»» Welcome everyone here, especially those who have joined us in the room and trekked
up here to Dallas, and those who also are joining us via the web.
I'm not sure my presentation is going to be quite as exciting as what we just did.
But hopefully you'll learn something to take away little tidbits.
So the acronyms that are used that I'll be referring to this time are acronyms you are
surely familiar with LTCH, long-term care hospital.
The Data Set, the LTCH CARE Data Set.
Maybe not so familiar, the Social Security Number Removal Initiative, which is going
to take place beginning in April of 2018.
It will be more information about that following, in the following presentations.
And then the Spontaneous Breathing Trial, which is part of our new Ventilator Measure,
that is also going to be discussed later in the presentation.
The objectives today in my presentation are just to give you a summary of some of the
changes, nuances, additions and/or omissions from the CARE Data Set.
Some of these changes are by the sections as you can see.
N will have our new Drug Regimen Review section.
That will be following my presentation with Carole Schwartz.
Section A deals with Administration A, few changes there.
I are Active Diagnoses.
GG of course are Function.
Section M with our Skin Integrity and then Section O which includes our Ventilator Liberation
Measure and also some of our influenza.
The Administration section, we have a few items that have been omitted from that.
As you can see the 2500, and 2510, and 2525 which are interrupted stays.
So they all will be removed in the new v4.00 of the CARE Data Set.
Also what I just briefly talked about in the Social Security Number Removal Initiative
we'll be introducing the MBI or the Medicaid Beneficiary Indicator, which again will take
place beginning in April 1, 2018 through December 9th of 2019.
And more information about that will be presented later.
Section B is our Hearing, Speech and Vision.
And there's only one change to that.
That's kind of a clarification.
So when we have understanding verbal, we're now adding "non-verbal language" to that.
So B0800 you'll see that it says verbal and now non-verbal content.
So beginning Section GG, probably one of the most lovely sections and loved sections that
we have.
We're adding a new activity to that section.
So when you're coding your self-care and mobility items, we do have 07 that you're familiar
with, with patient refused or your 09 with not applicable.
So now we're adding code 10, not attempted due to environmental limitations.
And we also are keeping 88 which is not attempted due to medical conditions or safety issues.
We also are removing some of these gateway questions on the admission and discharge for
does the patient walk.
They will be removed from that section.
And also there will be a skip pattern added for if the patient doesn't walk 10 feet.
Then you'll just skip on to the next section as opposed to -- if they can't walk 10 feet
they won't be able to walk 50 feet this time.
So we're skipping out of that.
In GG we're adding some clarification for and/or.
So when you're asked the question, wheelchair and/or scooter, there's just more clarification
on that.
And/or, again in the following sections, GG0170SS1 and the following is for your wheelchair or
scooter.
The next section is Section I that's your Active Diagnoses.
For that we just have separated the metastatic cancer and the severe cancer.
They used to be combined in one now we have them broken out.
We also have with some of the heart functions, the neurological functions.
And we've listed out the various transplants that might be appropriate or coded.
This slide just gives you a demonstration of how the severe metastatic cancers have
now been broken out into two separate codes.
Section M, another famous section are Skin Conditions for pressure ulcer.
We're using the term "injuries" which may be applied to the sections where it says,
"report based on highest stage existing ulcers/injuries."
So that will be added to all of those data elements that when we asked ulcers, it will
now say "/injuries".
That's just for better clarification.
They'll be added to all the M0300 data elements.
We also are removing the terms "suspected deep tissue injury and evolution" and replacing
it with a simpler term, "deep tissue injury."
It will be applied to the admission and the planned discharge for M0300G and M0300G1.
The last of the -- maybe not last, but Section M, still we're adding improved clarity, device,
which was added "non-removable dressing and device."
So that again is for more clarity.
If someone has a cast, if someone has a brace, that will be a little more applicable as opposed
to just a non-removal dressing.
So that's also been added to your M0300 series.
Also in Section M, we have removed M0800 series A-F which was on your planned and Discharge
Assessments.
So all of those elements will be removed from v4.00 of the LTCH CARE Data Set.
Section N is our new section, it's Medications.
And that's our Drug Regimen Review.
As you can see, we have two data elements that are added on the admission, Drug Regimen
Review and the Medication Follow-Up.
Then on the planned discharge, unplanned discharge and expired, we have the medication intervention.
And Carole Schwartz will be going over that in more detail.
Section O, Special Treatments, Procedures and programs.
We have added the IV medications on the admission.
We also have Spontaneous Breathing Trial, which is part of our new Ventilator measure.
That will be on admission.
And then the liberation rate which will be applied to the planned and the unplanned discharge.
We also have the removal of the invasive mechanical ventilator weaning and non-weaning items on
the item CARE Data Set in v4.00.
Also in Section O for Special Treatments, the influenza data elements as we want to
state, there really hasn't been any changes to that.
So they'll all remain the same.
Unchanged sections here are C, J, K, H, And Z.
So what was on v3.00 will also be present on the new data set v4.00.
So in summary, we just have the new sections.
Section N, which is your Drug Regimen Review.
Section A, your Administrative with just a few changes in there, some removals and some
adding.
Section GG, Function.
Section I, our Active Diagnoses.
Section M is your Skin Integrity.
The O is the Special Treatments, which is our new treatment ventilator liberation.
And that is it for me today to give a brief overview.
Following, we have much more detail on everything I just covered.
And I will welcome Carole Schwartz.