April 2019 Newsletter

Happy Spring & Happy Easter 

Monthly Motivator:

April hath put a spirit of youth in everything.—William Shakespeare

Get prepared! MAY is Better Speech and Hearing Month – Be prepared next month! This annual event provides opportunities to raise awareness about communication disorders and to promote treatment that can improve the quality of life for those who experience problems with speaking, understanding, or hearing. ASHA has many resources to help you celebrate BHSM every day.  www.asha.org . Some good educational material to share can also be found in the DiagnosTEX Bookstore and the Barium Barista Clinical Cafe at www.dysphagiadiagnostex.com. Check it out!

ABOVE and BEYOND By: Ronda Polansky M.S. CCC-SLP - Patient, Caregiver, and Healthcare Professional Educational Reference Sheets and Handouts for Effective Dysphagia Rehabilitation.  Over 30 handouts on specific disorders in dysphagia in ONE location to use in your practice, plus a resource section for SLP’s on cranial nerve testing, pharyngeal exercises, and treatment techniques. A need to have booklet in your therapy bag!!   Cost: $40.00. (plus S&H). Discounted to $30.00 for MBSH Month. Call us and we will get one out to you!

DVD – What You Can Not See at Bedside- Copies of MBSS studies for education of staff and families on various disorders and clear episodes of penetrations and aspirations. Cost - $40.00 (plus S & H). Discounted to $30.00 for MBSH Month. Great educational tool for anyone!  This is the same videos we presented at TSHA.

An SLP Should NEVER Lose Their Voice - Advocate for Proper Dysphagia Evaluations - Material to assist in educating Physicians, Administrators, Nurses and other Medical Professionals on Dysphagia and Modified Barium Swallow Studies

There are TWO new CEU Opportunities in Dallas with Ampcare ESP
Go to www.ampcarellc.com to register.

Use “diagnostex” as a discount code

April 12th in Dallas, Texas

May 13th in Dallas, Texas,

Social ME–dia Impact - Test Your HIPAA Knowledge:  In 2014, a New York hospital emergency room nurse posted a picture of an empty, blood-stained trauma room a doctor had taken and posted with the hashtag “#man vs. 6 Train”. Is this a HIPAA Violation?

While grounds of the picture was ruled “insensitive” rather than a HIPAA breach, the nurse came dangerously close to a violation of HIPAA 18 possible identifiers were made beyond the actual name because of the local news on this incident and many were able to identify the patient associated with the picture.  The nurse was fired for HIPAA policy violation.

Incident quoted from Law 360 article on a Checklist for Avoiding HIPAA Violations on Social Media.

If you are medical professional, confidentiality is the first priority, be very careful what you post, what you imply, who you point fingers at, and what you take pictures of. The Speech Community is large but in reality……very very small. All of these issues can be considered a federal offense and as a medical company if we are made aware of a breach of medical record we are responsible for reporting it. HIPAA fines range from $500-$50K for a FIRST offense even for those unknowingly breaching HIPAA. Social media is a casual, fun and personal way of communicating with the masses, but it is crucial to maintain a certain amount of professional standards and possibly professional distance. In this era, it is not if we will do social media, it is how well we will do social media. Everything you post becomes your personal brand, how do you want to be known?

PDPM – The new era for Speech Pathology 

New Patient-Driven Payment Model (PDPM) Proposal

  • There would be five case mix related components to the rate: physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), nursing, and non-therapy ancillary (NTA), along with the sixth component for non-case mix related costs.
  • The proposed PDPM would separately identify and adjust the case mix components—using primarily minimum data set (MDS) data—for the varied needs and characteristics of a resident’s care. The case mix components would then be combined with the non-case mix component to form the full SNF prospective payment system (PPS) per diem rate for that resident. The intent is to base as much of the rate as possible on patient characteristics instead of service provision.

Therapy minutes no longer play a role in determining payment.  While CMS still will require therapy minute reporting on the Discharge MDS, therapy minutes and related thresholds no longer drive payment.  Rather, patients are assigned to a CMG for each component using clinical information entered onto the SNF PPS Admission MDS which differs by component.  The only clinical information on the claim that impacts PDPM payments will be related to residents with HIV/AIDS.  In the final rule, CMS made no substantive changes to the patient characteristics and related classification.  See Figure 2 for a basic overview.  

PDPM Component and Patient Characteristics Used for Case-Mix Group (CMG) Assignment



Per Diem

# of Case Mix


- The primary reason for SNF Care ICD-10
- Functional Status – MDS Section GG Early and Late Loss

Payment Decreases

After Day 20



- The primary reason for SNF Care ICD-10
- Functional Status – MDS Section GG Early and Late Loss

Payment Decreases

After Day 20



- The primary Reason for SNF care  ICD-10
- Cognitive Status
- Presence of swallowing disorder or mechanically altered diet
- Other SLP related comorbidities

Average Daily Payment

No Variable Payment



- Clinical information from SNF Stay
- Functional Status – MDS Section GG Early and Late Loss
- Extensive Services Received
- Presence of depression
- Restorative nursing services received

Average Daily Payment

No Variable Payment



- Comorbidities present
- Extensive services used

​​Payment Decreases
After Day 3



With New PDPM structure, DiagnosTEX will be adjusting our FEE schedule later this year when PDPM goes into effect to assist the facilities with private pay patents with an additional convenience fee discount. More details to come.

Just a shout out to all of the TWU students who just finished their rotation with us!  We enjoyed having you all!  Best of luck as you continue your education and enter the workforce! Look forward to seeing out in the field!

Thank you, Dr. Bender, for having us out to the ACU Dallas Campus to show your students a close look at the Modified Barium Swallow Study.