2015 OIG Workplan Summary
It is not sufficient to rely on the physician order to evaluate and treat the patient, to substantiate the services rendered and billed. The 2015 OIG Workplan maintains their objective to reduce the number of false claims submitted by nursing homes for services rendered through rehabilitative clinicians. The licensed clinician has the burden to validate through the evaluation, plan of care and ongoing assessment of the patient why the technical skills provided by the discipline delivering care, is essential to the patient achieving the goals set forth in the care plan. Completion of documentation within the timeframes required, such as recording 30 day summaries at a minimum for Medicare-A beneficiaries and or daily encounter notes when treating
56431 Unit 1
638 Words | 3 PagesThey should be hold accountable for any breach in protocols. • Present format for electronic documentation does not allow for comprehensive clinical documentation during follow-up visit. Efforts should be made to upgrade the electronic medical record system to the standard of that expected for a medical center and research institute. This is to allow for proper documentation according to the industrial standard, and easy retrieval of patient’s information for clinical research. There is a need to employ a clinical documentation improvement specialist (CDIS) in this
Martin Alvarado's Foot Injury
190 Words | 1 PagesI am writing this to follow up our various telephone conversations and emails. You’ll recall that I am seeking a registered nurse to review records, prepare a report and possibly testify in a hospital fault case. The plaintiff, Martin Alvarado, is a brittle diabetic of current age 79. He sustained a fall while under the care of a registered nurse at Newman Regional Hospital. The fall resulted in a foot laceration which then became infected.
Omnibus Budget Reconciliation Act Case Study
131 Words | 1 PagesIn 1991, the United States government initiated the Nursing Home Reform Act, also known as the Omnibus Budget Reconciliation Act (OBRA) of 1987 that outlined “a set of national minimum set of standards of care and rights for people living in certified nursing facilities” (ncmust.com). OBRA requires all nursing home residents have a complete health evaluation upon admission to a long-term care facility, and to be re-evaluated quarterly or after any major changes in health or functional status. This evaluation process is called the Resident Assessment Instrument (RAI) which is composed of three components; Minimum Data Set (MDS), Care Area Assessment Process and RAI Utilization Guidelines. Together, the components of RAI provide information
Electronic Medication Error In Long-Term Care
206 Words | 1 PagesStrategies are methods or plans that solves a problem; strategies are essential to resolve issues to be able to prevent them from happening again and it helps to do a better job. Computerized physician’s order, electronic medication administration record with a barcode and reviewing the practice standards from CNO such as medication and documentation are the suggested strategies to inhibit the incidents and the breached ethical values from occurring again. Moreover, using information technology is the first strategy to impede medication error in the long-term care facility where an ethical value such as commitment to client was breached.
Inaccurate Reimbursement Analysis
109 Words | 1 PagesOverall, incomplete documentation and delinquent medical records cause inaccurate reimbursement and results in inaccurate gross revenue to the hospital. It can have a negative impact on the hospital budgeting and financial planning process for the hospital. It is for this purpose that every healthcare institution should be purposeful on reviewing the accuracy and completeness in clinical documentation, no matter the cost. Even though, for most physicians, most of their time is focused on the actual care of the patient and there is little to no time to devote to extensive documentation, it is imperative to understand patient care includes both the one-to-one attention and the documentation of said treatment.
Medicare Policy Summary
1033 Words | 5 PagesA therapist may do this once again in order to continue to receive reimbursement from Medicare for their services in order to generate more revenue for the clinic. Prior to the Jimmo versus Sebelius case in 2013, Medicare would deny coverage to patients receiving maintenance care for their condition due to their inability to demonstrate improvement from the skilled therapy services that they received (“Jimmo v Sebelius Settlement Agreement Factsheet,” 2013). However after the Jimmo versus Sebelius case, the Centers for Medicare & Medicaid Services revised portions of the manual which now states that coverage “does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care” (“CMS Manual System,” 2014). The correct action for the therapist to take in order to be in compliance with the rules is to provide adequate documentation as to why the patient would need and benefit from maintenance care services in order to prevent or slow the deterioration of their condition. An alternative would be to discharge the patient if they no longer require skilled and medically necessary services (“Jimmo v Sebelius Settlement Agreement Factsheet,” 2013) (“CMS Manual System,”
Mission Addition Summary
58 Words | 1 PagesMission Addition takes very basic math concepts and turns them into fun short, picture stories which help children to understand the concept. The book discusses basic addition topics such as adding one and two digit numbers, adding multiple numbers, counting money, and word problems. This would be a fun book to have in a preschool or kindergarten
Wait Times Essay
774 Words | 4 Pagesc. Current patients and new patient’s documentation would be different. Current patient’s documentation would be as to when they saw the doctor and the veteran’s feedback of the experience. While, new veteran’s wait times would be documented of when they requested the appointment and their experience of the visit using the Consumer Assessment of Healthcare Providers and Systems (CAHPS). (Shulken,
Patient Aligned Care Team Essay
651 Words | 3 PagesHope is not lost for our nations veterans, there are initiatives that may be implemented in order to improve the quality of care. We have identified four key areas that we feel will improve the quality of care for our nations veterans. These areas are; Patient Aligned Care Teams (PACTS), the program of vocational rehab, positive media relations, and universal electronic medical records. PACTS are formed when a veteran works together with multiple care disciplines in order to achieve whole person care and sustain life long wellness (VHA, 2015). These teams focus on patient medical partnerships, access to care, coordinated care among disciplines, and team based care with the veteran as the focus (VHA, 2015).
Explain The Importance Of Working In Health And Social Services
722 Words | 3 PagesWe would also inform them of any appointments she has that may affect their visits. To use one of these service users as another example, our support workers reported that the lady had deteriorated and it was becoming unsafe to support her. We then contacted her other care agency to inform them and we also reported to all other professionals involved in her care. This included the district nurses, her G.P., physiotherapist, and the Clinical Commissioning Group (CCG). We arranged a full reassessment of her needs and reviewed her support
Essay On Healthcare Reimbursement
475 Words | 2 PagesA physician can maximize reimbursement through improving charting and documentation. They can do this by avoiding EHR shortcuts. Although this feature may be viewed as a time saver, progress notes are crucial to clearly supporting continued hospitalization reasons. Some codes are time based and require precise documentation of time. Make sure each
Medicare Part B Case Study
1442 Words | 6 PagesWhich under the current design addresses long- term care for a limited amount of time, such as for rehabilitation purposes. These services cannot be received outside of a Medicare-approved facility, which means the person cannot reside in their home and receive the long-term care assistance under the current system. Therefore, we propose to amend this portion of the program to extend the funding for long-term care to include home care. Which consist of the relatives receiving monetary compensation for their care. Under the current policy, 41% of the Medicare budget of $50,000,000,000 is being advocated this particular area.
Open Group's Description Of The Target Operating Model
1119 Words | 5 PagesIntroduction Enterprise Architecture Enterprise architecture is defined as a “well-defined practice for steering enterprise analysis, design, planning, and implementation, by using a complete approach at all times, for the successful development and execution of a strategy. Enterprise architecture conducts architecture practices and principles to direct organizations during the business, information, process, and technology changes needed to complete their strategies. All these practices use the different characteristics of an enterprise to identify, inspire, and accomplish these changes” (Wikipedia). Ross, Weill & Robertson: “Enterprise Architecture as Strategy” Currently, business funds technology to support it.
Health Care Stakeholders Analysis
1010 Words | 5 PagesThe facilities enforcing protocols and policies to secure that employees are meeting government regulations. Doctors, nursing staff and support staff I must use their best ethical and moral judge in most case to ensure patients are being retreated. Thus, sometimes causing conflict with health care administration because health care workers sometimes unknowingly break policies or protocol by putting patients first. As well as hospitals and clinics have so many departments that there can be conflict of interest with patient care that can cause inconsistency with patient care (Santilli, J. el al., 2015, Para
Rehabilitation Counseling Personal Statement Essay
916 Words | 4 PagesAs I progress in my career, I feel that it is important to develop a personal style and technique that clients can relate to. I am also interested in learning more about assessments and evaluations as they drive the rehabilitation plan. While I have assessed hundreds of clients, I realize that there is more to learn. For instance, the trend over the next five years will be an increase in applicants who receive state-plan home and community based services. The Final Rule issued by The Center for Medicare and Medicaid will require that individuals receive services in the most integrated settings.
More about 2015 OIG Workplan Summary
56431 Unit 1
638 Words | 3 PagesMartin Alvarado's Foot Injury
190 Words | 1 PagesOmnibus Budget Reconciliation Act Case Study
131 Words | 1 PagesElectronic Medication Error In Long-Term Care
206 Words | 1 PagesInaccurate Reimbursement Analysis
109 Words | 1 PagesMedicare Policy Summary
1033 Words | 5 PagesMission Addition Summary
58 Words | 1 PagesWait Times Essay
774 Words | 4 PagesPatient Aligned Care Team Essay
651 Words | 3 PagesExplain The Importance Of Working In Health And Social Services
722 Words | 3 PagesEssay On Healthcare Reimbursement
475 Words | 2 PagesMedicare Part B Case Study
1442 Words | 6 PagesOpen Group's Description Of The Target Operating Model
1119 Words | 5 PagesHealth Care Stakeholders Analysis
1010 Words | 5 PagesRehabilitation Counseling Personal Statement Essay
916 Words | 4 Pages