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CMW Sneak Peek: Prepare for POA

Case Management Weekly, September 17, 2008

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$23,772: That’s the projected average annual loss per hospital starting October 1, when Medicare stops reimbursing hospitals for eight types of medical errors, according to a recent study by Thompson Publishing.

CMS launched a nationwide effort to prevent hospital-acquired conditions (HAC) in October 2007, requiring hospitals to report whether predetermined conditions were present at the time of a patient’s admission. Although facilities have had one year to correct any flaws, the pressure to report accurately on these diagnoses increases October 1, when Medicare will no longer reimburse a higher-paying MS-DRG if a selected HAC was not present on admission (POA).

“The focus has been on other departments, but the reality is that case management needs to be on top of every admission to ensure accurate reporting,” says Randi Ferrare, RN, BSN, MHA, MEd, president of Optima Healthcare Consulting, LLC, in Belleaire Bluffs, FL. “They are the ones that follow the patients—in one aspect or another—from admission to discharge concurrently ... Getting physicians to document if a condition was present on admission after the fact is almost impossible, and the risk associated with this is substantial.”

Check out the September 2008 issue of Case Management Monthly to get the full story, and check out all the benefits of being a Case Management Monthly subscriber!

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