Overcoming barriers to care for LGBT individuals can require a culture shift at an organization, but it can be as simple as adding additional options to forms. It’s up to organizations to close the gap, and HIM plays a central role in identifying barriers, implementing change, and fostering a culturally competent environment.
Nancy is a manager of a hospital with a large indigent population. Nancy notes that immediately after the implementation of healthcare reform, many of her patients have obtained some form of health insurance, usually Medicaid. Often, the patients access Medicaid with the help of the hospital’s expert financial counselors. Recently, however, the number of uninsured patients in the community seems to be increasing. As a result, more uninsured patients are being admitted. Before healthcare reform, many uninsured people failed to seek timely, preventive healthcare. Therefore, they were quite sick by the time they came to a hospital. Nancy is now seeing a resurgence of uninsured indigent patients.
Does your discharge planning process ensure patients are getting adequate and accurate nutritional support? It might not, according to two new studies presented at the American Society for Parenteral and Enteral Nutrition (ASPEN) Clinical Nutrition Week (CNW) conference.
Just before the MOON requirement became effective March 8, CMS added another hoop to jump through in an open door forum held February 28.The discussion in that forum forced many organizations to change course at the last minute as CMS announced it would not allow pre-populated check boxes in the free-text field of the MOON designated for describing clinical reasons for the service the patient receives. Organizations that had listened to experts touting the value of adding check boxes with specific rationale to the MOON were forced to revamp the form shortly before implementation.
Sally, a case manager assigned to surgical cases, has noticed a recent increase in challenging insurance cases since her hospital brought on a new trauma surgeon. One such challenging case began Christmas Eve, when an 80-year-old female patient with several fractures was admitted to Sally’s unit. The patient shared with Sally that her injury occurred when she tripped while exiting a major super store. She fell face first on an icy sidewalk. She had just finished her holiday shopping and all her presents were scattered in front of her. The ambulance drivers had been so accommodating. Before transporting the patient, they collected all the gifts and delivered them to the nearest hospital with the patient.
How many of us have a successful mentoring program established in our organization and department? For most organizations, I would venture to say mentoring is performed on a piecemeal basis and is likely not as effective as it could be. Far too often, mentoring efforts are disorganized and lack a dedicated trainer. If any training is given, it often consists of the same general orientation afforded to all new employees, regardless of the job they will be doing.
The following is a question and answer form created by Ronald Hirsch, MD, FACP, CHCQM, vice president of the Regulations and Education Group at R1 Physician Advisory Services in Chicago, to help outline some basics regarding the complex rules surrounding the three-day qualifying stay required, which Medicare requires in order for patients to qualify for the skilled nursing facility (SNF) benefit.You can use this as a starting point to create your own physician and provider training materials on this topic. Ensuring that providers are well-trained on this topic can help ensure patients get accurate information, which can make these discussions less difficult.
Organizations today are putting a lot of energy into getting ready to comply with the NOTICE Act and Medicare Outpatient Observation Notice (MOON) guidelines, which go into effect on March 8 (see related story on p. 1). But this new notification requirement is giving them a related headache to contend with as well: issues related to the three-day qualifying inpatient stay required for Medicare coverage of the SNF benefit. The NOTICE Act is intended to ensure patients are aware of their status and the financial implications it may have for them—in particular, how it might affect their postacute care options.
