A Series Of Tubes…

 

The Interwebs will be busy this week, our Humble Correspondent reports (Photo courtesy fine folks at Wikimedia Commons.)

Bill Myers

Washington, D.C.—Good morning, ProviderNation. The fine folks at AHCA/NCAL are taking to the Interweb Thursday for one of those elephant-in-the-room conversations about workplace violence.

As AHCA/NCAL’s Divine Adrienne Riaz-Khan points out*, nearly 70 percent of workplace assaults occur in health care settings, and the fine folks at OSHA have taken a harder look at the problem. The Webinar will be held at 2 p.m. EST and will feature Jackson Lewis P.C. superstar Nickole Winnett.

Very, Very, Very (&c.) Important

Speaking of Thursdays and people who are Very, Very, Very, Very, Very, Very Important, Your Humble Correspondent is looking forward to his grand entrance at Unique Residential Care Center’s Fifth Anniversary Gala, wherein the fine folks will celebrate their whole shelf of awards here in our nation’s capital.

Mazel tov, kids. Mazel tov.

Minnesota’s North Stars

Meanwhile, the fine folks at the Sabo Center for Democracy and Citizenship and Bipartisan Policy Center will host a Webinar of their own (why didn’t I copyright this whole Webinar thing?) next Thursday, Sept. 24, from 1 p.m. EST until 5 p.m. EST.

They’ve got themselves a star-studded lineup, including former Sen. Byron Dorgan (D-S.D.), former U.S. Rep. Martin Sabo (D-Minn.), and former U.S. Rep. Vin Weber (R-Minn.), who’ll wrestle with the policy challenges of an aging population.

MedPAC Recycling

Whatever else one thinks of the fine folks at MedPAC, let’s give them credit for reducing their carbon footprint by their willingness to recycle ideas. The group’s next congressional report is due next summer, but this week they released some initial data. AHCA/NCAL’s unsinkable Dianna Dorman quotes MedPAC as follows:

“… the Commission has long been concerned that the existing payment system does not encourage quality care and creates wasteful spending, noting there is substantial overlap of patients across settings, skilled nursing centers have incentives to encourage unnecessary therapy services and avoid certain patients, and a common assessment tool does not exist…”

Why does Your Humble Correspondent have this sinking feeling that MedPAC is going to harp on skilled nursing’s Medicare margins, and recommend even more managed care?

*I recognize that she’s dealing with workplace violence, but if you do not kneel before Adrienne, I will fight you.

Bill Myers is Provider’s senior editor. Email him at wmyers@providermagazine.com. Follow him on Twitter, @ProviderMyers.

 

Biggest Losers…

Good afternoon, ProviderNation.

This morning, the fine folks at CMS released the good news: off-label use of antipsychotics is down 9 percent in the first quarter of 2013.

And then the fine folks at AHCA released the better news: their members have reduced antipsychotics by 10.5 percent. More than two-fifths of the association’s member homes have reached the goal of 15 reductions in improper antipsychotic use.

“Over the past 15 months, there has been a movement to address antipsychotic use in individuals living with dementia, and AHCA members have been at the forefront,” association board honcho Neil Pruitt, Jr. said in a news release. “Our commitment to person-centered care is evident and will continue as we strive to reach our Quality Initiative’s 15 percent reduction goal.”

Meanwhile, local hero Joe DeMattos gets himself some ink.

You’re Gonna Need a Bigger Boat…

Good morning, ProviderNation.

Just when you thought it was safe to go back in the water. The Department of Health and Human Services’ Office of Inspector General is taking a new bite out of industry. A new report out this morning claims that skilled nursing facilities routinely flout rules on care plan and service requirements.

Based on a random sample of 245 nursing home stays during calendar year 2009, OIG claims that in:

• 37 percent of stays, homes “did not meet care plan or service requirements;”
• 26 percent of stays, homes “did not develop care plans that met requirements,” including “measurable objectives and detailed timeframes [sic];”
• 19 percent of stays, homes “developed care plans that did not address one or more problem areas identified in the beneficiaries’ assessments;”
• 15 percent of stays, homes “did not provide services in accordance with care plans;”
• 31 percent of stays, homes “did not meet discharge planning requirements;”
• 16 percent of stays, homes “did not have summaries of the beneficiaries’ stays or statuses at discharge;” and that in
• 23 percent of stays, homes “did not have post-discharge plans of care.”

The report is full of stark tragedies and horrors, about wound care and medication management, and suggests—without exactly saying—that billions in Medicare funds are apparently at stake.

AHCA Senior Vice President Greg Crist says that OIG’s report is missing the Big Picture.

“The report fails to acknowledge broader, more universal quality indicators that are trending upwards, not backwards, that a lack of viable care plans would result in if folks were indeed suffering. Every one of our members is required to implement a care plan on the first day an individual enters the building,” he says. “Care plans change daily because a patients’ health needs change daily. If the care plan didn’t match 100 percent every day, OIG sees that as a violation. We see that as practicing medicine. Circumstances change, and our caregivers are adapting to meet new medical conditions. We’re more focused on health outcomes and have seen them improve for our patients.”