Term
| Describe complex environment for patient management (4 areas) |
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Definition
Professional Development
Continual dynamic assessment
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communication to gain information, collection and analysis of medical information,application of special physical therapy knowledge,communication to provide information
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Decision making for patient management |
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Term
| A ______ _____ _______ (PPS) is a method of reimbursement in which medicare payment is made based on a predetermined, fixed amount. |
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Definition
| Prospective Payment System |
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Term
| The Patient Protection and Affordable Care Act established a public insurance option that ________(5 items). |
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Definition
1. Pays providers rates negotiated by Health and Human Services (HHS)
2. Expands medicaid
3. Creates national exchange. People can shop around for health insurance.
4. Subsidies to low income people for health insurance
5. Requires citizens to have insurance |
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Term
| Developed by CMS to prevent fraud, waste, and abuse in Medicare |
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Definition
| Recovery Audit Contractor (RAC) |
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Term
| How are Recovery Audit Contractors paid? |
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Definition
| Contingency fee basis on overpayments and underpayments they find. |
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Term
| This program is aimed at adjusting hospital payments for those institutions with higher than expected readmissions |
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Definition
| Hospital Readmissions Reduction Program and the ACA |
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Term
| The Hospital Readmissions Reduction Program fines hospitals for readmission of patients with _____, _____,_____,_______ , ______and _____, within 30 days. (Raised from 1% to 3%) |
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Definition
1. MI
2. CHF
3. pneumonia
4. Chronic lung disease
5. Hip replacement
6. Knee replacement |
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Term
Prediction model for readmission
H
O
S
P
IT
A
L |
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Definition
Hemoglobin at discharge (<12g/dL)=1 point
Oncology Service = 2 points
Sodium level at discharge (<135mEq/L) =1 point
Procedure during hospital stay =1 point
IT Index type of admission, non elective= 1 point
A Number of Admissions during past year =.5 - 1 point
Length of stay≥ 5 days = 2 points |
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Term
| The main reason pt's aren't successful when discharged to home. |
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Definition
| Toileting. Supervising person unable to help with toileting or emptying of BSC. |
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Term
| POC needs to be updated by MD every _____days or when POC expires, and MD needs to see pt. after ____days. |
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Definition
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Term
| PT and SP have a combined cap of |
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Definition
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Term
| No further physical therapy indicated if (5 items) |
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Definition
1. Pt is at or close to baseline
2. They are safe to return to prior living situation
3. Have met all goals
4.no progress has been made
5. PT needs to be consulted |
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