Jim "Smuz" Smerczynski is an Analytics and Statistics Consultant at Harmony Healthcare International (HHI). In his role at HHI, Smuz designs databases and establishes protocols for collecting and analyzing vast amounts of data pertinent to patient length of stay in Healthcare Facilities.
Prior to joining HHI, Smuz worked for 40 years as a Radar Systems Engineer at Raytheon Integrated
Defense Systems. Smuz received his Masters of Science in Electrical Engineering at Yale University.
Length of Stay,
Clinically Appropriate Stay
Today, we are going to be talking about length of stay. One of the major challenges when looking at the length of a therapy program is working with the patient to get them to understand that if they stay a little longer they will get a lot stronger. One of the key factors in setting goals and making sure the patient is going to return safely to their discharge environment is the home visit, but The home visit often can take up to three hours even longer and we just don’t have that kind of time within our departments. So, one of the suggestions that we have been using within our facilities is to utilize a home inventory check list. You can discuss this with the patient you can also bring the family in. Maybe the family can take pictures as well to give the therapist an idea of how the home environment is. Getting an idea of if there is a pet at home or how the cabinets are setup, if the patient is going to need to be bending significantly or reaching over head a significant amount of time can be really helpful in setting up your treatment sessions to make sure the patient is able to repeatedly do some of these tasks that they will be expected to do once they are transferred home from the Skilled Nursing Facility.
Length of Stay
Medicare Length of Stay: Harmony collects length of stay data for our clients. This information is a valuable tool for further analyzing Medicare revenue and rate trends. Some facilities have a brief Medicare length of stay. The intensity of programs offered soon after admission may not be realized with the limited length of stay. For example:
Length of Stay,
Medicare Length of Stay
Increase your Medicare Part A Revenue
There are numerous ways to increase your Medicare Part A Revenue Medicare Part A Rate. Here are a few suggestions for increasing your facility's Medicare Part A Revenue:
Medicare Part A,
Length of Stay,
MANAGING LENGTH OF STAY
Case management by the rehab staff is one of the primary factors effecting Medicare length of stay. Generally, when a patient is admitted for short term rehab their underlying medical conditions stabilizes before they have reached their functional potential. Therefore, although Harmony always teaches that nursing anchors all Medicare Part A skilled admissions, there are instances when the Rehab Department is the driving force behind the patients discharge plan.
Medicare supports providing rehab services to help the patient achieve their prior level of function. This should be thoroughly investigated and considered when discussing the patient's potential discharge and Medicare length of stay. The following is a brief list of questions to consider before taking a patient off therapy:
Is the patient going home with an assistive device they did not previously use? Does the patient have the potential to progress to a less restrictive device?
Are we asking caregivers to assist the patient with any of their ADL or IADL tasks that the patient was able to do before? Does the patient have the potential to do these tasks on their own with further training?
If the patient is returning to an assisted living facility, did the patient utilize all of their services before or will they be using services that they previously did not? Do they have the potential to resume their prior routine?
Even though the patient has assistance available (ALF, spouse, etc.) do they want to rely on their caregiver or are there activities the patient would like to be able to do on their own?
Does the patient enjoy making their bed every morning?
Would the patient prefer if other people did not wash their undergarments?
Does the patient like to make their own afternoon tea?
If yes is the answer to any of these questions it is clinically appropriate to investigate continuing the therapy program and further progress the patient to their highest functional ability. It is important to update the therapy plan of care to include new goals specific to these higher functioning tasks and ensure that it documented that these goals directly relate to the patient's prior level of function and appropriate Medicare length of say.
Length of Stay,
Rehab Case Management