title: Perceptions of inpatient rehabilitation changes after the Centers for Medicare and Medicaid Service 2010 regulatory updates contrasted with actual performance.
abstract: OBJECTIVE
  To compare and contrast subjective perceptions with objective compliance of the impact of the 2010 Centers for Medicare and Medicaid Service updates of the Medicare Benefit Policy Manual.
  Cross-sectional survey.
  
  
  METHODS
  An electronic survey was sent by the Uniform Data System for Medical Rehabilitation to all enrolled inpatient rehabilitation facility subscribers (n = 817). The survey was sent April 15, 2011, and responses were tabulated if they were received by May 15, 2011.
  
  
  METHODS
  Comparing and contrasting of the subjective perception to objective evaluation and/or compliance with the Medicare Benefit Policy Manual on case mix index, length of stay, admissions by diagnostic category as well as perception of preadmission screening, postadmission evaluation, plan of care, and interdisciplinary conferencing.
  
  
  RESULTS
  Twenty-five percent of the 817 facilities responded, for a total of 209 responses. Complete data were present in 148 of the respondents. For most diagnostic categories, perception of change did not mirror reality of change; neither did the perception between change in case mix index and length of stay. Perception did match reality in stroke and multiple trauma cases; respondents perceived an increase in admissions for the 2 impairments, and there was an overall increase in reality.
  
  
  CONCLUSIONS
  Comparison with actual data identified that gaps exist between diagnostic category perceptions and actual diagnostic category admission performance. Regulations such as the 75%-60% rule and audit focus on non-neurologic conditions as well as actual inpatient rehabilitation facility program payment reports may have influenced respondents perceptions to change associated with the Medicare Benefit Policy Manual modifications. This disparity between perception and actual data may have implications for programmatic planning, forecasting, and resource allocation.
authors: Department of Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA(∗).
authors: Richard V
authors: RV
authors: Riggs
authors: Department of Rehabilitation, Cedars-Sinai Medical Center, 8631 West Third Street, Suite 915 East, Los Angeles, CA 90048(†). Electronic address: pamela.roberts@cshs.org.
authors: Pamela S
authors: PS
authors: Roberts
authors: Uniform Data System for Medical Rehabilitation, Amherst, NY; Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, NY(‡).
authors: Margaret A
authors: MA
authors: DiVita
authors: Uniform Data System for Medical Rehabilitation, Amherst, NY; Health Care Studies Department, Daemen College, Amherst, NY(§).
authors: Paulette
authors: P
authors: Niewczyk
authors: Uniform Data System for Medical Rehabilitation, Amherst, NY(¶).
authors: Carl V
authors: CV
authors: Granger
mesh_terms: D000671:Amputation, Surgical / Q000534:rehabilitation; D001168:Arthritis / Q000534:rehabilitation; D019643:Arthroplasty, Replacement / Q000534:rehabilitation; D001927:Brain Diseases / Q000534:rehabilitation; D000072038:Cardiac Rehabilitation; D014487:Centers for Medicare and Medicaid Services, U.S.; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D050723:Fractures, Bone / Q000534:rehabilitation; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000534:rehabilitation; D009104:Multiple Trauma / Q000534:rehabilitation; D010343:Patient Admission / Q000706:statistics & numerical data; D011445:Prospective Payment System; D012047:Rehabilitation Centers / Q000458:organization & administration / Q000706:statistics & numerical data*; D013119:Spinal Cord Injuries / Q000534:rehabilitation; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D014481:United States