Discharge Appeal Rights: Are Your Systems in Place?

In the June/July 2007 issue of Case in Point, we covered a story that is important to all involved in discharge planning. One reader recently wrote to the author, Jackie Birmingham, asking an important question. Jackie asked that I publish this in an upcoming edition of Across My Desk, so that others can benefit from the answer.

Question: I recently read your excellent article in Case in Point on the new Medicare guideline. In the article you state, “Hospitals must deliver a copy of the signed notice to the beneficiary no more than two days prior to the discharge.” I have a question: Our department is doing it a little different. We bring in another blank form and have the patient again sign it, acknowledging the discharge etc., and issue him or her a copy upon discharge. Is this wrong? Do we have to bring a copy of the “dated” original form which was signed upon admission in our admitting department or is the process we are utilizing acceptable?

Answer from Jackie Birmingham: After I wrote the article, Medicare made the change that a new form can be issued and signed by the patient. You’re in good shape. I put a comment in the article that the rules would evolve and this is one of the changes that were made based on public comment.

Jackie advises all to review page 15 of the Centers for Medicare and Medicaid Services (CMS) Manual System: Pub 100-04 Medicare Claims Processing. There you will note: Alternative to Delivery of the Signed Copy. A hospital may choose to deliver a new copy of the IM (not a copy of the signed IM) during the required timeframes; however, the hospital must obtain the beneficiary’s or representative’s signature and date on the notice again at that time.

To review Jackie’s article, go to www.caseinpointmagazine.com and click on the June/July 2007 issue.

Press Ganey Releases National Report on ED Satisfaction

Press Ganey released the 2007 Emergency Department Pulse Report: Patient Perspectives on American Health Care. The report, which examines the experiences of 1.5 million patients treated at more than 1,500 emergency departments in 2006, is the definitive source on ED care from the perspective of the American patient.

Source: Press Ganey

Proceduralist Used to Reduce Risks

In another attempt to decrease medical errors, proceduralists are being used in hospitals to do various high-risk procedures such as paracentesis, place dialysis catheters, and other invasive procedures. While not a medical specialty in its own right, procedural medicine is emerging as an important new role. Hospitals say they reduce complication rates.

Source: Wall Street Journal, July 11, 2007

Editor’s Note: If you work in a hospital that has implemented this type of specialty, please email me at allewellyn@dorlandhealth.com to let me know how this new specialty is working at improving quality and decreasing errors.

Antibiotics Don’t Prevent Recurrent Urinary Track Infections in Small Children

Antibiotics given to small children to prevent recurrent urinary tract infections may be more harmful than helpful, according to a study published by the Journal of American Medical Association (JAMA). The study found that antibiotics serve more to increase the child’s drug resistance while doing nothing to protect the youngster from future urinary track infections.

Source: Forbes.com

Living Wage

In an attempt to raise the standard of living for people who make minimum wage while performing important and necessary tasks that benefit us all, St. Thomas University in Miami, Fla., became the second of two universities (the other is Georgetown) to implement the new Living-Wage Policy. A living wage is defined as a wage level that allows a family of four, with both adults working full time, to pay for food, housing and health care. Living wages are based on the cost of living in different geographical areas. Miami-Dade County ’s Living Wage Ordinance calculated a living wage as of August 2006 at $10.27 per hour. The more rigorous self-sufficiency standard calculated a living wage in Miami-Dade as $11.74 per hour. The federal minimum wage is $5.15 per hour while Florida’s minimum wage is $6.67 per hour.

Sources: Economic Policy Institute and The Florida Catholic, July 6-19, 2007

Is Your Hospital Listed?

U.S. News & World Report announced their annual list of the top U.S. hospitals. Take a few minutes to review the list and watch the video posted on the main page regarding Navigating the Hospital.

Source: U.S. News & World Report