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Hospitals hustle to train staff to document conditions present on admission

Quality Improvement Monitor, September 7, 2007

Hospitals should start training staff now to assess and document conditions present on admission to comply with CMS' final inpatient prospective payment system (IPPS) rule-an edict that has some in the healthcare industry howling and others pleading with the agency for more time.

"There's going to be a huge amount of training and learning," says Don May, vice president of policy for the American Hospital Association (AHA). "Hospitals aren't ready for it."

The rule says that beginning October 1, 2008, CMS will not pay for the following eight conditions unless they are documented as present on admission:

  • Serious preventable event -- object left in surgery
  • Serious preventable event -- air embolism
  • Serious preventable event -- blood incompatibility
  • Catheter-associated urinary tract infections
  • Pressure ulcers
  • Vascular catheter-associated infection
  • Surgical site infection -- mediastinitis after coronary artery bypass graft surgery
  • Patient falls

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