Blog

VAP is about to be revamped! The current criteria used to determine and track ventilator associated pneumonia (VAP) are undergoing an overhaul. Through the National Healthcare Safety Network (NHSN), the CDC, in cooperation with other subject matter experts and organizations, has formed a working group to review and update the “surveillance definitions” for what they are calling ventilator associated events…
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A few months ago, on the RehabNurse Listserve, I saw this question: “Does anyone d/c their patients in the late afternoon/evening on their last day of therapy, rather than waiting until the next morning and keeping them in the hospital overnight?  If so, what challenges have you come across, if any?” I replied: Although the third clarification document (pg 2….
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A continuation for Rehabilitation Therapy Caps (Part One) Background: The growth in Medicare outpatient spending for rehabilitation therapies put the budget out of balance causing the government to react by placing spending caps on the amount of therapy a beneficiary could receive in any one year. From 1980 through the mid 1990’s, Medicare’s costs for outpatient therapy services rose steadily….
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Let’s reminisce on a few facts from the Final Rule  1538F published in 2009 covering 2010 IRF fiscal year guidelines. These bullets will ring a bell, but did you consider the impact of all these statements combined? If not, let’s do so now!  It’s a realization that caught me off guard but certainly brings new light to medical necessity/medically reasonable IRF…
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Once again this year we witness what is becoming the annual ritual of extending the Medicare therapy caps; the failed attempt to correct all that is wrong with the outpatient payment methodology for rehabilitation therapies. The original $1,500 cap on Part B Medicare therapy services was intended as a cost control mechanism, but has not proved effective in saving Medicare…
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ATTENTION all managers! The Uniform Reporting Manual is being updated! Benjamin Franklin’s best known quote “Time is money” could not be more pertinent as the AARC seeks input from the respiratory care community regarding up-to-date time standards for both inpatient as well as outpatient procedures. The expanded procedure categories include: pulmonary function, blood gas, echo/non-invasive cardiology, hyperbaric medicine, sleep laboratory…
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Most often than not, therapy services already provided can be unfunded or denied based on two words – Medically Necessary. It is a concept that has gained popularity for denial from pre-authorization to post provided and unfunded care.  Yet there are criteria aimed around the concepts, that if taught well, staff could easily defend requirements. Criteria for Medically Necessary therapy…
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Improving quality and reducing the cost of care are primary objectives of healthcare reform.  Providers in all care settings are incented to demonstrate and report effectiveness in meeting these expectations. Developing the appropriate metrics to quantify improvements is the first step.  However, the lack of organizational validation could leave clinical people wondering why their efforts fail to produce greater impact…
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In one of my previous posts, I commented; “…in the final analysis, meaningful use is a function of the competence, compassion and caring of the warm-blooded men and women of healthcare.” I ran across an article in NURSE.com that underscores this point well. Cathryn Domrose wrote an article titled, “Health IT Might Cause Patient Safety Issues.” In it, she explores…
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If you need to educate staff about the importance of documentation and protecting hard earned revenue, you need to look no farther than an excellent resource provided by the Medicare Learning Network  entitled ‘Contractor Entities At a Glance,’ this comprehensive chart provides entity name, definitions and responsibilities along with the reasons those particular agencies may contact you.  In a few short…
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