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In This Issue
CMS Admission and Medical Review Criteria for Hospital Inpatient Services
As a condition of payment for hospital inpatient services under Medicare Part A, section 1814(a) of the Social Security Act requires physician certification of the medical necessity that such services be provided on an inpatient basis.  The order to admit as an inpatient is required for hospital inpatient coverage and payment under Part A.
 
Click here for more information.
 

CMS National Quality Measures for VTE and Stroke

Click here for details about the national quality measures for VTE.
 
Click here for details about the national quality measures for Stroke.

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September 2013
Greetings!

As editor of this newsletter, it is my goal to provide you with pertinent and timely information. We always appreciate your feeback in order to continually improve communications to our medical staff. 
  
Sincerely,
Regional Director of Medical Education
CHRISTUS Santa Rosa Health System
Jim Martin, MD
Message from the CMO 

 

As many of you know, CHRISTUS Santa Rosa has a set of goals on which it focuses each year. I thought that this would be good time to make sure that our Medical Staff is aware of these goals and how they will impact our medical care.

 

First, recognize that we must acknowledge the changing world of healthcare reform. We will all be accountable for our patients in settings beyond just our offices or in the hospital. To address this, we have a care transitions project, in which our admitting and attending physicians, case managers, and our partners in other health care locations (Medical Home, Nursing Home, Hospice, etc.) coordinate the transition of care through these various locations. We should be able to see more communication with case management, more efficiency in hospital care, and decreases in unnecessary hospital readmissions.

 

Read on

Mandatory Use of Electronic Signature
  silver-keyboard2.jpgCommencing October 1, 2013 mandatory electronic signature will be implemented at all CHRISTUS Santa Rosa (CSR) facilities, with the exception of the Children's Hospital of San Antonio.  

 

Click here for more information.
 
Click here for instructions on how to use Electronic Signature in Meditech.

 

 
Meet Our New COO

 

Ken Haynes joined CHRISTUS Santa Rosa Health System July 1 as the Chief Operating Officer for the Region. Ken was most recently with the Saint Joseph Health System in Lexington, Kentucky where he served as the President for three of the system's seven hospitals. 

 

We sat down with Ken to find out more about him, his goals, and areas of focus concerning the Medical Staff.

 

Q: Where did you grow up?

A: I grew up in Sylacauga, Alabama which is just south of Birmingham.

 

Q: Where did you go to college and graduate school?

A:  I went to the University of Alabama at Tuscaloosa for my undergraduate degree in Health Care Management with a concentration in Finance.  And then I received a Master of Science in Health Administration as well as an MBA, both from the University of Alabama at Birmingham.  I am currently a Fellow in the American College of Healthcare Executives.

 

Read on 

Superior Health Plan - STAR, CHIP, STAR PLUS, CHIP Perinate, STAR Foster Care, and Medicare Managed Care
  

After careful internal review and as a result of several non-productive discussions with Superior, CHRISTUS Santa Rosa Health Care has terminated its hospital services agreement with Superior Health Plan effective October 11, 2013. Over the past ten months, we have been in discussions with, and have come to agreement on new freestanding hospital rates for Children's with other Medicaid Managed Care Plans. The State of Texas has also recognized Children's as a freestanding children's facility as of September 2012 and increased the reimbursement rates for Children's comparable to those of other freestanding children's facilities in the state.  To date, we have made no progress with Superior Health Plan.

 

It is our intent to use all reasonable efforts to negotiate for a future contract with Superior to serve its Managed Medicaid members both at Children's and at our Adult facilities in San Antonio and New Braunfels. That said, our future rates and overall reimbursement must be comparable to other freestanding children's hospitals in the State of Texas if we are to continue participation with Superior Health Plan. It is our hope that we can negotiate a new agreement with Superior prior to October 11, 2013.  I will continue to notify you of any developments in this area.

 
Blood Utilization: Transfusion Criteria Clarified 
  
The CHRISTUS Santa Rosa Blood Utilization Committee uses the transfusion criteria recommended by the AABB (formerly the American Association of Blood Banks) for administration of packed red blood cells (RBC). These guidelines are based on randomized clinical trials (Ann Intern Med. 2012; 157:49-58). Other peer-reviewed articles have concluded that "compared with higher hemoglobin thresholds, a hemoglobin threshold of 7 or 8 g/dl is associated with fewer red cell units transfused without adverse associations with mortality, cardiac morbidity, functional recovery, or length of hospital stay" (JAMA. 2013; 309(1):83-4). 
 
In adult patients that are hemodynamically stable, RBC transfusion should be considered at hemoglobin concentrations of 7 g/dl or less. The AABB recommends a restrictive transfusion strategy and their guidelines are summarized as follows: 
  • In patients with hemoglobin concentrations of 8 g/dl or less, transfusion can be considered if:
    • The patient is postoperative (3 days)
    • The patient is symptomatic (chest pain, orthostatic hypotension, or tachycardia) unresponsive to fluid resuscitation
    • The patient has congestive heart failure
    • The patient has documented cardiovascular or cerebrovascular disease
  • Patients who are actively bleeding with acute blood loss of 20% of estimated blood volume or greater are appropriate for transfusion.
  • Patients with acute coronary syndrome should be considered for transfusion based on the clinical impression, regardless of the hemoglobin concentration.

Read on

Educational Activities

October CME Calendar
  

Educational Videos (not for CME credit)

For more information go to: www.christussantarosa.org/cme 


healthcare home for life

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Edited and Produced by: 
Jann Harrison, RN, MSN, Regional Director of Medical Education
CHRISTUS Santa Rosa Health System
210.704.3785/Email