without aggression.

Decrease oral intake
• Increased risk of UTI, falls and injury, dehydration, malnutrition, and weight loss.
• Sign and symptom of swallow disorder: Dysphagia.
• Sign and/or symptom of mouth sores and/or other diseases of the mouth.
• Change in mood: worsening of depression.
• Decreased skin integrity with risk of wound development.

Decreased mobility
• Increased risk of falls and injury.
• Increased risk of development of pneumonia, worsening COPD, asthma, and other lung conditions.
• Loss of respiratory muscle strength leading to decreased ability to expel and manage secretions.
• Increased risk of inability to self-pressure relieve with and without changes to skin.
• Increase pain and need for additional pharmacological interventions.
• Increased risk of a decline in joint range of motion, leading to contractures, worsening of arthritic joints.
• Changes to blood pressure and heart rate with worsening of CHF and increased risk of MI.


Cognitive deterioration considerations to be on the lookout for:

• Changes in safety awareness: increase impulsiveness
• Changes in problem solving
• Changes in memory: both short term and long term
• Changes in ability to make needs known
• Changes in vocal quality
• Changes in task initiation

Functional deterioration consideration to be on the lookout for:
• Change in and/or an increase assistance with transfers: bed, chair, toilet.
• Change in and/or increase assistance required for ambulation in room.
• Change in and/or increased need for assistance with dressing, bathing, toileting hygiene, toileting frequency, clothing management with toileting, room management skills, oral care, hygiene and grooming tasks, and self-feeding.
• Change in and/or increased need for assistance with using call light, phone, TV, and other electronic devices.

Therapy is Essential
✓ Therapy restores function
✓ Therapy ensures safe transitions to home or a lesser level of care
✓ Therapy combats complications due to immobility
✓ Therapy decreases risk of pressure related wounds
✓ Therapy decreases fall risk
✓ Therapy decreases risk of respiratory compromise
✓ Therapy decreases risk of DVT/PE
✓ Therapy decreases pain
✓ Therapy decreases risk of contracture
✓ Therapy clinical programs focus interventions on resident-specific needs
✓ Therapy boosts resident self-esteem and confidence, resulting in an improved quality of life




Encore Townhall

Encore Townhall Encore’s first Townhall was held on August 26th where we discussed:
  • Encore’s Vision
  • Organizational Chart
  • COVID-19 Vaccination Mandate
  • Student Program
  • Employee Recognition
  • PTO

Thanks to all who attended. Your voices were heard and will be used to further enhance our employee experience and overall culture of Encore.

Director of Innovation and Strategy
Encore is pleased to announce Drita Vulaj as our Director of Innovation and Strategy. Drita has devoted her whole professional career working for Encore as a Certified Occupational Therapist Assistant, Therapy Program Manager, and most recently, Regional Vice President.
Drita will continue her passion for geriatric health care by keeping Encore at the forefront of long-term care in this role. Her goal is to formulate effective new ideas and innovative strategies for program development, marketing, and additional value-added services for our customers.
! ! ! ! ! ! ! ! !

Encore has created reporting mechanisms to compare GG scores to national benchmarks.
Contact Your RVP for Details!





Submit Comments to CMS Opposing the Significant Cuts to the CY 2022 PFS

Encore is continuing our campaign against reimbursement reductions in CMS’ CY 2022 Medicare Physician Fee Schedule (PFS) Proposed Rule.  We are requesting our employees, customers, and/or long-term care partners to submit a comment letter to CMS outlining your opposition to the cuts and their impact.  It’s important for CMS to hear significant opposition to the cuts.
NASL has prepared a template comment letter for you that urges CMS to delay for one year the implementation of the 15% payment differential for services furnished by physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) to allow CMS to finalize regulations on this provision at the end of 2021, and then give time to providers to train staff on the new requirements and prepare for the change.  In addition, the comment letter template also asks CMS to provide for an exemption to the policy for providers serving Medicare patients in rural and underserved areas of the country.  You are welcome to add additional content to the letter regarding impact to patients you serve.

LINK TO TEMPLATE:    https://app.govpredict.com/gr/t08idbqw

COVID-19 Vaccination Mandate

On August 28th, President Biden announced that all nursing home staff must become vaccinated against COVID-19 at facilities receiving federal Medicare and Medicaid funding.

With staffing shortages in long-term care, singling out our industry can potentially make staffing woes worse. We agree with Mark Parkinson, President and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), when he stated, “Vaccination mandates for health care personnel should be applied to all health care settings. Without this, nursing homes face a disastrous workforce challenge.”

This new mandate may take effect as early as September.


OSHA’s Emergency Temporary Standard
Encore is committed to providing a safe and healthy workplace for all its employees. We developed a COVID-19 Plan, which includes policies and procedures to minimize the risk of transmission of COVID-19, in accordance with OSHA’s COVID-19 Emergency Temporary Standard (“ETS”).  Encore has multiple workplaces that are substantially similar, and therefore has developed a single COVID-19 Plan, with site-specific considerations.  Individual Hazard Assessments have also been completed for each of Encore’s worksites.  

If you have questions or concerns regarding your specific plan, please reach out to your Regional Vice President.




ICD-10 Mapping

PDPM utilizes International Classification of Diseases, Version 10 (ICD-10) codes in several ways, including to assign patients to clinical categories used for categorization under several PDPM components, specifically the PT, OT, SLP and NTA components. The ICD-10 code mappings and lists used under PDPM are available on the PDPM Website at:


In response to stakeholder feedback and to improve consistency between the ICD-10 code mappings and current ICD-10 guidelines, CMS made several changes to the PDPM ICD-10 code mappings: