AMDCP Credit Designation: This session has been approved for a total of 1 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
The American Medical Directors Association designates this educational activity fora maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Presenter(s): Paula G. Sanders, JD Disclosure(s): PaulaG. Sanders, JD has no relevant financial relationships to disclose. Session Description: This session presents a timely overview of recent changes in Medicare, Medicaid and other payors' reimbursement policies as they attempt to improve patient safety by refusing to pay for ‘never events’ and preventable serious adverse events. While the majority of these initiatives, including coding for conditions that are present on admission, are focused on hospitals, their potential impact on the daily operations of SNFs should not be underestimated. This session explores some of the potential unintended consequences on SNFs of this movement to use payment to improve patient safety and quality of care. Medical directors should betaking an active role in their facilities to prepare for the impact of these new payment policies. This session provides practical suggestions about steps to be considered. Learning Objectives:
Discuss Medicare and other payors' never-event policies and theirimpact on SNFs
Prepare for increased scrutiny and reporting of patient safety andquality of care issues
Evaluate current documentation practices involving transfers to/fromhospitals
Anticipate the likely imposition on SNFS of non-payment fornever-events
References: Institute ofMedicine.Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.:National Academies Press, 2001. Institute ofMedicine. Toerr is human: Building a safer health system. Washington, D.C.;National Academies Press, 1999. ASHRM. Disclosure: What works now and what can work evenbetter (part 3 of 3). Chicago,IL; Feb. 2004. ASHRM. Disclosure: Creating an effective patientcommunication policy (part 2 of 3). Chicago,IL; Nov. 2003. ASHRM. Disclosure: The next step in better communication withpatients (part 1 of 3). Chicago,IL; May 2003. Pennsylvani Medical Assistance Bulletin Number 01-07-11,Preventable Serious Adverse Events. Jan. 14, 2008