August 31, 2026 · 1 min read · rounding, pain, antipsychotics
She was labeled agitated. Nobody had asked about her back.
She was labeled agitated. Sundowning, the note said. Started on a low-dose antipsychotic three days in.
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Insights
Notes from consult rounds
What a physiatrist sees in skilled nursing facilities: the payment signal, the chart, and the gap between them. Republished from Dr. Raj Desai and Precision Pain & Rehabilitation on LinkedIn.
August 24, 2026 · 1 min read · therapy, gg, attendance
Adding therapy minutes will not fix your GG scores. Attendance will.
Adding therapy minutes will not fix your GG scores.
ReadAugust 17, 2026 · 1 min read · medicare advantage, denials, oig
95% of appealed Medicare Advantage SNF denials were overturned. Only 18% were appealed.
OIG looked at Medicare Advantage denials for SNF admission. In the month they studied, plans denied 12% of requests. Of the denials that got appealed, 95% were overturned.
ReadAugust 10, 2026 · 1 min read · pdpm, therapy, nta
PDPM took away the day-3 alarm on refused therapy
Under RUG-IV, a resident who refused therapy cost you money that day. Minutes dropped, the RUG dropped, the rate dropped with it.
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