Thirty percent of the home health care workers' compensation cases managed by Total Medical Solutions (TMS) were discharged prior to the "order-end date," the last date the physician had anticipated that services would be required.
The figure comes from an internal review of 250 cases with an intake date between March 1 and July 15, 2009. Of the early discharges, 27 involving RN or LPN services were discharged an average of nine days early. Twenty four of the cases involved physical therapy and were discharged an average of 10 days early and 10 cases involved home health care aides and nine involved intravenous or infusion services.
"With home health care adding hundreds of dollars a day to a claim, earlier discharge represents significant savings for our clients," said Cara Barde, president of TMS.
TMS has a policy of having staff in patients' homes within 24 hours of the receipt of doctors' orders. "We start treatment early and provide the level of professional expertise these complex cases require," she added.
Getting the right equipment, right treatment and right people into the home at the right time facilitates faster recovery and shorter length of home health care services, according to Barde. TMS attributes much of its success to having staff who have a great deal of experience in managing complex workers' compensation home health care cases. "Our rehabilitation technicians and other staff have comprehensive knowledge of very specialized, assistive technologies and how to best use them in treatment plans for workers' compensation patients," Barde said. "Whether it's wound vac, lift chairs, or finding the most economical and medically expedient way to schedule nurses and nurse's aides, TMS customizes programs to each patient and to that patient's home environment."
Source
Total Medical Solutions
воскресенье, 3 июля 2011 г.
суббота, 2 июля 2011 г.
Project Lifesaver Program Helps Law Enforcement Locate At-Risk Citizens Across The USA
It all started because of failure, a missing person who couldn't be located in time. It was
and still is a story that happens monthly, if not weekly all across our nation.
For families and caregivers exploring options of how to protect a loved one who wanders
away from the safety of their home due to Alzheimer's, Dementia, Autism, Intellectual
Disabilities or other wandering conditions, there is hope.
Started in 1999, the organization began from the ranks of a Search and Rescue group affiliated
with the Chesapeake Sheriff's Office in Chesapeake, Virginia, known as the 43rd Virginia
Search and Rescue Organization.
Currently, there are over 735 agencies (Law Enforcement, EMS, Fire and more) in 43
states, District of Columbia and Canada participating in the Project Lifesaver® program
Bringing Loved Ones Home®.
Since Project Lifesaver International is a non-profit (501
(c) (3)) organization, funding is a result of private and corporate donations and grants. Donations
are used directly for programs, rescues and educational expenses.
To date, Project Lifesaver has had 1,732 national search and rescue of a Project Lifesaver
client maintaining a 100% recovery rate and zero fatalities. The average national find time
of a client on the Project Lifesaver Program is less than thirty-minutes.
People who are enrolled in the Project Lifesaver Program wear a personalized wristband
that emits a tracking signal. When caregivers notify the local Project Lifesaver agency that
the person is missing, a search and rescue team responds to the wanderer's area and starts
searching with a mobile locater tracking system. Search times have been reduced from
hours and days to just minutes, the average rescue time if notified is less than 30-minutes.
Before Project Lifesaver, searches across the country were averaging 9 hours and costing
taxpayers approximately $1,500 per hour. Many searches actually took days, with hundreds
of responders, resulting in much higher costs and many with tragic endings.
One
search in Chesapeake in 1979 cost the city $342,000 and was unsuccessful. The basic cost
to start this program in an agency is less than $8,000, finding someone alive is priceless.
For more information on Project Lifesaver or a participating agency near you, call 1-877-
580-LIFE or visit projectlifesaver.
and still is a story that happens monthly, if not weekly all across our nation.
For families and caregivers exploring options of how to protect a loved one who wanders
away from the safety of their home due to Alzheimer's, Dementia, Autism, Intellectual
Disabilities or other wandering conditions, there is hope.
Started in 1999, the organization began from the ranks of a Search and Rescue group affiliated
with the Chesapeake Sheriff's Office in Chesapeake, Virginia, known as the 43rd Virginia
Search and Rescue Organization.
Currently, there are over 735 agencies (Law Enforcement, EMS, Fire and more) in 43
states, District of Columbia and Canada participating in the Project Lifesaver® program
Bringing Loved Ones Home®.
Since Project Lifesaver International is a non-profit (501
(c) (3)) organization, funding is a result of private and corporate donations and grants. Donations
are used directly for programs, rescues and educational expenses.
To date, Project Lifesaver has had 1,732 national search and rescue of a Project Lifesaver
client maintaining a 100% recovery rate and zero fatalities. The average national find time
of a client on the Project Lifesaver Program is less than thirty-minutes.
People who are enrolled in the Project Lifesaver Program wear a personalized wristband
that emits a tracking signal. When caregivers notify the local Project Lifesaver agency that
the person is missing, a search and rescue team responds to the wanderer's area and starts
searching with a mobile locater tracking system. Search times have been reduced from
hours and days to just minutes, the average rescue time if notified is less than 30-minutes.
Before Project Lifesaver, searches across the country were averaging 9 hours and costing
taxpayers approximately $1,500 per hour. Many searches actually took days, with hundreds
of responders, resulting in much higher costs and many with tragic endings.
One
search in Chesapeake in 1979 cost the city $342,000 and was unsuccessful. The basic cost
to start this program in an agency is less than $8,000, finding someone alive is priceless.
For more information on Project Lifesaver or a participating agency near you, call 1-877-
580-LIFE or visit projectlifesaver.
пятница, 1 июля 2011 г.
Medicare Payment Advisory Commission Approves Recommendations For Nursing Homes, Primary Care
The Medicare Payment Advisory Commission on Wednesday voted to approve several recommendations to Congress focused on Medicare reimbursements for skilled nursing facilities and primary care, CQ HealthBeat reports (Reichard, CQ HealthBeat, 4/10).
The commission recommended amending the Medicare payment system for skilled nursing facilities to add a "separate nontherapy ancillary component" that includes prescription drugs and intravenous therapy. MedPAC also recommended revising the therapy component of the system to base reimbursements on "predicted patient care needs" and implementing a provision for "outlier payments" for unusual financial losses. In addition, the commission recommended a proposal under which HHS Secretary Mike Leavitt would require skilled nursing facilities to report diagnosis information, dates of services on claims filed and "services they furnish separately" on patient assessments. Facilities with the highest profits would receive the largest payment cuts, while those losing money would receive the largest increases (Kaiser Daily Health Policy Report, 3/11).
The commission also recommended an increase in payments to physicians designated by Leavitt as primary care-focused practitioners in an attempt to address a growing shortage of such physicians, CQ HealthBeat reports.
In addition, MedPAC considered a recommendation to establish a pilot program that would provide Medicare beneficiaries with a "medical home" to oversee their care. Under the proposal, physicians would be required to establish their capability to provide primary care; coordinate preventive, maintenance and acute health care services; employ health care information technology for active medical support; conduct care management; provide access and communication to patients at all times; and keep updated records of patients' advance directives, including the types of treatments they should receive if they are incapacitated.
MedPAC in June will formally present the recommendations in a report to Congress (CQ HealthBeat, 4/9).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
The commission recommended amending the Medicare payment system for skilled nursing facilities to add a "separate nontherapy ancillary component" that includes prescription drugs and intravenous therapy. MedPAC also recommended revising the therapy component of the system to base reimbursements on "predicted patient care needs" and implementing a provision for "outlier payments" for unusual financial losses. In addition, the commission recommended a proposal under which HHS Secretary Mike Leavitt would require skilled nursing facilities to report diagnosis information, dates of services on claims filed and "services they furnish separately" on patient assessments. Facilities with the highest profits would receive the largest payment cuts, while those losing money would receive the largest increases (Kaiser Daily Health Policy Report, 3/11).
The commission also recommended an increase in payments to physicians designated by Leavitt as primary care-focused practitioners in an attempt to address a growing shortage of such physicians, CQ HealthBeat reports.
In addition, MedPAC considered a recommendation to establish a pilot program that would provide Medicare beneficiaries with a "medical home" to oversee their care. Under the proposal, physicians would be required to establish their capability to provide primary care; coordinate preventive, maintenance and acute health care services; employ health care information technology for active medical support; conduct care management; provide access and communication to patients at all times; and keep updated records of patients' advance directives, including the types of treatments they should receive if they are incapacitated.
MedPAC in June will formally present the recommendations in a report to Congress (CQ HealthBeat, 4/9).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
четверг, 30 июня 2011 г.
Dramatic Increase In Patients Going From Hospitals To Home Care
The number of patients who needed home health care after being discharged from hospitals surged by about 70 percent (2.3 million to 4 million) from 1997 to 2008, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.
In contrast, the number of patients routinely discharged to their homes without the need for additional care grew by less than 8 percent, from 27 million to 29 million patients, during the period.
The federal agency also found during 1997-2008:
- Some 5 million hospital patients were discharged to nursing homes and other long-term care facilities - an increase of 35 percent (from 3.7 million to 5 million).
- There was a 40 percent increase in the number of patients (264,000 to 370,000) who left the hospital against medical advice.
- Hospitals transferred an additional 4 percent of patients to other hospitals (846,000 to 878,000 )
- Fewer patients died in the hospital - a decrease of 5 percent (from 852,000 to 811,000).
This AHRQ News and Numbers summary is based on Exhibit 1.5 in HCUP Facts and Figures 2008, which provides highlights of the latest data from the 2008 Nationwide Inpatient Sample, a part of AHRQ's Healthcare Cost and Utilization Project.
In contrast, the number of patients routinely discharged to their homes without the need for additional care grew by less than 8 percent, from 27 million to 29 million patients, during the period.
The federal agency also found during 1997-2008:
- Some 5 million hospital patients were discharged to nursing homes and other long-term care facilities - an increase of 35 percent (from 3.7 million to 5 million).
- There was a 40 percent increase in the number of patients (264,000 to 370,000) who left the hospital against medical advice.
- Hospitals transferred an additional 4 percent of patients to other hospitals (846,000 to 878,000 )
- Fewer patients died in the hospital - a decrease of 5 percent (from 852,000 to 811,000).
This AHRQ News and Numbers summary is based on Exhibit 1.5 in HCUP Facts and Figures 2008, which provides highlights of the latest data from the 2008 Nationwide Inpatient Sample, a part of AHRQ's Healthcare Cost and Utilization Project.
среда, 29 июня 2011 г.
Home Health Advance Beneficiary Notice (HHABN) Being Revised - Again, USA
Home health agencies will recall that a revised Home Health Advance Beneficiary Notice (HHABN) was slated to go into effect on May 1, but it ran into a roadblock. This came in the form of agencies' comments on the revised form and challenges to CMS's estimate of how much of a burden it would create for providers. So CMS has gone back and revised the HHABN once more, this time with comments due on July 24, with the intent of requiring home health agencies to use only this form as of September 1. In the meantime, providers should continue to use the current HHABN. CMS is seeking Office of Management and Budget approval of its new form, in a clearance package that you can access through aahomecare (go to Advocacy and Government Relations by clicking on the button on left of homepage and see Home Health heading on the Advocacy page).
Agencies must issue an HHABN in cases where they believe that items and/or services will not be reimbursed by Medicare (Option 1), they will no longer provide care for financial or business reasons (Option 2), or a beneficiary's homecare services are being reduced as a result of physician's orders (Option 3). CMS has simplified the language on the notices, which are in both English and Spanish, and has provided a much more realistic estimate of the frequency of issuance and burden on providers. Medicare estimates that 87.9 percent of HHABNs will fall into the Option 3 category and that agencies will issue an average of 2.12 notices during an episode of care.
You may want to provide input to CMS and OMB after reviewing CMS's six-document clearance package. If you have any comments please also e-mail them to Ann Howard at ahowardaahomecare by July 17 so that we can incorporate your input into AAHomecare's comments. In addition to the OMB clearance documents, HHAs will want to review 26 new Q&As that CMS posted on its beneficiary notices website on June 20. (See Advocacy and Government Relations at aahomecare by clicking on the button on left of homepage and see Home Health heading on the Advocacy page).
American Association for Homecare
625 Slaters Lane
Suite 200
Alexandria
VA 22314
USA
(703) 836-6263.
aahomecare
Agencies must issue an HHABN in cases where they believe that items and/or services will not be reimbursed by Medicare (Option 1), they will no longer provide care for financial or business reasons (Option 2), or a beneficiary's homecare services are being reduced as a result of physician's orders (Option 3). CMS has simplified the language on the notices, which are in both English and Spanish, and has provided a much more realistic estimate of the frequency of issuance and burden on providers. Medicare estimates that 87.9 percent of HHABNs will fall into the Option 3 category and that agencies will issue an average of 2.12 notices during an episode of care.
You may want to provide input to CMS and OMB after reviewing CMS's six-document clearance package. If you have any comments please also e-mail them to Ann Howard at ahowardaahomecare by July 17 so that we can incorporate your input into AAHomecare's comments. In addition to the OMB clearance documents, HHAs will want to review 26 new Q&As that CMS posted on its beneficiary notices website on June 20. (See Advocacy and Government Relations at aahomecare by clicking on the button on left of homepage and see Home Health heading on the Advocacy page).
American Association for Homecare
625 Slaters Lane
Suite 200
Alexandria
VA 22314
USA
(703) 836-6263.
aahomecare
вторник, 28 июня 2011 г.
Caregivers And Physicians Need Education About Battery Ingestion In Children
Ten years of case studies at a pediatric hospital and a thorough literature review have shown that it is not uncommon for children to ingest small "button" batteries, either through swallowing or inserting the batteries into their noses.
In a paper presented at the 2009 American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO in San Diego, researchers revealed that a significant lack of knowledge about the dangers of button batteries exists in the lay population and in healthcare providers.
Button batteries are miniature disc batteries that are typically used to power hearing aids, watches, calculators, and many commonly used items, including small toys and musical greeting cards. Each year, more than 3,000 people of all ages in the U.S. unintentionally swallow these batteries, according to the National Capital Poison Center in Washington, DC. Sixty-two percent of battery ingestions involve children under the age of 5, with a peak incidence in 1- and 2-year-olds.
While many children who ingest button batteries recover with few long-term health issues, some develop long-term complications that significantly deteriorate quality of life, such as tracheostomy-tube or gastrostomy-tube dependence, vocal paralysis, and septal perforation with saddle nose deformity. The authors say expeditious identification and treatment of button battery ingestion is crucial, for which continuing education must be provided to pediatricians, primary care, urgent care, and emergency room care providers, and otolaryngologists.
The authors also concluded that increased public awareness is necessary to diminish the incidence of such ingestions. Industry changes, including improved packaging and button battery markings, will also be fundamental to this process.
Title: Button battery ingestion in the pediatric population
Presenters: Dale Amanda Tylor, MD and Seth Pransky, MD
In a paper presented at the 2009 American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO in San Diego, researchers revealed that a significant lack of knowledge about the dangers of button batteries exists in the lay population and in healthcare providers.
Button batteries are miniature disc batteries that are typically used to power hearing aids, watches, calculators, and many commonly used items, including small toys and musical greeting cards. Each year, more than 3,000 people of all ages in the U.S. unintentionally swallow these batteries, according to the National Capital Poison Center in Washington, DC. Sixty-two percent of battery ingestions involve children under the age of 5, with a peak incidence in 1- and 2-year-olds.
While many children who ingest button batteries recover with few long-term health issues, some develop long-term complications that significantly deteriorate quality of life, such as tracheostomy-tube or gastrostomy-tube dependence, vocal paralysis, and septal perforation with saddle nose deformity. The authors say expeditious identification and treatment of button battery ingestion is crucial, for which continuing education must be provided to pediatricians, primary care, urgent care, and emergency room care providers, and otolaryngologists.
The authors also concluded that increased public awareness is necessary to diminish the incidence of such ingestions. Industry changes, including improved packaging and button battery markings, will also be fundamental to this process.
Title: Button battery ingestion in the pediatric population
Presenters: Dale Amanda Tylor, MD and Seth Pransky, MD
понедельник, 27 июня 2011 г.
Louisiana Nursing Home Owners Likely To File Lawsuit Against State For Lower Medicaid Rate Increase In 2009, Health Official Says
Louisiana Department of Health and Hospitals Secretary Alan Levine on Friday said that the state likely would face a lawsuit from nursing home owners if Medicaid cuts approved by the state House are not restored, the New Orleans Times-Picayune reports (Moller, New Orleans Times-Picayune, 5/24). The House this month approved a $30 billion state budget for fiscal year 2009 that is $240 million less than Gov. Bobby Jindal's (R) proposed budget.
Jindal's original budget called for a $600 million increase in Medicaid funding, including about $21 million for new initiatives. The House Appropriations Committee cut the spending increase by $183 million but did not specify where the reductions would come from. In a letter to House and Senate leaders last week, Levine wrote that the cuts would affect a wide range of health care providers, and the biggest reductions would be for hospitals, nursing homes and pharmacies.
Levine said that implementing the Medicaid cuts would include $38.6 million in payment cuts to nursing homes (Kaiser Daily Health Policy Report, 5/22). On Friday during a state Senate Finance Committee hearing, Levine said nursing homes are entitled by law to receive a rate increase that would cost the state about $69 million.
Commissioner of Administration Angele Davis has asked lawmakers to restore the health care cuts. Doing so, however, could bring the proposed budget near the constitutional cap on state spending, according to the Times-Picayune (New Orleans Times-Picayune, 5/24).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Jindal's original budget called for a $600 million increase in Medicaid funding, including about $21 million for new initiatives. The House Appropriations Committee cut the spending increase by $183 million but did not specify where the reductions would come from. In a letter to House and Senate leaders last week, Levine wrote that the cuts would affect a wide range of health care providers, and the biggest reductions would be for hospitals, nursing homes and pharmacies.
Levine said that implementing the Medicaid cuts would include $38.6 million in payment cuts to nursing homes (Kaiser Daily Health Policy Report, 5/22). On Friday during a state Senate Finance Committee hearing, Levine said nursing homes are entitled by law to receive a rate increase that would cost the state about $69 million.
Commissioner of Administration Angele Davis has asked lawmakers to restore the health care cuts. Doing so, however, could bring the proposed budget near the constitutional cap on state spending, according to the Times-Picayune (New Orleans Times-Picayune, 5/24).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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