May 2013 Newsletter


May 2013


Happy Mother’s Day to all mothers!

Happy Memorial Day!

Remember our men and women (including moms) that have sacrificed ALL

to fight and maintain our freedom!

Hug a Mom this month, whether it is yours or not!

                        Clinical Café Newsletter

By: Ronda Polansky M.S. CCC-SLP

Monthly motivator:

And I’m proud to be an American, where at least I know I’m free.
And I won’t forget the men who died, who gave that right to me. -Lee Greenwood

DiagnosTEX Holiday – Memorial Day – DiagnosTEX will not be operating vans on Monday May 27th, but will run all vans Tuesday through Friday that week.  Please keep this in mind when scheduling your MBSS around that time.  e have veterans working for DiagnosTEX.   We honor them, any others who have served, and those who are currently sacrificing for our freedom! We also remember those who paid the ultimate price for our country and our freedom today!  Thank you from the bottom of our hearts to all the veterans who served and are serving our county and everything we stand for! 


MAY is Better Speech and Hearing 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.

New!! Educational Handout for Patients and Their Families for Better Speech and Hearing Month – Be sure to get yours next time we see you!

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

May 6-10 National Nursing Awareness Week


E-Stim CEU Course – Saturday May 4, 2013 in Austin

Presented by AMPCARE, hosted by Professional Imaging

For more information email  or call 682-561-2444

Great seeing everyone at the Arlington E-Stim course on 4/13.  Thank you for all the great feedback!!!


CEUs DiagnosTEX is planning on hosting a spring CEU course in June, be looking for more information in next newsletter. You will be able to get you 2 hours of Ethics in this course!


2013 TALK WALK at NorthPark Center to Benefit People With Parkinson Disease – Dallas, TX – Dallas area nonprofit Parkinson Voice Project invites North Texas to help celebrate Better Speech and Hearing Month by participating in its 5th annual TALK WALK at NorthPark Center on May 4, 2013 from 9am to 1pm. Participants can register online at

What: 2013 TALK WALK

Where: NorthPark Center, 8687 N. Central Expressway Dallas, Texas 75225

When: Saturday, May 4, Registrants may arrive at any time between 9:00am & 12:30.

How: Call (469) 375-6500 or visit Admission is $30 for adults and $15 for children (13 and younger), “PledgeWalker” registrations are $10 and require a $100 fundraising commitment.

Why: To raise money and awareness for the treatment of speech and swallowing disorders in people with Parkinson disease and related disorders


DiagnosTEX Travel Fee of $25.00 per facility visit (not per patient) – DiagnosTEX prides itself in very affordable services for mobile dysphagia consultation including Modified Barium Swallow Studies. Despite recent changes in healthcare, DiagnosTEX remains below the average of national cost for Mobile MBSS in the USA, other states such as Massachusetts have Part A rates at $390 per patient.  Approximately 10 years ago, rates in the DFW area, for this service, were $275 per patient paid for by the facility. We are 50% below the Medicare allowable for this service.  We considered increasing our Part A rates above our current $190.00 but the travel fee allows the facility to share the cost with the patient. A cost for a patient going to the hospital including transportation is between $800.00 to $1100.00, the rate for an ambulance trip in DFW is anywhere from $15-$17 per mile (is you facility at least 2 miles from a hospital?), portable X-ray bills $265 travel fee per patient. We were recently contacted by a home health company stating it cost them close to $500 to send the patient to the hospital as an outpatient excluding transportation, 43% less than what we bill with the travel fee of $25.00. We contacted a local hospital in the area to confirm area cost and they quoted us the following; “The quote for outpatient regardless of med A, B or Insurance is $1024.57. Private pay receives 35% discount. “

DiagnosTEX is not comparable to any other service because we beat every other option available and the savings to the facilities is more than half the cost for the convenience of the procedure coming directly to the patient. Part A = $190.00 (+ travel fee) and Part B = $83.00-$88.00 depending on county + travel fee). Please share this information with your Administrators and those concerned with the cost.


Scheduling MBSS in a Timely Manner – In this new healthcare era, it is more cost effective for everyone to schedule and group appropriately, the same time management is how DiagnosTEX maintains cost effectiveness is our mobile operation.  We can usually schedule patients within 24-72 hours of a request, but this is not something we have never and cannot guarantee. Most of you are familiar with our successful efforts in completing that 24-72 hour response, and when that does not happen you feel service is not meeting expectations. We frequently have a 2 page pending list at the end of each day and the average response time for scheduling is 3 days (excluding weekends). At times this extends to 4 – 5 days. We contacted some local outpatient facilities for comparison,  and OP MBS scheduling is up to 2 weeks out. In comparison to the information we gathered, we are still meeting the patients need within a timely manner. There are often times SLP’s limit us in scheduling due to day of week or time of day and this only results in the study being placed back on the pending list and being delayed another couple days. Please know our heartfelt goal is to get to everyone in a timely manner, it benefits the patient, you as a therapist, as well as us!


DiagnosTEX QA – October 2012 – Summating averages over previous years of QA performed at DiagnosTEX 2003-2013, show many relevant and consistent trends have been identified. QA provides effective measurements to show the importance of an instrumental assessment in the evaluation and treatment of dysphagia.  Following up on patients and tracking trends assists in appraising the overall cost effectiveness this type of measurement provides to healthcare and rehab treatment.

We evaluated 684 patients in October and during this month we recommend: thin liquids on 316 patients, nectar on 121, honey on 44 and pudding ion 8. (More thin liquids than thickened liquids!! We always like that!)  Seventy-seven (77) patients were reported as receiving PO prior to MBSS and ultimately received an NPO recommendation. Fifty-three (53) of the 77 were silent aspirators. Out of the 684 patient, 235 aspirated and 204 of those were silent (84%)! This is significant!!!

We had 66% of the cases documented to have initiated PO that were previous NPO status. (YAY!!!)

During this month we also documented that 47% showed some esophageal involvement.

The MBSS shows a cost savings to healthcare on many levels, including ability to develop an appropriate treatment plan, improve discharge rates, reduction of alternate means of feeding and determining appropriate diets to reduce dysphagia risks.


 Conclusion summary of a few scientific posters and research presented at DRS 2013

  1. Effect of a Reclining Posture on Velopharyngeal Closing Pressure During Deglutition  – Enri Nakayama – Velopharyngeal closure was significantly affected (reduced) by a reclining posture. It was less noticeable with nectar but results indicate that a reclining posture and bolus viscosity effects VP closing pressure.
  2. Perceived Dysphagia and Swallowing Problems in Individuals with COPD – Sushma Santosham – 97.5% did not recognize their dysphagia and thin liquid proved more difficult in all COPD patients.
  3. Effect of Covering the Hard Palate on Food Bolus Formation and Compensatory Adaption Over time – Tomohide Sato, DDS – Covering the palate with full dentures prevented completion of bolus formation during mastication, but this did disappear over time (as the patient compensated)
  4. Effect of Dentures on Swallowing Function in the Edentulous Elderly – Hisanori Yamamoto, DDS – Edentulous status increased bolus size, increased premature loss, and increased delay. These effects worsened with age.  Dentition improved swallowing on all patients.
  5. Impact of Nasogastric Tubes on Swallowing Physiology in Older, Healthy Volunteers: A Randomized Controlled Trail – Pryor Lee, Ward, L., Conwell, P., O’Connor S., Finnis M., Chapman M., – Conclusion: Findings support that NGT presence can increase penetration-aspiration, pharyngeal duration and residue in older health individuals (15 subjects ranging from 60-80 yo, evaluated by 2 MBSS with liquid trails, puree, and solid).


Increase Swallowing Disorder (Dysphagia) Research — Support this Petition to the National Institute of Health (NIH).