DiagnosTEX March 2015 Newsletter


Happy St. Patrick’s Day

“May your blessings outnumber the shamrocks that grow

and may trouble avoid you wherever you go

may your right hand alwaysbe stretched out in friendship

and never in want.”


Fun Facts about March:

  • It is the first month of Spring which begins between March 19-21.
  • In the Southern Hemisphere, March is the same as September in the Northern Hemisphere.
  • Each year March and June end on the same day of the week.
  • It is the time of year when animals start to wake up from hibernation.
  • March Madness is a basketball tournament played by the NCAA.
  • Easter is sometimes celebrated in March.
  • Birthstone: aquamarine and bloodstone.
  • March 6, 1836 – Fort Alamo fell to Mexican troops led by General Santa Anna.
  • March 10, 1862 – The first issue of U.S. government paper money occurred as $5, $10 and $20 bills began circulation

March is Brain Injury Awareness Month – By the year 2020, TBI is expected to be the number one health problems in the world.  The CDC currently estimates 5.3 million Americans currently have long term need for help performing ADL’s as a result of their TBI. In Texas, close to 150K people sustain TBI each year, and this does not account for those who went to ER and were released or those who never went to ER. TBI hospitalization totals are approximately 1.8 billion each year and only 5% of the survivors receive the rehab they need.  In Texas there is no TBI Medicaid waiver to support long term needs. Advocacy efforts can help by contacting area government representatives and ask that funding be made available to acquired brain injury survivors.


Upcoming CEU Opportunities

Dysphagia Research Society– March 11-14 in Chicago, Illinois

Texas Speech and Hearing Annual Convention – March 19-21 in San Antonio, Texas

  • ·        (AMPCARE will have a booth, be sure to stop by there!)


QA for 2014 – DiagnosTEX completes QA on 1 month out of every year. We follow up on every patient that we have seen in that month. You have probably received a call from us at some time during this QA process.  Thank you to all of you who either answered when we called J or were prompt in getting back to us, you make this so much easier for us. The following areas that we address in the QA report are:


  • MBSS tallies per month with additional QA documentation
  • MBSS diet and treatment recommendations
  • analysis of patient outcomes post-MBSS
  • silent aspiration vs. aspiration with reflexive cough
  • NPO status prior to MBSS with resultant initiation of PO
  • use of compensatory strategies and/or facilitative techniques
  • esophageal disorders screened
  • E-Stim treatment


We had some great outcomes. The most exciting thing was that we were able to get 100% of the documented 473 cases conferred.  A few statistics to share from the QA:

  • Rec Liquid consistencies: Thin = 221, Nectar = 65, Honey thick = 68, and Pudding 8.
  • 34% (161 patients) aspirated during the MSS
  • 84%  (135 patients of the 161) of those who aspirated were silent aspirators
  • 37% of patients were identified with esophageal involvement
  • 56% of the patients were discharged approximately 4-8 weeks after the MBSS.

Great information from these QA reports that we have shared and will continue to share yearly with ASHA and CMS to show that MBSS is a quality evaluation standard for dysphagia and in the long run can reduce healthcare costs by appropriately treating the disorder.


Medicare and Congress in the upcoming months

On Tuesday, April 1 2014 President Barack Obama signed the “Protecting Access to Medicare Act of 2014,” HR 4302, which creates a one-year patch for the Sustainable Growth Rate (SGR) Medicare physician payment formula, to April 2015.  That is coming up soon and may affect our reimbursements rates again..  Among many other provisions in that 45-page bill was a delay in the conversion to ICD-10 by one year, to October 2015.  Section 212 reads, “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C. 1320d–2(c)) and section 162.1002 of title 45, Code of Federal Regulations.”

Dysphagia Tidbit –  New Research Uncovers Significant Concerns Amongst Healthcare Professionals Regarding Treatment for Patients With Swallowing Disorder TROWBRIDGE, England, November 10, 2014 /PRNewswire/ — New research published outlines the concerns healthcare professionals (HCPs) have about the education and help available for those treating patients with the swallowing condition dysphagia. The survey, conducted by independent research firm Research Now and commissioned by Wiltshire Farm Foods, the UK’s leading frozen meals delivery service, found that over half of the 213 HCPs surveyed felt out of date on the current nutritional treatment approach for dysphagia. Despite the fact that dysphagia affects patients of all ages and is associated with a very wide range of conditions including stroke, cancers of the head and neck, and dementia, 70% of respondents felt that there is not enough help and education about the condition for HCPs working in the community.

In addition, the survey found: Nearly half of all HCPs surveyed had not been trained on dysphagia in over 2 years, and 10% have not received any training whatsoever.

73% of HCPs were concerned about the nutrition or food their dysphagia patients have been eating over the last 12 months, with 13% concerned about more than 10 of their patients.  Eating food of incorrect consistency can have serious implications for patients with dysphagia, and can lead to malnutrition, dehydration and aspiration of food.

53% of the HCPs surveyed had seen cases in the last 12 months where not giving texture-modified foods had directly contributed to aspiration in their patients.  47% felt it had contributed to malnutrition.

HCPs and patients are confused about the nutrition options available for dysphagia patients: There is a lack of consistent use of national descriptors for texture-modified food, and few patients are aware that pre-prepared texture modified meals are available on the market. 


Joe Korner, Director of External Affairs at the Stroke Association, said: “There are around 1.2 million people in the UK living with the devastating impact of stroke, and we estimate that well over two fifths will experience swallowing problems as a result. It’s important that healthcare professionals in the field of stroke have the training, knowledge and support they need to help patients manage their dysphagia. Stroke survivors who receive the right nutritional support are far more likely to make a better recovery. “