Mary, an experienced nurse case manager, has worked on her medical unit for five years. She likes her assignment because it is never boring; she services a wide variety of patients with complex medical problems, and she feels satisfyingly challenged by the intricacies of each case. This is why, when the unit’s nurse manager approaches Mary about transferring a patient to another acute care setting with only a few hours’ leeway, Mary believes she can make it happen.
This April, CMS made a switch, changing the volume of charts allowed for Quality Improvement Organization (QIO) short-stay audits. Prior to this change, the number of charts selected for audit ranged from 10 charts for small hospitals to 25 charts for larger hospitals. Now, the 175 hospitals with the highest volume of short stays will have 25 charts audited, while hospitals with a “Major Concern” rating on a previous audit will receive a request for 10 charts.
Participation in the Supplemental Nutrition Assistance Program can lead to decreased healthcare claims and out-of-pocket costs for low-income adults, according to a JAMA Internal Medicine study.
Catastrophic hurricanes, mass shootings, and devastating wildfires—this autumn brought disasters that affected many regions of the country, which should have prompted organizations to consider how well equipped they are to handle such events.
Sometimes it’s the condition of the caregiver, not the patient, that prompts a visit to the emergency department (ED). According to a study published in the Journal of the American Geriatrics Society, this problem is not only resulting in unnecessary ED visits, but in higher costs.
A new effort is underway to allow observation stays to count toward the three-day stay required by CMS to qualify for reimbursement for a postacute skilled nursing facility stay.
