July 2013 Newsletter


July 2013

Happy Independence Day!

                        Clinical Café Newsletter

By: Ronda Polansky M.S., CCC-SLP


Happy 4th of July to everyone celebrating our country’s independence and honoring our veterans and current military! Thank you to everyone who has served and/or is currently serving our country! We appreciate you more than you will ever know!  We know that freedom does not come free… there is a cost! DiagnosTEX will run Thursday July 4th but will be closed on the 5th. Please keep this in mind when scheduling your MBSS.


Texas Summers – HOT! HOT! HOT! Shall I describe it any other way??? Unfortunately, this time of year is one we dread in the mobile business!  Hot temperatures, being parked on hot concrete in the sun, running A/Cs on high, and/or sitting on one location for long periods of time can often cause our generators to overheat.  We take all precautions and maintain all required and preventative maintenance on our equipment, and strive to ensure this does not happen… but the Texas summer can be unforgiving and generators can only get “so hot” in triple digit temperatures. Please be aware that IF these generator issues occur we may have to adjust your scheduled time.  Any time we can park under a portico (covered entrance at the front of a building) would be helpful to us, your patients, and the completion of your studies.  Please check with your administrators on this; we appreciate your understanding.


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. Summer Discount $30.00 (plus S&H). Call us and we will get one out to you!

Thank you to all who have ordered and have also referred others SLP’s to it!


Summer CEU – Upcoming E-stim Courses in July

  • New Orleans, Louisiana on July 13, 2013
  • Dallas, Texas – July 20, 2013

For more information call 1-682-561-2444 or visit www.ampcarellc.com


DiagnosTEX CEU – Pam and I had intended to have a DiagnosTEX summer CEU course but due to other areas demanding our time as well as covering for summer vacations, we will have to postpone a course until the Fall.  We will keep you informed!  Thanks for the calls and checking in with us on this!


What will the MBSS add to my the patient’s Part B Therapy Cap ?

We have had several calls asking what our MBSS fee will add to the Part B amount that is subject to the cap. The 92611 will be applied to the therapy cap, so that amount will vary based on county:

Dallas County:             $ 88.06

Tarrant County:            $ 86.14

All Other Counties:       $ 83.48



Medicare Recommends “Regular” Diet for Nursing Home patients

This title to the ASHA article is misleading.  According the Medicare memorandum, the default diet in nursing homes should be regular.  It does state “Unless a medical condition warrants a restricted diet, consider beginning with a regular diet and monitoring how the person does eating it” (pg. 12).  It also states that interdisciplinary team members, including health care practitioner’s should be involved in balancing risks of aspiration against potential benefit or more liberal diets and food consistencies, and deciding whether there are viable alternatives” (pg. 25)

ASHA is still working with CMS regarding the interpretation and implementation of these standards. As I have mentioned before in previous newsletters, the CMS guidance to state surveyors states that these practice standards are NOT requirements.


It is interesting in regards to our QA how the diet levels were documented in relation to this controversial topic of regular diets.


Diet Recommendations

Month, Year


Soft Regular

Mechanical Soft


October, 2012






Liquid Recommendations

Month, Year





October, 2012






Method of Nutrition (as recommended post-MBSS)

Month, Year



October, 2012





The total number patients who aspirated during October, 2012 MBSS performed by DiagnosTEX was 235.  Of the 235 patients who aspirated, 204 of those were silent aspirators.  This statistic is extremely important, indicating that 87% of those who aspirate do so SILENTLY.