Back in May, CMS put a hold on short-stay inpatient audits related to the 2-midnight rule. That hold was lifted effective September 12, 2016, according to a FAQ published by CMS as CMM reported last month. Our readers are wondering, however, about the latest information when it comes to these reviews. We reached out to Ronald Hirsch, MD, FACP, CHCQM, vice president of the Regulations and Education Group at Accretive Health in Chicago, to give us the latest update.
Mrs. Gray, a 93-year-old is in the ICU, has been diagnosed by her physician as having chronic heart disease that has progressed to “end stage.” The physicians set up a meeting at the patient’s bedside to discuss this prognosis with her and invite a representative of every member of the healthcare team to participate. Among those attending the meeting were the nurse case manager and social worker, who makes sure a representative from spiritual care is also present. Since the patient has told them that she has no family or friends, which the social worker validates after an extensive investigation, there are no significant others to attend. Mrs. Gray is truly the last living member of her family.
Hard to believe but this year the Commission for Case Manager Certification celebrates its 25th year of certifying case managers. Are you one of them? I hope so and I hope your management supports the need for its staff who serves in a case manager role to be certified.
The recent adoption of a refined version of the Patient Safety Indicator (PSI) 90 composite by the Agency for Healthcare Research and Quality (AHRQ) has a significant impact on what discharges are included in PSI 15 (Unrecognized Abdominopelvic Accidental Puncture Laceration Rate).
This week’s Medicare updates include finalization of two new payment models, the January 2017 update of the ASC Payment System, an OIG report on vulnerabilities that remain under CMS' 2-Midnight Rule, and more!
