June 2014 Newsletter

June 2014

Summer is here!

Clinical Café Newsletter

By: Ronda Polansky M.S. CCC-SLP

Happy Father’s Day!

and

Do not forget to fly your American flag on the 14^th in honor of our country, our troops and our freedom!

Flag Day falls within National Flag Week, a time when Americans reflect on the foundations of the nation’s freedom. The flag of the United States represents freedom and has been an enduring symbol of the country’s ideals since its early days. During both events, Americans also remember their loyalty to the nation, reaffirm their belief in liberty and justice, and observe the nation’s unity.Although Flag Day is a nationwide observance, it is not a public holiday in many parts of the United States. It is a legal holiday in a few areas in the USA, such as Montour County in Pennsylvania.

The Mikkelson family has grown by 2 feet! –We have had many checking in………Congratulations Kelli and Robert!!! Finley Mikkelson was born on May 16^th. We wish them all the very best life has to offer!

New staff – We would like to welcome Veronica Macias to our clinical team of SLP’s! She is enduring our training program for several months, so we appreciate your support and patience as we train her DiagnosTEX style! J.

DiagnosTEX QA Results on 568 patients in a month – these are significant stats!

Method of Nutrition Recommended
- PO = 443
  - Liquid Recs: Thin = 268, Nectar = 105, Honey = 65, Pudding = 5
  - Diet recs: Regular = 173, MS = 107, Puree = 162
- NPO =121
Discharge Rate after MBSS = 60%
Documented Aspiration – 38%
- Of those that aspirated – documented Silent Aspiration = 80% (wow!)
Decrease in alternate means of feeding (NPO to PO) = 60% (YAY!)
Esophageal disorders identified = 45%
Strategies implemented and effective during PO = 38%

June 21^st is the first day of summerTexas Summers –They can be 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 all 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 during these hot days, if 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 and let us know if this is possible, we appreciate your understanding.

Scheduling pending studies in a new healthcare era

We have had many calls recently, as facilities are not getting their swallow studies scheduled as quickly as they would prefer and what they have experienced from us in the past. Due to a new healthcare era that has resulted in reimbursement cuts of at least 30%, in turn resulted in required budget changes for us. DiagnosTEX has had to make some organizational decisions to remain profitable and stable in a volatile healthcare environment. When we started 10 years ago, reimbursement was significantly different, government was different, and the healthcare provided to those who needed it was different………………. we operated differently. In addition to reimbursement changes, we now have electronic health records to contend with, requiring more documentation than ever before. The mobile operation remains an avenue that has not been recognized as its own entity by Medicare. We are considered no different than a free standing facility, therefore our cost of extra staff, maintenance on vehicles, fuel etc. are not considered in the reimbursement for our MBSS. Although our reimbursement has decreased annually, we have continued to provide this service at a lower cost to the facilities, much lower than transporting the patient out to the hospital but ambulance. We continue to petition Medicare about these issues today, but it is a slow process and will not happen overnight, like most governmental issues.

Saying all this, we need our customers to recognize, that although the service is still needed and still requested, our ability to get out to you in 24- 48 hours is no longer as easy or reasonable as it used to be. Not to say that we won’t get to your patients that quickly, but there is a high possibility once a study is sent in there may be a period of 1 week before it is scheduled. If the situation requires immediate attention, you may need to consider a hospital. Home health patients can always schedule with us at our Hurst office, to be seen at 8am or late in the afternoon, this would also eliminate their travel fee. Effective this year, we have reduced the number of our mobile clinics on the road in a day, as our vans can only operate to maximum efficiency if we schedule several studies geographically in a more condensed area.

As always we have a very difficult time meeting the needs of those who require a specific time, day and/or specific date, as we are unable to schedule in that manner being a mobile company. Such scheduling requires a free standing facility. Mobile is for the convenience of us coming to you and not having to schedule outside the facility or home that would require transportation to that location. We ask for your flexibility and understanding regarding scheduling that may exceed a 2-3 day wait, in this new era of healthcare. We will continue to provide the same quality as you have always expected from us.

There is an App for that !– ASHA Community Mobile App

From your mobile device, click on the appropriate link below or visit your app store and search “ASHA Community” and Download the ASHA Community Mobile App

Unique features of the ASHA Community Mobile App:

Convenient. Read all the latest discussions from your subscriptions in a single feed.
Seamless. Reply to discussions and post new discussions without pinch-to-zoom maneuvers.
Searchable. Find your colleagues in the directory and easily add them to your personal contacts. With a couple of taps on your screen, you can send an e-mail or make a phone call to another ASHA member.
Latest news. Find ASHA’s Twitter feed and the ASHA sphere blog directly in the app.

Visit community.asha.org/mobile to learn more about ASHA’s new mobile app. If you have app-related questions, e-mail community@asha.org.