September 2014 newsletter


September 2014

Clinical Café Newsletter

By: Ronda Polansky M.S. CCC-SLP

With Great Respect,

We pay tribute to the creation of our nation’s strength, freedom and leadership….

The American Workers!!!

Back to school time for our kids!

We are closer to Fall! September 23rd is the first day of Fall!



Upcoming HolidayDiagnosTEX will be closed on Labor Day, Monday September 1, 2013. 

Please consider this when scheduling your studies. We will operate Tuesday – Friday that week.

What are we celebrating? A day off?? Yes!!  But also, 146 million people 16 years and older in the nation’s labor force in June 2014.  Source: U.S. Bureau of Labor Statistics


Parkinson’s Voice Project – SING OUT! A Voice Revolution

Saturday, September 13, 2014 – 2:00 P.M.
A family-fun performance by The LOUD Crowd. Enjoy 1960s music, along with the endearing antics of Lamb Chop and Mallory Lewis, the daughter of Shari Lewis, who first introduced the charming sock puppet. FOR RESERVATIONS CALL 469-375-6500


Dates to remember in September:

Did you know that September 22 is Family Day?  A day to eat dinner with your children.

National Grandparent’s Day –

National Women’s Health and Fitness Day –

National Assisted Living Week –

National Rehabilitation Awareness Week –

Healthy Aging Month –

Alzheimer’s Memory Walk (September-November) –  I will be walking this October in Grapevine! If anyone would like to donate to my walk, I would appreciate your support to help to end this terrible disease, as we all are up close and personal with this professionally and some of us personally. Please go to the website and donate to the team “Heels of Hope”.   Thank you



Observers during a MBSS on the mobile clinic – DiagnosTEX chooses to be flexible in allowing observers (professionals, families etc) on the mobile clinic during our exams.  This is not a TX state requirement and policy is left completely up to us as a  facility/company.  As a company we have the option to not allow observers to attend the procedure, as this is no different than a radiological suite at the hospital.  We do limit the number of observers in excess of 2-4, as well as we expect appropriate and professional behavior. The patient must also be in agreement with allowing the observers to be on board.  At no time, does anyone observing the procedure approach the therapist or the patient during the study without prior approval or invitation. The entire study is being recorded visually and on audio for the medical record.  Vocal interpretation of the study, during the procedure, should be completed by the evaluating SLP of DiagnosTEX and not the observing therapist, staff and/or family members in the background, as this distorts the audio recording.  Any education with the family can be done after the study is completed or back in the facility when we provide you with a copy of the DVD to review with them.  Any staff of DiagnosTEX has the right to ask anyone to leave the van or terminate the study if any situation interferes with the procedure being completed in a quality manner or if anyone becomes verbally abusive or a threat of any kind to any of the staff or the patient.  We fully expect the treating SLP to have already evaluated family dynamics, each individual person they are accompanying on the clinic, and have educated them on the procedure and standard protocol for observing.  Please understand we have a job to do as well and we want to do a quality job in an ideal diagnostic environment. If you have any questions, comments or concerns, please feel free to contact us.  Thank you in advance for your understanding and help with this.


DENIALS  – MC and healthplans are denying coverage when medical needs exist BUT patients fail to make reasonable progress due to poor follow through or attention to medical advice and this absolutely includes AMA DIETS and multiple repeat studies after months of treatment. Although it is their right to sign an AMA, it does not avoid denial of additional evaluations or treatment. They also have the option of a repeat study if they are willing to pay out of pocket for the services, if coverage is denied.

Plans are denying services for patients that have reached their functional potential although deficits still exist. We value the information that you provide us. Value your medical record as much as your direct exam and direct treatment of the patient. It is our job as treating therapists to dig through the chart paperwork, old and new, for any and all clues. To have a dysphagia you must have a dysphagia right?  Determine which came first the illness or the dysphagia. HTN is absolutely not a good supporting diagnosis for dysphagia and should not be the only diagnosis listed on the paperwork sent in for an MBSS. Find information and diagnosis that supports medical necessity for doing an MBSS and then please document it clearly on the paperwork. Repeat studies must have documentation to support the medical necessity of it, or it will be audited and high risk for denial.

When requesting a study, please fax in most recent H& P with all of the other paperwork.  The consult form is also required to be filled out in its entirety, as this is your documentation as the treating therapist as to why you feel this study is necessary. Your name and paperwork (consult form) goes in with any and all audits and the information you provide will be a closely securitized as our reports.


Dysphagia Tidbit – Types of Pneumonia

Understanding the types of pneumonia is a good start to an evaluation and very beneficial in your bedside swallow evaluation:

  1. Dysphagia related pneumonia – recurrent pneumonia may be ongoing due to aspiration
  2. Non-dysphagia related pneumonia – if no hx of dysphagia check hx for  reflux and use of acid suppression treatment, chemical irritants, allergens, vomiting episodes recently
  3. Hospital acquired pneumonia – pathogens, infections from the institution admitted to
  4. Ventilator acquired pneumonia – usually widespread infiltrates, strong correlation with oral pathogens
  5. Community acquire pneumonia – diffuse infiltrates and not in dependent lobes