Spring 2016
... to Lead, Educate, Mentor and Respond ...
What’s Inside
Kentucky Conclave
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Join your colleagues for a weekend of education, networking, exhibits food and fun at the Kentucky Conclave!
19 Documentation Series 20
Pain Symposium 21 Wellness & Neurological Disorders 22 Total Joint Reconstruction Program 24 Education & Exercise for Fibromyalgia 25
Senate Bills 18 & 20 Pass Thanks to KPTA Lobbying
KPTA Efforts Help Pass Legislation Benefitting Patients and Physical Therapy Thanks to the lobbying efforts of the KPTA, two influential bills were passed during the Kentucky General Assembly’s 2016 Legislative Session. Senate Bill 18 (SB18) addresses material changes to contracts and Senate Bill 20 (SB20) develops an appeal process for Medicaid. The KPTA is currently asking the Kentucky Department of Insurance for guidance on the impacts of SB18. For now, we can identify a few things in the bill that are clear. SB18 creates clear guidelines for insurers to follow when changing existing agreements with health care providers. These include a 90-day notice of “material changes” to an existing agreement, the color and size of the envelope used to make such notices to providers, and the process and timelines for replies from providers to insurers.
Sen. Ralph Alvarado, the bill spon sor from district 28, originally limited the bill to physicians, but because of the KPTA’s efforts in collaboration with other allied health professionals, the bill was amended to include all health care providers. SB20, also sponsored by Sen. Alvarado, is long-sought legislation to establish an appeals process for Medicaid providers once the “internal appeals process” of a Medicaid Managed Care Organization has been exhausted. Under the new law, providers may appeal to the Cabinet for Health and Family Services for a decision. One additional change to the bill was that the ‘loser’ of an appeal may be required to pay up to $1,000 for the cost of the administrative hearing used to determine the outcome of the appeal. SB20 went into effect April 8, 2016. SB18 will go into effect January 1, 2017. We encourage our members to read this legislation and understand your rights and the rights of your patients. Contact Leigh Ann Thacker, KPTA lobbyist, with questions.
Now Accepting Nominations
• Commitment to Professional Development/ContinuDeadline for Nominations is July 1, 2016! ous Learning These pages contains information on the following awards: • Community Service/Promotion of the profession • Donald H. Lange Lifetime Achievement Award • Commitment and Support for Physical Therapy • Outstanding Physical Therapist Service Award Research • Outstanding Physical Therapist Assistant Service Award • Be nominated by at least one letter of support evidenc• Richard V. McDougall “Fledgling” Award ing the above criteria. • David A. Pariser Exceptional Educator Award *Fledgling Award nominees should have practiced for at least 2 years • Outstanding Clinical Instructor Award but not more than 5 years. Awards will be presented at the Kentucky Conclave Open- The David A. Pariser Exceptional Educator Award ing Reception on Friday, September 9 at 7:00 pm at the E.S. Criteria: Good Barn on the campus of the University of Kentucky • Nominees must be PTs or PTAs who have been actively (#0097 on the campus map) engaged in teaching physical therapist students (entry or There are many deserving PT and PTA professionals in advanced level) or physical therapist assistant students in our organization. Please consider taking a moment to nomiformal education for at least five years. nate a co-worker or colleague who has exhibited outstanding • Nominees must be either clinical or academic educaleadership and service to our profession! (Nominees must be tors. Nominees must have a faculty appointment of any APTA/KPTA members). Click here to download a list of rank (part-time or full-time) or receive compensation for past award winners. their teaching responsibilities. • Teaching must occur in an academic setting within one Donald H. Lange Lifetime Achievement Award or more accredited physical therapist or physical theraThe purpose of the award is to recognize the Physical pist assistant education programs, or advanced level proTherapist who has exhibited outstanding leadership, innograms for physical therapists, from which students earn vation in practice, mentorship, and ongoing service to the an academic qualification. profession of Physical Therapy. The award is named for • Teaching solely as a component of continuing educaDon Lange, PT. Mr. Lange practiced in Kentucky for many tion does not constitute eligibility for this award. years. Not only was he an exceptional clinician and mentor • Nominees must be KPTA Members. of young physical therapists, he also was instrumental in the development of Kentucky’s practice act. Mr. Lange’s impact The nominee must have demonstrated the following: on the profession of Physical Therapy, the lives of all those • Exceptional teaching effectiveness in the academic sethe touched and his commitment to life-long learning and ting; leadership is the foundation for this award. • Excellence as a role model for academic teaching for Criteria: The award shall be based on the following. students, faculty, and clinicians. • Must be or have been a member in good standing of the APTA/KPTA. Submission Requirements: • Must have a commitment to life-long learning as The following documents must be submitted for candievidenced throughout their career. date consideration: • Must have exhibited mentoring to students and/or • Current curriculum vitae or resume of the nominee other PTs and PTAs, impacting on their professional lives. • A letter of nomination from a KPTA student member • Must have exhibited a pioneer spirit by promotion, cultithat specifically focuses on the strengths of the nominee vating and expanding the profession of Physical Therapy. in relation to the award criteria, not to exceed 2 pages • Be nominated by at least one letter of support • A letter of support not to exceed 2 pages, from a PT or evidencing the above criteria. PTA colleague from the nominee’s institution Outstanding Physical Therapist Award Outstanding Physical Therapist Assistant Award Richard V. McDougall “Fledgling” Award* Criteria: Nominations will be judged by the Awards committee on the following: • Contribution and Participation in the APTA/KPTA • Clinical Expertise, Educational/Teaching Expertise or Administrative Expertise
SEND NOMINATIONS FOR DON LANGE, OUTSTANDING PT, PTA, FLEDGLING & DAVID PARISER AWARDS TO: Sam Brown Awards Committee Chair ptmpts@windstream.net 68 Oak Tree Lane Monticello, KY 42633 Continued on pg. 4
Now Accepting Nominations Deadline for Nominations is July 1, 2016! Continued from pg. 2 Please include in your letter: Name, address, email, phone numbers, work location and job title of Nominee. Name, address, email and phone numbers for person making the nomination.
Outstanding Clinical Educator Award Criteria: • Clinical Instructor for 3 years, averaging 1 student per year • Nomination should be submitted with: letter of rec-
ommendation from a PT or PTA student whom the CI has supervised; one letter of recommendation from an ACCE in a KY PT/PTA program; nominee’s CV or resume (additional letters of support are not required, but may be submitted) NOMINATION FORMS FOR OUTSTANDING CLINICAL EDUCATOR CAN BE FOUND AT: Award Details and Nomination Form Student Statement of Recommendation Form SUBMIT CLINICAL INSTRUCTOR NOMINATIONS TO: kptaky@gmail.com
Congratulations Award Winners! The UK PT program would like to congratulate the following who have received awards this spring: Susan Effgen, PT, PhD: CHS Distinguished Scholar Award Esther Dupont, PhD: CHS University Research Professor Lynn English, PT, MSEd, DPT: Teacher Who Made a Difference Anne Harrison, MSPT, PhD: Teacher Who Made a Difference Art Nitz, PT, PhD: Teacher Who Made a Difference Kate McNamera, SPT: Outstanding PT student (Lexington) Jacob Scalf, SPT: Outstanding PT student (Hazard) Carolyn Blissett, SPT: CHS Dean’s Award for Excellence in Service Paul Kline, DPT: Robinson Graduate Award for Research Creativity We look forward to sponsoring the KPTA Student Conclave in September!
WKU Receives Accreditation
Western Kentucky University Receives Initial CAPTE Accreditation for Doctor of Physical Therapy Program WKU’s Doctor of Physical Therapy program has received initial five-year accreditation from the Commission on Accreditation in Physical Therapy Education. “Obtaining accreditation is a momentous event in the development of the DPT program,” said Dr. Neale Chumbler, dean of WKU’s College of Health and Human Services. “This accreditation underscores the rigor of the curriculum and the stellar credentials of the DPT faculty. This further provides nationwide credibility and will extend our reach of applicants for future cohorts around the United States.” Accreditation is the latest milestone for the DPT program, which graduated its inaugural class earlier this month. “We are pleased to announce that the DPT program has received official word that it has been granted initial accreditation status,” said Dr. Harvey Wallmann, program director. “Accreditation has been the culmination of several years of hard work on the part of the faculty, staff, students and all the stakeholders and we’d like to thank everyone for helping us make this happen.” After receiving legislative approval in 2011, WKU’s third practice-based doctoral degree was approved by the Board of Regents in January 2012 and by the Council on Postsecondary Education in April 2012. The program received Candidate for Accreditation status from the CAPTE in April 2013 and started the inaugural class in June 2013. Physical therapy programs are not eligible for initial accreditation until the final semester of the program has been completed prior to graduation. CAPTE meets twice a year (spring and fall) to review programs. “One of the reasons we hired Dr. Wallmann was his expertise to ensure that accreditation would be forthcoming,” said Tom Pennington, a local businessman and physical therapist who led the efforts to develop the program at WKU. “We are very proud of Dr. Wallmann and the staff.” A physical therapy education program must be accredited to allow graduates to sit for the licensure exam, which is required in all states. “We are absolutely delighted for our first class and for all 90 students who put their trust in a program that was not yet accredited and put their faith in WKU that this would be a positive result,” Pennington said. “We are happy for the students and for their families.” About CAPTE: The Commission on Accreditation in Physical Therapy Education is the only accreditation agency recognized by the U.S. Department of Education and the Council for Higher Education Accreditation to accredit entry-level physical therapist and physical therapist assistant education programs; has been recognized as an independent agency since 1977 and has been the only recognized agency to accredit physical therapy programs since 1983; accredits
CAPTE Summary of Action Western Kentucky University On May 4, 2016, the Commission on Accreditation in Physical Therapy Education made the following decision regarding the Doctor of Physical Therapy Program education program at Western Kentucky University. Status: ACCREDITATION Action Taken: Grant Accreditation Effective Date: May 4, 2016 Reason for Decision: The Commission based its decision to grant accreditation status [for a period of five years] on the program’s general compliance with the intent of the Evaluative Criteria and on the expectation that the program can and will, within the next two years, bring itself into compliance with all of the evaluative criteria. The program is asked to provide additional information, in the form of a Compliance Report, regarding the following: • Program assessment • Assessment of core faculty • Sufficient number of core faculty, • Curriculum assessment, and • Program outcomes. The program is accredited during this period to implement the program described in the Selfstudy Report, especially as it relates to enrollment and resource levels consistent with the admission of one cohort of students annually unless and until the program seeks approval of substantive change(s). over 200 physical therapist education programs and over 250 physical therapist assistant education programs in the U.S. and three physical therapist education programs in other countries (Canada and Scotland); has 29 members from a variety of constituencies; maintains a cadre of more than 250 volunteers who are trained to conduct on-site reviews of physical therapy programs; conducts on-site visits to approximately 70 programs annually; reviews information from approximately one-third of all accredited programs at each meeting; is an active member of the Association of Specialized and Programmatic Accreditors (ASPA) and subscribes to the ASPA Code of Good Practice.
Western Kentucky University Graduates First Class of DPTs WKU graduated its first 30 DPTs from the university’s doctor of physical therapy program May 2016.
Those graduated included: Whitney Ryan Allen of Elizabethtown; Alexis Elizabeth Anderson of Lancaster; Allison Elizabeth Pare Baston of Tompkinsville; Devin D. Bell of Columbia; Rett Coode of Maryville, Tenn.; David Dahl of Bowling Green; Katie M. DiTommaso of Fort Wright; April D. Ford of Bowling Green; D. Brianne Fortney of Beechmont; Megan Nicole Fuller of Bowling Green; Dominique K. Goutsis of Vancouver, British Columbia; Lorelei B. Gunn of Brentwood, Tenn.; Timothy L. Hall of Nebo; James B. Harlan of Henderson; Jacob M. Hicks of Owensboro; Emily K. Hubbuch of Nashville; Tom W. Jones of Bowling Green; Cristina J. Macke of North Las Vegas; Kelli Wray McKinney of Lebanon Junction; Lauren Caudill McReynolds of Brownsville; Terrell J. Muse of Somerset; Melissa Reece of Freeburg, Ill.; Shannon Marie Sims of Bowling Green; Laura Smith of Bowling Green; Wesley A. Smith of Leitchfield; Patrick Clay Stalcup of Burkesville; Kirsti E. Vittitow of Boston; Kimberley Wilson of Summersville; Emily Rigney Wright of Danville; and William Jason Wright of Bowling Green.
Honorary WKU - DPT Class of 2016 Inductees Mike Muscarella (left), and KPTA Western District Chair Tom Pennington (right) with Dr. Harvey Wallmann.
(L to R) WKU CHHS Dean Neale Chumbler; President Gary Ransdell; Dr. Harvey Wallmann, Tom Pennington
Western Kentucky University Graduates First Class of DPTs
WKU-DPT Class of 2016
2016 DPT Award Recipients: Dr. Katie DiTommaso – Service Award; Dr. Emily Hubbuch – Outstanding Achievement Award; Dr. Megan Fuller – Excellence in Research Award; Dr. Shannon Sims – Excellence in Research Award; Dr. Emily Rigney Wright – Excellence in Research Award; Dr. Allison Baston –Leadership Award; Dr. James B. Harlan – Service Award
New Educational Opportunity in the Orofacial Pain Clinic at the University of Kentucky The University of Kentucky Orofacial Pain Clinic, in Lexington Kentucky, announces a continuing education opportunity for physical therapists in the form of a one week shadowing program. The clinic provides care for patients with head and neck disorders, including temporomandibular disorders, primary headaches, cervicogenic headaches, and neuropathic pain. The Orofacial Pain Clinic team is made up of physical therapists, dental practitioners, and psychologists and is located in an inter-professional medical environment at the Kentucky Clinic on UK’s campus. This highly successful shadowing program has been offered to dental practitioners for more than thirty years, under the guidance of the internationally respected clinician, author, researcher, and teacher, Dr. Jeff Okeson. We are excited to announce this program now has an expanded physical therapy focus, and early reviews by physical therapists have been excellent. • The goal of the shadowing program for physical therapists is to provide the practitioner with in-depth information about inter-professional care for the person with orofacial pain, with an emphasis on the role of the physical therapist in the pain team. • The objectives of the program are to provide an overview of the components of the inter-professional examination, teach assessment and diagnostic classification for this population, and provide observations of examination, clinical decision making, and interventions for complex patients. You will find this program to be valuable for you whether you plan to work as part of an inter-professional team with complex patients with pain and/or develop the orofacial pain area as a niche in your practice.
Garrett Naze, PT, DPT, provides education to Kathy Ringo, a patient in the UK Orofacial Pain Clinic, about the cause of her pain and specific strategies she can use to help manage her pain.
• The fomat involves substantial inter-professional clinical observation supplemented by web-based and live lecture/ seminar experiences, journal club participation and lab practice. If possible, we will tailor the experience to your special interests and clinical needs, such as cadaver dissection, behavioral health, oral surgery, sleep disorders, etc. • The faculty include Jeff Okeson, DMD (Program Director); Anne Harrison, PT, PhD; Garrett Naze, PT, DPT, OCS, FAAOMPT; Isabel Moreno, DDS, PhD (Clinic Director); and Charley Carlson, PhD (Director of Behavioral Health and Research). The program tuition is $960 for 5 days. A 3 day shadowing program will be considered on an as needed and as possible basis ($750). For more information, contact Anne Harrison, PT, PhD, alharr01@uky.edu, University of Kentucky Orofacial Pain Clinic: 859-323-5500
The Orofacial Pain Clinic team (dentistry, physical therapy, psychology) and students use televised observation to discuss treatment for a patient receiving care in the clinic.
Travis Dills Receives National Scholarship
DILLS RECEIVES NATIONAL SCHOLARSHIP FOR OUTSTANDING STUDENT PERFORMANCE WHILE AT SOMERSET COMMUNITY COLLEGE Somerset, Ky (May 5, 2016) – Travis Dills, of Somerset, has been named the recipient of the 2016 Mary McMillan Scholarship Award by the American Physical Therapy Association (APTA). Dills is in his second year of studies in the Somerset Community College (SCC) Physical Therapist Assistant (PTA) program. He will be presented the award at a ceremony at the APTA National Convention and Exposition in Nashville, Tennessee in June. The award includes a $3000 scholarship. Dills was also recognized nationally in 2016 as the recipient of the APTA’s Outstanding PTA Student Award recipient in the fields of geriatrics and orthopaedics and also represented Kentucky at the Federal Advocacy Forum in Washington, DC, where he met with legislators to discuss issues important to the physical therapy profession. The Mary McMillan Scholarship Award honors Mary McMillan, a dedicated pioneer of physical therapy in the United States and abroad, the founding President of the APTA, and an esteemed teacher. The intent of the award is to recognize students who exhibit superior scholastic ability and potential for future professional contribution. Awards are made on a competitive basis and recipients are selected based upon superior scholastic performance, past productivity, evidence of potential contribution to physical therapy and service to the APTA. Dills has been active within the American Physical Therapy Association (APTA) and has served as vice-chair of the Kentucky Physical Therapy Association’s (KPTA) Student Special Interest Group and was a member of the KPTA’s All-Academic Team in 2015. In addition, Dills has served as the president of his class and was appointed to the PTA Program’s Advisory Board by the college president. He has maintained a cumulative grade
2016 Mary McMillan Scholarship Award winner Travis Dills (left), of Somerset, with SCC PTA Program Director Ron Meade.
point average of 4.0, has been named to the Dean’s List and is a member of Phi Theta Kappa International Honorary. He attended SCC as the recipient of the Mattie Helen Elliott Scholarship. He is employed by the Total Rehab Center of Somerset and is a fitness trainer at Club Fit. “Travis has excelled in his courses while enrolled in the program,” said PTA Program Director Ron Meade. “He has worked very hard and is deserving of this recognition.” Dills’ nomination was supported by classmate Chris Kent. Dills is the eighth SCC PTA student to be recognized with the award. Past winners include: Courtney Watts of Kings Mountain; Samantha Grubb of Barbourville; Debora Lasure of Stanford; Josh Yancey of Science Hill; Chris Garland of Burkesville; Valarie Cooper of Jamestown; and Jeff Buis of Liberty. Dills graduated from the SCC PTA Program in May. He is the son of Mike and Sharon Dills of Somerset. He plans to further his education by obtaining a doctor of physical therapy degree or enrolling in medical school. For more information about the SCC PTA Program, please contact the director of the program at ron.meade@ kctcs.edu.
Lymphedema Therapy Certification
The University of Kentucky Physical Therapy program is always looking for ways to thank their clinical sites for their dedication to students. Providing a location and support for a nationally recognized training program within the state is one way to do that. In an effort to boost the number of certified lymphedema therapists and to support clinical sites in the region: The Division of Physical Therapy of the University of Kentucky is hosting a 135 hour Lymphedema Therapy Certification class this summer! All therapists at our clinical sites receive a 20% discount on the class – that’s a savings of $620! The discounted tuition rate is $2480. Two ways to register: Contact Lisa at Klose Training lisa@klosetraining.com or 303-245-0333. Let her know you are a therapist at a UK clinical site and would like to register for the class. Register HERE through the Klose Training online store and use the special coupon code UK20% Save the dates for the on-site portion of the course: August 5-13, 2016. Register soon because the course begins with 45 hours of an Online HomeStudy Module. The home study is followed by classroom instruction that emphasizes hands-on learning. For detailed course descriptions, click on the link for Lymphedema Therapy Certification on the Klose Training website. This class will be held on the University of Kentucky campus in the Wethington Building where the PT program is located.
With the increased interest in cancer prehab and rehab nationwide, many physical therapists are left wondering how and when to treat patients who have been diagnosed with cancer or are undergoing treatment for cancer. Members of the UK Division of Physical Therapy are looking for creative ways to be involved and to provide instruction on the latest information to local and regional therapists. A survey was distributed over a year ago to all members of the KPTA regarding their knowledge level and interest in the topics of cancer prehab and rehab. The overwhelming majority of respondents indicated that they were very interested but unsure about how to proceed. The Division is hosting a one day course through the Oncology Section of the APTA. The course will be held in Lexington on Saturday July 16 from 8 am to 6 pm. The course is taught by nationally recognized experts in the field. There is a lab component to the course to enhance learning of the material. Registration is made directly through the Oncology Section of the APTA at oncology@apta.org. CEUs will be available. The early-bird deadline for registration is June 16.
APTA Student Advocacy Dinner
Physical Therapy Students Learn Importance of Advocacy at Unique Dinner Event LOUISVILLE, Ky. (May 24, 2016) – More than 30 physical therapy students from Bellarmine University, University of Kentucky, Western Kentucky University, Maysville University and Jefferson Community and Technical College attended the American Physical Therapy Association (APTA) Student Advocacy Dinner in Louisville on April 21. The dinner was sponsored by KORT and organized by Bellarmine University Doctor of Physical Therapy (DPT) student Nick Beckham. “The dinner was a truly unique event that gave students from several schools around the state a chance to meet and talk with other PT students, faculty, and leaders in the profession. We discussed how we, as students, could make an impact on the legislation that will be affecting our future patients. We saw how we could help shape the future both for ourselves as professionals and for those we serve,” said Beckham. National Advocacy Dinners were held across the country from April 13-May 4, in 15 cities including Louisville, Phoenix, Chapel Hill, Dallas, Los Angeles and New York. The dinners provide students with the opportunity to ask questions of a panel of physical therapy professionals and learn about top legislative and other issues affecting physical therapy today. They learn how they can get involved and make a difference now as a student advocate.
KORT President Jason Chambers served on the discussion panel regarding the importance of advocating for the profession, and volunteering and serving in the KPTA. “KORT was a proud sponsor in this inaugural event and we hope this will spur other passionate physical therapists and physical therapist assistants to take a stand for what we do and for the thousands of patients we serve as a profession on a daily basis,” said Chambers. For over 28 years, Kentucky Orthopedic Rehab Team (KORT) has been the specialist in outpatient physical and occupational therapy in Kentucky and Southern Indiana. Local ownership and independent operations allow our therapists to work one-on-one with patients helping them to regain strength, increase flexibility, improve mobility, and reduce pain without medication or surgery. Selected as a “Best Places to Work in Kentucky” for 12 consecutive years, and with over 45 locations, KORT has the most board certified Orthopedic Specialists and Vestibular Rehabilitation specialists of any other provider in the Commonwealth. KORT’s certified athletic trainers provide services to more than 30 high schools and colleges making us the largest sports medicine provider in the region. KORT has improved more lives by providing compassionate care to more people, in more communities, and in more locations than any other outpatient physical or occupational therapy provider in the state of Kentucky. Through our years of commitment to the physicians and patients of Kentuckiana, KORT is time tested and most trusted.
E-Notes from the APTA Payment Policy & Advocacy Department What’s New?
New Round of HIPAA Audits Will Include Business Associates Get ready for a new round of Health Insurance Portability and Accountability Act (HIPAA) audits—and this time, they’re going to be even broader in scope to include not just providers and other entities, but also the “business associates” that handle patient data. And just like the first phase of audits completed in 2012, the process includes onsite visits. The new round of audits, conducted by the Department of Health and Human Services’ (HHS) Office of Civil Rights (OCR), is aimed at a “wide range of health care providers, health plans, health care clearinghouses, and business associates,” according to information from HHS. The audits will not include entities currently under investigation or under compliance review. The audit process will begin with entity desk audits, conducted electronically, and followed by a second round of desk audits of that entity’s business associates. OCR hopes to complete this phase of the process by the end of December 2016. After that, OCR will shift to onsite audits intended to cover “a broader scope of requirements from the HIPAA Rules than desk audits.” Afterwards, auditors will provide draft findings to the entities with the opportunity to respond. Those responses will be included in a final report. HHS describes the audits as “primarily a compliance improvement activity” after which aggregated results will allow OCR to “better understand compliance efforts with particular aspects of the HIPAA Rules.” Still, HHS says, “should an audit report indicate a serious compliance issue, OCR may initiate a compliance review to further investigate.” The latest audit is the second phase of a review program required by the 2009 American Recovery and Reinvestment Act, which also increased HIPAA security requirements and stipulated that a HIPAA-covered entity’s business associates — companies that process, analyze, or handle data — are also subject to HIPAA rules. The first phase ended in 2012. OCR has already begun emailing providers and other entities about the startup of phase 2. APTA offers a HIPAA webpage with resources to help physical therapists and physical therapist assistants understand the requirements. In addition, HHS has published a helpful guide to security of health information, and recently posted an announcement about the newest round of audits, including a list of frequently asked questions. SNF Use of Highest Therapy Categories to be Investigated by RACs New data now available from the Centers for Medicare and Medicaid Services (CMS) seem to back up allegations that many skilled nursing facilities (SNFs) are inappropriately using “ultra-high” (RU) and “very high” (RV) rehabilitation categories to increase their payments — and improve their
bottom lines. The findings have prompted CMS to turn over the issue to recovery audit contractors (RACs). On March 9, CMS released a new public use file on SNF utilization in 2013, representing more than $27 billion in Medicare payments and approximately 2.5 million stays among 15,055 facilities. The file breaks down the numbers in multiple ways, allowing users to look at payments arranged by resource utilization groups (RUGs), average payment amount per beneficiary, geographic regions, and therapy minutes. The data were based on SNF Part A institutional claims. According to CMS, the data on the use of RV and RU therapy contain a telling detail: namely a significant number of patients whose therapy time was within 10 minutes of the lowest possible threshold that would still allow the SNF to get the RV or RU payments. The report shows that in 2013, more than 1 in 5 SNFs reported 75% or more of their RV or RU minutes in amounts just over the required minimums (between 500-510 minutes per week for RV 720-730 minutes for RU). Overall, RU received $16.6 billion in 2013, while RV was associated with $5.5 billion in payments. “CMS strives to ensure that patient need, rather than payment system incentives, are driving the provision of therapy services,” said Shantanu Agrawal, deputy administrator for program integrity and director of the CMS Center for Program Integrity in a news release. Agrawal added that concerns over the ways in which RV and RU were being used have prompted CMS to refer the issue to the RACs for investigation. “Our hope is that data transparency will facilitate real changes,” Agrawal said. The RAC referral adds to what have been difficult times for SNFs over the past few months, as the press, the US Department of Justice, and the US Department of Health and Human Services have focused attention on SNF billing practices. Among other SNF-related data in the file: • The average standardized payment per stay for all SNFs was $10,919, with an average stay of 28 days. • The states with the highest average standardized payment per stay were Indiana ($12,406), Texas ($12,064), and California ($11,862). • States in the southwest had “notably high” percentages of RU assessments that fell just inside the thresholds, according to CMS, but so did California, Nevada, and “a few Southeastern states.” CMS Will Test Payment Increases to Selected SNFs In its continuing search for ways to reduce avoidable hospitalizations among skilled nursing facility (SNF) patients, the Centers for Medicare and Medicaid Services (CMS) will test a new payment system that would increase some payments and reward multidisciplinary care planning. The test, set to launch in the fall of 2016, would increase
payments to physicians conducting a comprehensive assessment in an SNF to the same amount they receive for providing the assessment in a hospital, according to a CMS news release. The new model would also provide new payments to practitioners “for engagement in multidisciplinary care planning activities,” and for treatment of 6 conditions that CMS says are linked to 80% of avoidable hospital admissions: pneumonia, dehydration, congestive heart failure, urinary tract infections, skin ulcers, and asthma. CMS plans to select approximately 250 SNFs to participate in the model, which will apply to both Medicare and Medicaid beneficiaries. The test system will be coordinated through Enhanced Care and Coordination Providers (ECCPs), CMS-funded groups that have been working with the agency since 2012 to reduce avoidable hospitalizations for SNF patients. A total of 7 ECCPs have been collaborating with SNFs to provide training and preventive services; now 6 of those 7 will serve as hubs for the new payment model. The 6 participating ECCPs are the Alabama Quality Assurance Foundation, HealthInsight of Nevada, Indiana
University, the Curators of the University of Missouri, The Greater New York Hospital Foundation, and Pennsylvania-based UPMC Community Provider Services.
Federal Payment
Inpatient Payment Proposed Rule Eliminates ‘2 Midnight’ Reeducations, Delivers 1-Time Increase to Hospital The Centers for Medicare and Medicaid (CMS) will not only back away from payment cuts associated with the “2 midnight” rule in 2017, but will actually award hospitals a .6% increase, according to a proposed inpatient prospective payment system (IPPS) and long- term care hospital rule released recently. In addition to the shift away from the penalties, the proposed rule continues the agency’s push for more quality reporting and value-based purchasing. The biggest news from the proposed rule is that CMS will not implement a .2% reduction for inpatient services — a cut designed to offset what it had anticipated would be increased spending associated with the 2-midnight rule. The 2-midnight rule was intended to reduce costly admissions in
E-Notes from the APTA Payment Policy & Advocacy Department cases better suited to outpatient treatment by stipulating that auditors can presume that an admission is reasonable and necessary if the patient spent at least 2 days as an inpatient, defined as 2 midnights in a hospital bed. The rule was challenged in a lawsuit filed by the American Hospital Association (AHA) and other groups. In September, a judge partially sided with the AHA and ordered the US Department of Health and Human Services to justify the cut. While CMS maintains that the assumptions it used to establish the cut were reasonable, it has announced in a fact sheet that the penalty will be permanently removed “in light of recent review and the unique circumstances.” Additionally, to account for the effects of the penalty in the years since the rule’s adoption in 2013, CMS has announced that hospitals will receive a 1-time .6% increase in 2017. According to an article in Modern Healthcare, the combined effects of the adjustment and other additional payments in the rule amount to a $539 increase for the IPPS.
Component Advocacy News and Tips
Oregon First State to Sign On to PT, PTA Licensure Compact Oregon has made physical therapy history by becoming the first state to join the Physical Therapy Licensure Compact (PTLC), a system that aims to make it possible for physical therapists (PTs) and physical therapist assistants (PTAs) to practice in multiple states through a single license and privilege. The legislation, signed into law by Gov. Kate Brown, adopts standard language allowing Oregon to participate in a system in which a PT or PTA with a valid, unencumbered license in one participating state may practice in any other participating state. Qualified PTs and PTAs would be able to choose any or all participating compact states to gain practice privileges, but would only need to maintain licensure in their “home” state. Other notable provisions in the new rule: The push for adoption of the PTLC among states is being • CMS will implement a standardized process for ensurled by the Federation of State Boards of Physical Therapy ing that Medicare beneficiaries who have been receiving (FSBPT) and APTA, working with state APTA chapters, state outpatient observation status for more than 24 hours are regulatory boards, and supporters of increased licensure porwell-informed of how observation status affects costtability. That effort officially launched earlier this year. sharing and eligibility for Medicare coverage of skilled Though decidedly good news, Oregon’s adoption of the nursing facility services. A form, called MOON (MediPTLC is only a first step: to become operational the system care Outpatient Observation Notice), must be accommust have at least 10 participating states. In a recent article panied by an oral explanation. The patient (or designee) on the PTLC in PT in Motion magazine, APTA Vice Presmust also sign the MOON to verify that he or she underident of Government Affairs Justin Elliott said that states stands the implications of observation status. should consider moving on the issue soon. “The creation of • The Value-Based Purchasing Program will expand to a compact for PTs and PTAs is truly going to transform the include not only more units but more measures used to state licensure process,” Elliott said, “all while maintaining evaluate those units—over time. The additional units and even improving the level of public protection in the comwon’t be added until 2019, and the additional measures pact states.” — which include 30-day pneumonia mortality, acute “The federation is thrilled Oregon was the first state to myocardial infarction, heart failure, and coronary artery enact the Physical Therapy Licensure Compact,” said bypass grafting mortality rates — will be added in 2021 FSBPT President Maggie Donohue, PT. “This is a demonand 2022. stration of how APTA, the FSBPT, the Oregon Chapter, • In order to satisfy the requirements of the Improvand the Oregon Physical Therapy Licensing Board can work ing Post-Acute Care Transformation (IMPACT) Act, together to benefit the health care consumer. We trust OreCMS is proposing 3 claims-based measures and 1 new gon is the model for continued collaboration and advanceassessment-based quality measure to be included in the ment of patient access to physical therapy services.” LTCH quality reporting program (QRP). The 3 claims Like Donohoe, APTA President Sharon L. Dunn, PT, PhD, based measures are discharge to community, Medicare OCS, hopes that Oregon’s decision will pave the way for othspending per beneficiary, and the potentially preventer states. able 30-day post-discharge readmission measure. The “The PTLC is a common-sense solution to provide greatassessment-based measure being added is a drug regimen er licensure portability and increased patient access, and to review conducted with follow-up for identified issues. facilitate the use of telehealth.” Dunn said. “We applaud APTA regulatory affairs staff will continue to monitor the the state of Oregon for being the first to enact the compact proposed rule, and will make a fact sheet available in the legislation and look forward to more states joining in the coming weeks. near future.”
APTA Resources
CJR Resources and Webinar The Comprehensive Care for Joint Replacement Model (CJR) is a new payment model for episodes of care related to total knee and total hip replacements under Medicare. The model was rolled out on April 1, 2016 and is being tested for 5 years in 67 metropolitan statistical areas. Programs under the model will be administered by hospitals in the participating regions, and will directly impact physical therapist practices in those areas. For more information on this model please see our CJR website: www.apta.org/cjr. Utilization Management Vendor Map questionnaire As mentioned previously, APTA is in the process of developing additional Utilization Management resources including a UM map. Please be on the lookout for an email that will contain a brief questionnaire on UM activities in your state. Completing this information will be instrumental in assisting the components and APTA in developing strategy moving forward.
APTA Activities / Calendar of Events
Save the Date for the 2016 State Policy and Payment Forum! Mark your calendars for the 2016 APTA State Policy and Payment Forum. The forum will be held September 17-18 in Pittsburgh, Pennsylvania. APTA will post additional information and updates on the State Policy and Payment Forum webpage later this year.
To Register for the 2016 Kentucky Conclave Click Here
Kentucky Conclave 2016 (All times Eastern) Friday, September 9* 6:00 p.m. - 7:00 p.m. PTA Party (E.S. Good Barn, University of Kentucky) 7:00 p.m. Opening Reception & Awards Ceremony; Exhibit Hall (E.S. Good Barn, University of Kentucky) *The E.S. Good Barn is located at 1451 University Drive, Lexington, KY 40536 (on the corner of Farm Road and University Drive). Please click here to view a map. The red boxes on the map indicate where you can park after 5:00 p.m. Saturday September 10 All programming on Saturday is held in the Charles T. Wethington(CTW) Building of the University of Kentucky 8:00 a.m. - 9:00 a.m. Registration, Breakfast CTW 014 (basement) Attendees may select one of the following sessions: 9:00 a.m. - 12:15 p.m. “A Day in the Life of Physical Therapy: Documentation Series,” Presented by Tim Welker, COTA/L and Jennifer Greco, COTA/L CTW 127 (The Commons) 9:00 a.m. - 12:15 p.m. “Pain Symposium,” Presented by William Haney, MD; Jessie Podolak, PT, DPT, TPS; Brittany Thompson, PT, DPT CTW 014 (basement) 12:15 p.m. - 1:30 p.m. Lunch & KPTA Business Meeting CTW 014 (basement) Attendees may select one of the following sessions: 1:45 p.m. - 3:00 p.m. “Community-Based Exercise, Wellness, and Physical Therapy for Individuals with Neurological Disorders,” Presented by Megan Danzl PT, DPT, PhD, NCS; Liz Ulanowski, PT, DPT, NCS; Natalie Elliott, PT, DPT; Megan Veltman, PT, DPT CTW 127 (The Commons) 1:45 p.m. - 3:00 p.m. “University of Kentucky Total Joint Reconstruction Program: Advancements in Acute Care Rehabilitation and Implications upon Discharge for Continued Physical Therapy Care,” Presented by Robert Huellemeier, PT, DPT CTW 411 1:45 p.m. - 3:00 p.m. Student Interprofessional Meet and Greet CTW 415 1:45 p.m. - 5:00 p.m. “Education and Exercise for Fibromyalgia Patients: Register Today A Neuroscience Approach,” Presented by Jessie Podolak, PT, DPT, TPS Kentucky Conclave 2016 CTW 014 (basement) please note this class adjourns at 5:00 p.m. • 5.5 category 1 contact hours awarded for attending the KenParticipants (licensed PTs/PTAs & students) may choose to attend tucky Conclave any of the sessions offered. • KPTA PT Members: $150 • KPTA PTA Members: $125 Sessions geared toward students include: A Day in the Life of Physical Therapy: Documentation Series • KPTA Student Members: $50 Pain Symposium • Non-members: $225 Student Interprofessional Meet and Greet
Campbell House Accommodations: Discounted Rate If you need accommodations, the Campbell House (1375 South Broadway, Lexington) has a group block reserved for the KPTA at a discount rate of $119.00. Call 859-255-4281 to make your reservation. Please make your reservation by August 29, 2016, and be sure to mention you are with the “Kentucky Physical Therapy Association.”
Attention students: Win Free Registration to the 2016 Kentucky Conclave If chosen, you will be expected to “blog” your experience on social media! This entails; posting a photo (or more) of your activities at the conclave, as well as create a quick summary of the events you attended on your class Facebook page as well as the Facebook page of the Kentucky student SIG! We want to see what you learned and enjoyed throughout the conference! Please fill out this form and return it to Kalie Reams SSIG chair, via email: kptassig.chair@gmail.com. Name: Email: School: Graduation Year: Physical Therapy Interests: Why do you want to attend the 2016 Kentucky Conclave? What social media outlets (Instagram, Facebook, YouTube, LinkedIn, Twitter, etc.) will you use to blog your experience?
A Day in the Life: Documentation
Presented by Rehab Care Join our 2016 Platinum Sponsor, RehabCare, as they present an interactive session geared toward students on documentation. This interactive course will delve into SMART Casamba, an electronic medical record documentation system. Using iPads, attendees will employ the system via a case study and will go through all the processes of patient documentation from admission to discharge. With over 30 years of experience in the industry, Kindred Rehab Services – RehabCare is the largest contract rehabilitation company in the country. Kindred provides rehabilitation services, including physical, occupational, and speech-language therapies, to nearly 2,600 hospitals and long-term care facilities in 47 states, covering virtually every care setting including inpatient, outpatient, skilled nursing, home health, long-term acute care and assisted living. For more information, contact Annie Roden or visit the RehabCare website. Tim Welker Manager of Clinical Systems Development • 12 years as a Systems Analyst and Project Management at Kindred HealthTim care/RehabCare Welker • 3 years on the Institutional Review Board at Washington University in St Louis • 20 years as a COTA/L: Inpatient, Outpatient, Skilled Nursing Facility, Long Term Acute Hospital, Home Health
Jennifer Greco Business Analyst in SRS Development • Analyzes and researches/ problem solves issues with ElecJennifer tronic Document Greco ation & Billing Program (SMART) if the HELP DESK can’t resolve • Works with the clinical management and business management teams and the vendor (Casamba) to develop new features/enhancements to the program • Tests upcoming versions of the program before it is sent out into the field • Inpatient and Outpatient Neuro-Rehab (Stroke & Brain Injury) at Barnes-Jewish Hospital/Rehab Institute of St Louis; SNF at Life Care Center of St Louis; Acute Care and General Inpatient & Outpatient Rehab at Christian Hospital • Taught a Physical Disabilities lab for a semester and has been a guest lecturer for a Splinting Lab at two local OTA programs • Was the FIM Coordinator at Life Care Center of St Louis, where she calculated their FIM stats and presented them monthly to our group of St Louis University physicians • Has served on the Advisory Board for the OTA program at St Louis Community College at Meramec for 10-plus years.
Pain Symposium
Featuring: Teaching Patients About Pain: Therapeutic Neuroscience Education This will be a 3 hour presentation, starting with a 1.5 hour lecture from Jessie Podolak, PT, DPT, TPS, followed by Brittany Thompson, PT, and Dr. Bill Haney. Jessie Podolak, PT, DPT, TPS Title: Teaching Patients About Pain: Therapeutic Neuroscience Education Objectives: Upon completion of this lecture participants will be able to: • Contrast traditional educational models with therapeutic neuroscience education • Cite evidence for the efficacy of therapeutic neuroscience education in the management of chronic musculoskeletal disorders • List eight components to the bio-psycho-social approach to understanding pain • Articulate the difference between-bottom up and topdown approaches to treating painful conditions • Develop an understanding of “The Body’s Alarm System” story and identify patients to which it would apply Jessie Podolak, PT, DPT, TPS Jessie Podolak, DPT, PT, TPS, is in her eighteenth year of practice, with experience in hospital, skilled nursing care, aquatic, and orthopedic Jessie outpatient settings. Podolak During the past 12 years, she has developed expertise as a manual therapist, as well as a therapeutic pain specialist, working extensively with patients suffering from low back pain, neck pain, joint injuries, arthritis, fibromyalgia and other types of chronic pain. She utilizes therapeutic neuroscience education with her patients on a daily basis, as well as a hands-on approach including manual therapy, therapeutic exercise, and Pilates. She owns and operates her community’s first direct-pay physical therapy practice and collaborates with local physicians, mental health practitioners and massage therapists to coordinate care which delivers a consistent message about pain. She is currently on faculty with International Spine and Pain Institute. As a part of ISPI, she participates in research and teaches other physical therapists across the country how to best serve people living in pain. Jessie is an APTA credentialed clinical instructor and guest lecturer at her local technical college for the physical therapist assistant program.
Brittany Thompson, PT, DPT Objectives • Discuss integration of Therapeutic Neuroscience Education into clinical setting • Provide case study of patient with persistent pain • Examine the relationship between PT and Pain Management MD Brittany Thompson, PT, DPT Brittany obtained her Bachelor’s degree from the University of Dayton and her Doctorate of Physical Therapy from Bellarmine UniversiBrittany ty. She is an active Thompson member of the American Physical Therapy Association. Brittany is currently a clinic director at ProRehab Physical Therapy in Louisville, Ky., with her clinic specifically focusing on chronic pain patients. She is currently pursuing a Therapeutic Pain Specialist Certification through Evidence in Motion and will be the first therapist in Kentucky to obtain this certification. When Brittany is not treating patients she enjoys exercising, walking her dog, boating on the Ohio River and spending time with her husband and family. William Haney, MD Title: Interventional & Multidisciplinary Pain Management William Haney, MD Dr. Haney is the owner and operator of the East Louisville Interventional Pain Specialist, PLLC (ELIPS). Haney has been serving the Greater LouWilliam isville area for the Haney past 22 years. Haney is a board certified anesthesiologist with a specialty in pain management. He has a unique KBML certificate to operate a physician owned pain practice. A Kentucky native, he is a Diplomat of the American Board of Anesthesiology and the American Academy of Pain Management and the American Board of Pain Medicine. He also has been certified with the American Board of Interventional Pain Physicians. Haney is a qualified and eligible candidate of the Fellow of Interventional Pain Physicians as sponsored by the World Institute of Pain.
Community-Based Exercise, Wellness, and Physical Therapy for Individuals with Neurological Disorders
An Outline • Introduction – evidence for community-based exercise and physical therapy offered through Bellarmine University and Norton Healthcare • Huntington’s Disease Exercise Group • Yoga for Essential Tremor • Parkinson’s Disease Golf Clinic • Parkinson’s Disease Exercise and Wellness Retreat • Suggestions for Development and Implementation of Programs in Your Local Community
Session Overview This session, geared toward an audience of clinicians and academicians, will highlight community-based exercise programs and physical therapy for individuals with neurological diagnoses, patient populations who benefit from ongoing lifelong involvement of a physical therapist and exercise. These community-based programs are a great way to integrate physical therapy and physical therapist assistant students as an opportunity to increase awareness and involvement of physical therapy. The presenters will discuss a diverse group of programs integrated into the community through physical therapist support and utilizing DPT students. Background research will be presented discussing how these programs began and the effect these groups have had in these specific neurological populations. The presenters will also share suggestions about how to begin community programming in other local communities. Learning Objectives • Describe the current state of the evidence for community-based exercise and wellness programs for individuals with neurological disorders • Describe various types of community-based exercise and physical therapy programs for individuals with neurological diagnoses • Discuss how to integrate physical therapy and physical therapist assistant students into these programs • Discuss how to begin community-based exercise models in your local community
Speakers Megan Danzl PT, DPT, PhD, NCS Assistant Professor Doctor of Physical Therapy Program Bellarmine University, LouisMegan ville, Ky. Danzl Dr. Danzl is an assistant professor at Bellarmine University and is course director for the Adult Neurological Rehabilitation course. She also teaches in the Neuroscience, Neurology, and Service Learning courses. She is board certified as a Neurologic Clinical Specialist by the American Board of Physical Therapy Specialties. She is the education and research coordinator for the Bellarmine University/Norton Healthcare Neurologic Residency Program. Her research agenda interests include education by physical therapists to patients and caregivers in neurological rehabilitation and community-based exercise programs for those with neurological disorders. Liz Ulanowski, PT, DPT, NCS Assistant Professor Doctor of Physical Therapy Program, Bellarmine University and Director of Bellarmine/Norton Liz Neurologic ResiUlanowski dency Program, Louisville, Ky. Dr. Ulanowski is board certified as a Neurologic Clinical Specialist by the American Board of Physical Therapy Specialties. She currently manages the Bellarmine University/Norton Healthcare Neurologic Residency Program. Her primary teaching responsibilities are in Pediatrics, Service Learning Clinic, Neurology and Neurological Rehabilitation for the Adult Patient. Her clinical focus and scholarship interests are physical activity and rehabilitation for patients with movement disorders.
Natalie Elliott, PT, DPT Physical therapist at the Cressman Rehabilitation Center-Norton Brownsboro Hospital and adjunct faculty member of Bellarmine Natalie University, LouElliott isville, Ky. Dr. Elliott graduated from the Bellarmine University DPT Program in 2013 and recently completed Norton/BU Neurologic Residency program in January of 2016. Natalie is currently working as a Physical Therapist at Cressman Rehabilitation Center for Movement Disorders. Natalie is certified as a yoga instructor and developed a class specific to those with Essential Tremor after having conducted a research study examining the benefits of yoga with this specific neurological population.
Megan Veltman, PT, DPT Acute care physical therapist at Norton Brownsboro Hospital and adjunct faculty member of Bellarmine University, Louisville, Ky. Megan Dr. Veltman Veltman is an acute care physical therapist at Norton Brownsboro Hospital and adjunct faculty member for the Adult Neurological Rehabilitation course at Bellarmine University. She graduated from the University of Wisconsin-Madison in 2014 and completed Norton/Bellarmine University’s Neurologic Residency program in January 2016. She collaborated with faculty and students at UW-Madison to create a neurologic pro bono physical therapy clinic and is currently directing a golf and exercise clinic for people with Parkinson’s disease.
University of Kentucky Total Joint Reconstruction Program
Advancements in Acute Care Rehabilitation and Implications upon Discharge for Continued Physical Therapy Care This course is designed to help participants understand the interdisciplinary framework of the acute care total joint reconstruction rehabilitation program with particular emphasis on the importance of early mobility and preferred discharge to home, both of which are supported by evidence-based research. This shift in clinical practice has been influenced by the Comprehensive Care for Joint Replacement (CJR) model to improve the quality and efficiency of care specifically provided to CMS beneficiaries. It has been shown that early mobility on post-operative day zero can decrease cardiopulmonary risk factors, the length of inpatient stay, and initial patient apprehension. These results support an increased emphasis on discharging patients directly home and beginning home health or outpatient physical therapy services within the first five days following surgery. By doing so, the acute care rehabilitation program has the potential to increase demand for outpatient and home health physical therapy services in Kentucky. In an effort to achieve optimal patient outcomes, the specific post-operative rehabilitation protocol designed by each surgeon should be integrated into each patient’s home health or outpatient plan of care to create uniformity post-surgery and allow for standardized outcomes that can be measured. Learning Objectives • Understand the structure of the UK Total Joint Reconstruction Program and the role of physical therapy within the interdisciplinary team approach • Review the evidence-based benefits of early mobility
• Discuss the importance of discharging patient’s directly to their home • Determine the impact of CJR initiatives and the implications for continued care in home health and outpatient settings • Review the post-operative rehabilitation protocol and discuss clinical outcomes desired by each surgeon Robert Huellemeier, PT, DPT Good Samaritan Inpatient Rehabilitation Services Coordinator University of Kentucky HealthCare, Robert Lexington Ky. Huellemeier Initially worked five years in an outpatient orthopedic setting specializing in post-operative rehabilitation. Joined UK HealthCare in 2014 to focus on treating patients following total joint reconstruction in the acute care setting. Became Inpatient Rehabilitation Services Coordinator at Good Samaritan Hospital in 2015 and currently serve a dual administrative/patient care role. Recommended Participant Level Designed for PT’s and PTA’s who care for patients in acute care hospitals, acute and subacute rehabilitation centers, home health and outpatient settings.
Education and Exercise for Fibromyalgia Patients: A Neuroscience Approach
Presented by Jessie Podolak, PT, DPT, TPS Upon completion of this 3 hour educational session the participants will be able to: • Define fibromyalgia in a way that is consistent with an understanding of modern pain science • Develop a greater understanding of why neuroscience education is needed for patients with FM and why it provides superior results compared to biomedical education • Describe the changes seen in seven output systems in patients with fibromyalgia • Implement one metaphor or story to explain symptoms such as brain fog or widespread pain to patients with fibromyalgia • Recognize the importance of graded exposure and movement-based approaches versus passive treatment techniques in this patient population • Apply the information from the education session into clinical practice Patients suffering from fibromyalgia present a myriad of challenges for the physical therapist. While the evidence clearly supports an active treatment approach including exercise and graded exposure to functional tasks, this can be the last thing a patient who feels exhausted and hurts all over wants to hear. It is imperative that physical therapists have a sound biologic understanding of fibromyalgia as the foundation for both empathetic engagement and effective treatment. The evidence-based material covered in this course will pave the way to successful application of education, exercise, pacing and graded exposure, and will equip clinicians to promote meaningful change in the lives of their patients.
Course Outline A Neuroscience Approach I. Overview a. Brief overview on the history and biomedical view of fibromyalgia b. Contrast with Bio-Psycho-Social Model II. A closer look at fibromyalgia a. Systems overview i. Lion story b. Neuroscience definition of FM c. Neurotags for chronic pain i. Brain meetings story III. Treatment Strategies a. Educating patients with fibromyalgia i. Prevailing models ii. Therapeutic neuroscience education 1. Lion 2. Brain Meetings 3. Nerve Sensors b. Exercise i. The evidence for cardiovascular exercise ii. Specific vs. general exercise c. Graded exposure d. Pacing e. Team approach i. CBT ii. Role of supportive modalities