Week 1-3 Flashcards
1
Q
Acute care frequency of care
A
15 - 30 mins daily as needed
2
Q
Type of patient in acute care
A
Medically ill/ unstable/ newly diagnosed
- Dysphagia
- Speech, language, cognitive-linguistic disorders from stroke
- Head injury
- Respiratory issues
- Other medical complications
3
Q
Acute care: how services are provided / what is our role
A
- Need written order from physician
- SLP might be consultant
- Evaluate and diagnose communication / swallow disorders
- Provide treatment
- Educate/counsel patient and family
4
Q
Acute rehab: what is our role
A
- Referral from physician to evaluate
- Order from physician to treat
5
Q
Acute rehab: type of patient
A
- Dysphagia
- Speech language / cognitive linguistic impairments due to stroke
- Head injury
- Other neurological disorders
6
Q
Acute rehab: frequency of services
A
- Generally 5 - 7 times per week for 60 mins
- 3 hours of therapy per day (SLP, OT, PT)
- (if only OT and SLP needed must provide 1.5 hours)
- Must make up minutes if cut short
7
Q
Acute rehab: when and how are services provided
A
- Individual and group
- Conduct functional evaluations and set functional goals
- Might have to work weekends
- SLPA’s can be used
- Possible co-tx
8
Q
Acute rehab collaboration pieces
A
- Weekly team meetings to discuss patient treatment and length of stay
- Accountability (fill out Functional Independence Measure)
9
Q
Home health: who is the patient, amount of services, role of SLP
A
- Medically stable to return home
- 2 times a week 1 hour
- evaluate and treat in person’s home setting (educating caregivers)
10
Q
Outpatient: patient, amount of services/type, setting
A
- Medically stable to return home
- 1 to 2 times a week 45 - 60 minutes individual
- Hospital or medical facility
11
Q
SNF: patient, amount of service/type
A
- Person who cannot return home after rehab, older, increased cultural diversity, medical acuity / severity, complexity of resident diagnoses, focus on dysphagia management
- 3-5 times a week 30 - 60 min individual
12
Q
Long-term care: patient, services
A
- Cannot return home after SNF, older, increased cultural diversity, medical acuity / severity, complexity of resident diagnoses,
- Focus on dysphagia management
- 3 to 5 times a week 45 - 60 mins
13
Q
Medicare Part A coverage
A
- Hospital inpatient, SNF, hospice and some home health
- Don’t pay premium, cost based system
14
Q
Medicare Part B coverage
A
- Doctor’s services, outpatient health care and therapy
- Pay a premium: optional enrollment
15
Q
Medicaid eligibility
A
- For families with low income/resources
- Pregnant women
- Children or teens
- Person who is aged, blind and or disable
- Other situations (e.g. high medical bills)
16
Q
Medicare eligibility
A
- 10 years of work (40 quarters)
- 65+
- Some under 65 with disabilities
- People with end-stage renal disease (require dialysis or transplant)
17
Q
Why did they need to change the medicare system in the 90’s / what came next?
A
- People were giving/billing for services that were not needed
- There was no cap to what could be reimbursed
- People were living longer and more people were in SNF
- Less intergenerational living
- PPS came next
18
Q
What is PPS
A
- Prospective Payment System
- System based on predetermined payment rates for outpatient services, inpatient rehabilitation, medicare fee schedule to long-term care facilities
19
Q
PPS payment system
A
- Patient placed into “category” based on diagnosis
- Payment determined by category
- Payment is based on what they expect costs to be associated with recovery / therapy for that particular diagnosis
20
Q
Issues with PPS
A
- Cherry pick patients based on who is going to make the facility money
- Place each patient into a category based on diagnosis
- Make or lose money depending on whether the cost goes over or under reimbursement amount
21
Q
What is PDPM
A
- Patient Driven Payment Model
- Payment system only for SNF
22
Q
PDPM qualifying factors
A
- Primary diagnosis, cognitive impairment, a diet or swallow disorder, and/or need for mechanically altered diet
- More qualified = more money
- Can provide little services in the beginning and more later on
23
Q
Key points about documentation and goal writing
A
- Document services you provide, education given, etc.
- Documentation has to include how they are progressing
- Goals/treatment needs to be dynamic and continuously reevaluating
- Goals need to be clear so that someone else can provide same treatment
- Documentation needs to be done in a timely manner (varies depending on setting)
24
Q
Ways to help clients with low health literacy (written)
A
- Use short sentences
- Write in active voice
- Include little to no jargon
- Emphasize key points with headings
- Chunk information
- Bullet points
- Picture graphics
25
Q
Ways to help clients with low health literacy (verbal)
A
- Slow speech / take time to talk to patient/family
- Use plain language
- Use pictures
- Give small amounts of info and repeat it
- Use “teach back” method
- Encourage questions
26
Q
Vulnerable populations for health disparities / low health literacy
A
- Race/ethnicity
- Low SES (educational attainment correlates to health literacy)
- Location: urban vs. rural vs. suburban
- Sex/gender/sexual identity
- Incarcerated populations: men and women
27
Q
What is the WHO-ICF framework?
A
- International Classification of Functioning
- Body structure/function (impairment)
- Activities (limitations)
- Participation (restrictions)
- Environment (barriers)
- Personal factors
28
Q
PPOs
A
- Preferred Provider Organization
- More expensive than HMO
- Out of pocket cost higher
- Higher co-pays/deductibles
- Choose provider in or out of network
29
Q
HMOs
A
- Health Maintenance Organizations
- low/moderate price healthcare
- Pay monthly premium; low co-pays
- Control cost by controlling healthcare access
- Can only see approved doctors
- Covers preventative care
30
Q
HMO and PPO impact on SLP services
A
- Length of stay: payment for hospitalization length of stay restricted
- Payment for rehab limited to certain # of sessions
- Not necessarily based upon need of patient
- HMO restricts where you can receive services
31
Q
Fee for service
A
- Unlimited choice of service providers
- Pay higher monthly premium + deductible before insurance begins to contribute to care
- Basic coverage = cost of visit, hospitalizations, surgery
- Pay upfront then file for reimbursement
32
Q
ICD-10 codes
A
- International Classification of Disease
- Have primary diagnosis (ALS, Huntington’s or Alzheimer’s)
- Have secondary diagnosis (ex. primary = dementia secondary = cog impairment or dysphagia)
33
Q
CPT codes
A
- Common Procedural Technology codes
- Change frequently must check ASHA
- Used to make sure people are billing in the same way
- Bill in units (1 = 8 - 23mins, 2 = 23 - 38mins)
