IPoC

[lejeunesage]

For those of you who do IPR, what definition of "day" do you use to determine whether an IPoC is compliant?

"In accordance with 42 CFR § 412.622(a)(4)(ii), in order for the IRF admission to be considered reasonable and necessary, the overall plan of care must be completed within the first 4 days of the IRF admission; it must support the determination that the IRF admission is reasonable and necessary; and it must be retained in the patient’s medical record at the IRF"

Does this mean 96 hours or 4 calendar days.

If a patient is admitted Monday at 1500, does Monday count as day 1?
Are you out of compliance if you sign the IPoC on Friday morning?
Or do you have until Friday at 1459?

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[DMBandFan86]

I’ve always thought 4 full days since admit time. But I don’t push it. Usually complete after initial evals in 24-48 hours. Mostly a copy and paste note but sometimes I just add the therapy goals myself. I consider this the most useless note and wish they would get rid of it.

I’ve had locums providers cover me for vacation and sometimes they don’t do the ipoc or sign it in compliance. I still haven’t had anyone come back and say we lost payment because of that.

 

[RangerBob]

Agree IPOC is a waste of time.

I’m told by our program director Day 1 is the day of admission, so I sign it by the end of Day 4.

No sure what the absolute truth is, but it seems I’m safe from every angle to follow her view, and there’s zero benefit it signing later. Especially since it’s a paper note on our unit and there’s no true time stamp like there would be if it were an electronic note.

 

[Iamnew2]

For those of you who do IPR, what definition of "day" do you use to determine whether an IPoC is compliant?

"In accordance with 42 CFR § 412.622(a)(4)(ii), in order for the IRF admission to be considered reasonable and necessary, the overall plan of care must be completed within the first 4 days of the IRF admission; it must support the determination that the IRF admission is reasonable and necessary; and it must be retained in the patient’s medical record at the IRF"

Does this mean 96 hours or 4 calendar days.

If a patient is admitted Monday at 1500, does Monday count as day 1?
Are you out of compliance if you sign the IPoC on Friday morning?
Or do you have until Friday at 1459?

Day 1 is day of admission. So if they admit on Monday at 1500, then Monday is day #1, Tuesday #2, Wednesday #3 and Thursday #4. So yes Signing on Friday in the am would make it technically late.

 

[Iamnew2]

Agree IPOC is a waste of time.

I’m told by our program director Day 1 is the day of admission, so I sign it by the end of Day 4.

No sure what the absolute truth is, but it seems I’m safe from every angle to follow her view, and there’s zero benefit it signing later. Especially since it’s a paper note on our unit and there’s no true time stamp like there would be if it were an electronic note.

Agreed also that it's a waste of time. Just like they did away with PAPE they should do away with IPOC.
I also agree with your/your program director's interpretation as day 1 is day of admission.

 

[Momentum70]

ive only worked at a few places, but each one the ipoc automatically fired/printed/notified on day 3, that way in case there is an issue you have some grace period and the therapists have to get their things done by 48hours so at 72 it always completed and you are not waiting on anyone.