tag:blogger.com,1999:blog-1235922847401035250.post3787986108376464535..comments2023-03-31T05:17:46.047-05:00Comments on Nurses Uniting: NNOC testimony to TBONnurse advocatehttp://www.blogger.com/profile/12236609820294804473noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-1235922847401035250.post-2769578849386553382008-10-05T19:04:00.000-05:002008-10-05T19:04:00.000-05:00The law that went into affect.. where Medicare and...The law that went into affect.. where Medicare and Medicaid will not pay for Hospital Aquired Conditions, went into effect October 1st.. <BR/><BR/>October 1st - What's New at Your Hospital?<BR/>Starting October 1, 2008, Medicare will stop paying hospitals for complications arising from ten preventable Hospital Acquired Conditions (HACs). <BR/>HACs Which CMS Will Not Pay For<BR/>Pressure ulcers stage III & IV<BR/>Severe Falls & Trauma<BR/>Vascular Catheter Associated Infection<BR/>Poor Glycemic control<BR/>Catheter Associated Urinary Tract Infection (UTI)<BR/>Deep Vein Thrombosis & Pulmonary Embolism (DVT)<BR/>Surgical Site Infection after Ortho and Bariatric<BR/>Surgical Site Infection after CABG<BR/>Foreign Object Retained after Surgery<BR/>Blood Incompatibility<BR/><BR/>How will CMS decide when not to pay hospitals?<BR/>Unless the condition was "Present on Admission (POA)," or, at the time of admission a complete workup was done which neither confirmed nor ruled out the condition, CMS will no longer move patients whose condition worsens while in the hospital to the higher, more lucrative DRG that reflects these complications.<BR/><BR/>Why is Medicare Changing How it Pays Hospitals?<BR/>CMS's goal is to "transform Medicare from a passive payer to an active purchaser of higher quality, more efficient health care." In addition to not paying for HACs, Medicare's other new hospital "Value Based Purchasing" initiatives include<BR/><BR/>(a) Public Reporting. At HospitalCompare.gov , CMS publishes how hospitals score on 42 quality measurements, including patient satisfaction surveys.<BR/>(b) Pay for Performance. Hospitals will be paid extra for high rankings, or for showing improvement; they will be penalized for low scores. CMS has sent Congress a comprehensive Pay-for-Performance plan and is awaiting approval.<BR/>(c) Other initiatives. More HACs will be added to Medicare's "do-not-pay" list next year; for example, Ventilator Acquired Pneumonia, with annual costs of $4 billion, is under consideration. Also in CMS's sights: penalizing hospitals for failure to rescue, and for 30-day readmission for heart failure, heart attack and pneumonia.<BR/><BR/>How will these changes affect nurses and healthcare workers?<BR/>In theory, Medicare's paying hospitals based on patient care quality SHOULD be a major incentive for hospital executives to listen to their nurses about how to fix the root causes of poor quality - eliminating problems like short-staffing, abuse of OT, and over-use of temporary nurses and travelers. The entire patient care team matters: If there is not enough EVS staff, there will be cleanliness and infection-control problems; if there are not enough nursing assistants, patients are at risk for falls and bedsores. So also with shortages in respiratory care, imaging, laboratory and pharmacy staff.<BR/><BR/>In practice, will hospitals instead put their focus solely on charting and documentation - adding even more paperwork burdens that drain even more of nurses' time away from caring for their patients?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1235922847401035250.post-83997152739876433542008-10-03T07:24:00.000-05:002008-10-03T07:24:00.000-05:00I wish we could get every nurse with a story simil...I wish we could get every nurse with a story similar to the ones we presented that day to show up at the next open meeting. Hundreds of nurses would bring the attention that this issues deserves.<BR/> I plan to complete the advisory form and to be at the next Board meeting to hear their response.nurse advocatehttps://www.blogger.com/profile/12236609820294804473noreply@blogger.com