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If your documentation assurance program focuses on reimbursement alone, you're not going far enough. With pay-for-performance initiatives on the rise and increasing mandates for public reporting of hospital data, it's critical that the medical record accurately reflect the severity of illness and the services provided to your patients.
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Regular audits and continuing education are the keys to a successful documentation assurance program, says Liz Youngblood, RN, MBA, vice president, patient care support services at Baylor Health Care System in Dallas.
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"When I conduct an initial review of the chart, I read it from the beginning, like a story starting with the emergency department notes, through the history and physical and start building a story from a clinical standpoint.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
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Although the proposed OASIS C is often described as more user-friendly than the current OASIS, the addition of process measures will be a major change for many agencies.
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The biggest challenge that home health managers will face with the proposed OASIS C is the addition of 30 process measures that will affect outcomes.
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"We try to address the issue of continuum of care, explaining to the family why members are at the current level of care, and when and where they should receive care in the future. We work with the discharge planners at the facility to help the member transition between levels of care," King says.
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With the number of uninsured patients increasing rapidly, the case management and social work staff at North Broward Medical Center are faced with the challenge of making sure patients receive the follow up they need to stay healthy and out of the hospital.
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Diversification is not only sound investment advice during these rocky economic times, but it also is sound fundraising advice. While a financial advisor will recommend a mix of cash, short-term savings such as certificates of deposit and stocks in a variety of industries or types of companies, fundraising experts for hospice recommend a development plan that addresses passive and active efforts as well as short- and long-term activities.
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Although independence is an attractive feature of working in home health, job satisfaction can be affected negatively if the home health worker does not feel safe.
