Jump to content
RemedySpot.com

RE: observation patient denials

Rate this topic


Guest guest

Recommended Posts

Guest guest

Unfortunately the concept of other disciplines mobilizing patients seems to be

something we all struggle with.

I don't understand why linking increased mobilization vis a vis using more than

just PT, leading to reduced LOS and cost is such a difficult concept to

understand or put into action.

Theresa M. Morrone PT, MS, CCS

Director, Physical Therapy

NewYork Presbyterian Hospital/ Columbia University Medical Center

180 Fort Washington Ave Rm 170

New York, NY 10032

Tel Fax

________________________________

From: PTManager [PTManager ] on behalf of Eileen

Casey [ecasey@...]

Sent: Tuesday, July 24, 2012 9:21 AM

To: PTManager

Subject: observation patient denials

How are those in acute care dealing with observation patients and orders for

PT/OT?

We are getting an influx of patients admitted with dehydration, hyponatremia,

failure to thrive, confusion etc and PT is being ordered almost on admission

rather than rehydrating, normalizing electrolytes etc and seeing if the patients

returns to their baseline function.

We have been struggling trying to educate the docs and nurses that it is not

solely PT that can get patients out of bed and walking. Has anyone found an

effective strategy for dealing with this? Has anyone developed an algorithm that

would help guide MDs in their orders? Any suggestions would be appreciated.

Eileen Casey, PT

Director Rehabilitation Services

Brattleboro Memorial Hospital

17 Belmont Ave

Brattleboro, VT 05301

(P)

(F)

ecasey@...<mailto:ecasey%40bmhvt.org>

__________________________________________________________

The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the individual or

entity to whom it is addressed and may be subject to legal privilege. If you

have received this e-mail in error you should notify the sender immediately by

reply e-mail, delete the message from your system and notify your system

manager. Please do not copy it for any purpose, or disclose its contents to any

other person. The views or opinions presented in this e-mail are solely those of

the author and do not necessarily represent those of the company. The recipient

should check this e-mail and any attachments for the presence of viruses. The

company accepts no liability for any damage caused, directly or indirectly, by

any virus transmitted in this email.

__________________________________________________________

Link to comment
Share on other sites

Guest guest

We control this in two ways. First, as a preventative, we have explained to the

docs that these patients are outpatients, so they incur fees rather than having

their therapy buried in a DRG rate, they require certain sorts of documentation

exceeding that of typical inpatients that at least minimally burdens the docs,

they require consents not covered by the standard inpatient observation care

consents, and that if the therapy is necessary for any term longer than the

observation stay, the entire thing will have to be redone anyway by either

outpatient or home health services. The focus on the cost of unnecessary

services has tended to minimize the referrals. The second way we control them is

by explaining the whole thing again in the instance of a referral, only with the

patient's name in the blanks. This approach, while time consuming, has been

pretty effective, and has provided long-term benefits.

When a bad referral manages to sneak its way past our defenses, we follow

through with it, occasionally without charge if it's particularly flagrant,

figuring that the patient should not have to bear a financial burden for

unnecessary care. The latter is a rare occurrence.

Dave Milano, PT

Rehabilitation Director

Laurel Health System

________________________________________

From: PTManager [PTManager ] On Behalf Of Eileen

Casey [ecasey@...]

Sent: Tuesday, July 24, 2012 9:21 AM

To: PTManager

Subject: observation patient denials

How are those in acute care dealing with observation patients and orders for

PT/OT?

We are getting an influx of patients admitted with dehydration, hyponatremia,

failure to thrive, confusion etc and PT is being ordered almost on admission

rather than rehydrating, normalizing electrolytes etc and seeing if the patients

returns to their baseline function.

We have been struggling trying to educate the docs and nurses that it is not

solely PT that can get patients out of bed and walking. Has anyone found an

effective strategy for dealing with this? Has anyone developed an algorithm that

would help guide MDs in their orders? Any suggestions would be appreciated.

Eileen Casey, PT

Director Rehabilitation Services

Brattleboro Memorial Hospital

17 Belmont Ave

Brattleboro, VT 05301

(P)

(F)

ecasey@...<mailto:ecasey%40bmhvt.org>

__________________________________________________________

The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the individual or

entity to whom it is addressed and may be subject to legal privilege. If you

have received this e-mail in error you should notify the sender immediately by

reply e-mail, delete the message from your system and notify your system

manager. Please do not copy it for any purpose, or disclose its contents to any

other person. The views or opinions presented in this e-mail are solely those of

the author and do not necessarily represent those of the company. The recipient

should check this e-mail and any attachments for the presence of viruses. The

company accepts no liability for any damage caused, directly or indirectly, by

any virus transmitted in this email.

__________________________________________________________

Link to comment
Share on other sites

Guest guest

Eileen,

We had similar issue a couple years back and it ended up being primarily one

doc. I handled it by discussing with CEO and the MD that it was revenue losing

practice to have PT involved while on OBS. The discussion did greatly reduce the

frequency of those orders but never did eliminate them entirely.

Just like other issues in Rehab it comes down to each of us educating/informing

the other medical professional we work with what really is best practice.

Gwilliam, PT, MHA, CWS

Director of Rehabilitation

Bowie Memorial Hospital

>

> How are those in acute care dealing with observation patients and orders for

PT/OT?

> We are getting an influx of patients admitted with dehydration, hyponatremia,

failure to thrive, confusion etc and PT is being ordered almost on admission

rather than rehydrating, normalizing electrolytes etc and seeing if the patients

returns to their baseline function.

> We have been struggling trying to educate the docs and nurses that it is not

solely PT that can get patients out of bed and walking. Has anyone found an

effective strategy for dealing with this? Has anyone developed an algorithm that

would help guide MDs in their orders? Any suggestions would be appreciated.

>

>

> Eileen Casey, PT

> Director Rehabilitation Services

> Brattleboro Memorial Hospital

> 17 Belmont Ave

> Brattleboro, VT 05301

> (P)

> (F)

> ecasey@...

>

>

> _______________________________________________________________

>

> The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the individual or

entity to whom it is addressed and may be subject to legal privilege. If you

have received this e-mail in error you should notify the sender immediately by

reply e-mail, delete the message from your system and notify your system

manager. Please do not copy it for any purpose, or disclose its contents to any

other person. The views or opinions presented in this e-mail are solely those of

the author and do not necessarily represent those of the company. The recipient

should check this e-mail and any attachments for the presence of viruses. The

company accepts no liability for any damage caused, directly or indirectly, by

any virus transmitted in this email.

> _______________________________________________________________

>

>

>

Link to comment
Share on other sites

Guest guest

,

Your recent blog post reports that Dr. Pyne, reported by NYT as a

physical therapist who stated that no could return to play by

season's end. Dr. Pyne is, in fact, a CHIROPRACTOR doing rehabilitation on

. Please let it be known, and please encourage all PT's on this list

serve, to write to the NYT to correct the story. Our profession should not

be made to take the blame for the comments of a NON PHYSICAL THERAPIST.

http://www.sportslabnyc.com/curr.php

--

* M. Ball, PT, DPT, PhD, MBA, OCS*

*Board Certified in Orthopaedic Physical Therapy*

*Residency Trained in Orthopaedic Physical Therapy*

Carolinas Rehabilitation, Orthopaedic Physical Therapy Residency Faculty

NorthEast Rehabilitation, Staff Physical Therapist

cell:

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...