New CMS payment, what Hospitals are not reimbursed for:

Nurses General Nursing

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Specializes in psych. rehab nursing, float pool.

On October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) ceased reimbursing Medicare- and Medicaid-certified hospitals for 10 conditions, which it says are preventable, unless the conditions are present on admission (POA). POA is defined as a condition that's present at the time the order for inpatient admission occurs, including conditions that develop during an outpatient encounter, such as in the ED or during observation or outpatient surgery. If a patient develops any of the 10 hospital-acquired conditions (HACs), the costs to treat the condition will be paid by the healthcare provider.

What do you need to know about these reimbursement changes and what can you do, as a nurse, to help ensure your facility isn't adversely affected? Get the facts here.

The link shows the 1O conditions which are not covered once a patient is hospitalized.

http://www.nursingcenter.com/library/static.asp?pageid=839474

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Don't even get me started...

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Specializes in psych. rehab nursing, float pool.

Batman, Does that mean you have all the same policy upgrades that we have experienced since this went through.... It is insane in many instances. like somehow we on purpose cause these things to happen.

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Batman, Does that mean you have all the same policy upgrades that we have experienced since this went through.... It is insane in many instances. like somehow we on purpose cause these things to happen.

It's sanity. Make sure everyone has a MRSA and urine screening before admissions to try and protect yourselves. There are things on that list you just can't control. If you want to ensure a patient with dementia, etc. doesn't fall you better have a sitter because I can't guarantee they won't. Of course we don't get sitters. We also have patients that need foleys not getting them for fear of UTI. So nice patients have to suffer for this crap. It's infuriating.

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Specializes in psych. rehab nursing, float pool.

The insanity part to me, is no dvt for patient who has hip or knee surgeries.

Unfortunately we have had this happen to patient's who post operatively were put on dvt prophylactics including lovenox, coumadin, ted hose scd's encouraged to get up and out of bed, started physical therapy etc. Still a few have ended up with dvt's. This is what is insane to me.

I sure agree with test people before hosp or day of hospitalization for MRSA or uninary infections. However it adds tremendously to over all costs to our facilities.

I find it all a ploy by the government to avoid paying as much as possible.

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It's just another example of government overkill and a way to once again, blame it on nursing. It's not fiscally responsible to "overstaff" - anything above what the mysterious acuity formula calls for, but OMG, someone falls because two of you were doing a lift/xfer, someone was running meds to ER which left no one to answer the bed alarm when grandpa crawls over the bed rails and breaks her arm!!!! Oh yeah, and she's crawling out of bed because no one wants to use physical or chemical restraints and won't put a foley in so she can't get a UTI - but by God she's gotta pee and just the wrong time.

slowly stepping away from the soap box~

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The insanity part to me, is no dvt for patient who has hip or knee surgeries.

I find it all a ploy by the government to avoid paying as much as possible.

I disagree with 99% of it. Some of it no matter what we do can't be avoided because different people react differently. And it's all about the government avoiding to pay. The biggest shame of it is that patients really suffer and the medical workers get all the blame. It's disgusting.

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I disagree with 99% of it. Some of it no matter what we do can't be avoided because different people react differently. And it's all about the government avoiding to pay. The biggest shame of it is that patients really suffer and the medical workers get all the blame. It's disgusting.

Nope...the Powers That Be TRY to give me all the blame BUT I refuse to accept it!!! That drives them crazy and will eventually get me terminated however I just won't play that game.

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Specializes in ICU/Critical Care.

The thing that cracks me up the most is the falls, apparently in some institutions, patients have the "right" to fall but of course CMS isn't paying for it.

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The thing that cracks me up the most is the falls, apparently in some institutions, patients have the "right" to fall but of course CMS isn't paying for it.

Yup. They have us in a can't win situation. They have the right to fall but if they do they won't pay. The stupidity is astounding.

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Specializes in ICU/Critical Care.

I think sometimes even stage 3-4 wounds can't be prevented. I had a patient, very frail and thin, multiple intubations, on TPN/Lipds and developed a stage 3 on her coccyx and I think it also depends on the patient's age.

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Before these insane rules are posted, CMS has a period where you can post your comments, CMS is also level funding for the next couple of years.

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