SACPR | Annual Spring Conference
DCH Regional Medical Center - Tuscaloosa, AL
Friday, April 6th, 2018
| 2018 SACPR Conference Panel Q & A |
2018 SACPR Conference Panel Discussion
Q: If a Medicare patient takes a 90-day summer vacation, comes back to complete 12 remaining sessions. Is this allowable?
A: Yes, they have 36 weeks to complete the program
A: Yes, they have 36 weeks to complete the program
Q: Does Medicare cover mitral clip and valvuloplasty procedure for Cardiac Rehab?
A: Yes, Medicare covers for valve repair
A: Yes, Medicare covers for valve repair
Q: When do you discharge patients that stop coming to CR?
A: Every program is slightly different. You should create a discharge policy that speaks to discharge/drop outs and follow this. Many programs give patients 2 weeks, attempt to contact them via phone a couple of times and drop them out after no response.
A: Every program is slightly different. You should create a discharge policy that speaks to discharge/drop outs and follow this. Many programs give patients 2 weeks, attempt to contact them via phone a couple of times and drop them out after no response.
Q: What are the Medicare requirements for someone to repeat CR with diagnosis of CHF: exacerbation? re-hospitalization?
A: The answer from the group & audience was if there is a new exacerbation, the patient qualifies for another program
A: The answer from the group & audience was if there is a new exacerbation, the patient qualifies for another program
Q: What are the legal (HIPPA) regulations regarding Registry?
A: Registry subscribers have access only to their program’s patient information and to aggregated data from the registry as a whole. Subscribers are not able to access or view other programs’ data. AACVPR-approved non-subscribers, such as researchers, have access only to aggregated and/or de-identified registry data. The data will be de-identified with respect to patient and program identifiers unless specifically permitted by the participating programs and required by the researcher. Hospital systems with multiple participating programs may request files of de-identified patient data from all programs within their system. In addition, registry subscribers and AACVPR sign a Participation Agreement for limited data use giving AACVPR access to patient-specific information. AACVPR may use this information to provide reports of national outcomes and trends and to track morbidity and mortality rates. (Read more about the Participation Agreement.)
A: Registry subscribers have access only to their program’s patient information and to aggregated data from the registry as a whole. Subscribers are not able to access or view other programs’ data. AACVPR-approved non-subscribers, such as researchers, have access only to aggregated and/or de-identified registry data. The data will be de-identified with respect to patient and program identifiers unless specifically permitted by the participating programs and required by the researcher. Hospital systems with multiple participating programs may request files of de-identified patient data from all programs within their system. In addition, registry subscribers and AACVPR sign a Participation Agreement for limited data use giving AACVPR access to patient-specific information. AACVPR may use this information to provide reports of national outcomes and trends and to track morbidity and mortality rates. (Read more about the Participation Agreement.)
Q: How can tobacco status area be improved on the Registry? EX: Patient never smoked but dips. What is the best way to accurately note this?
A: You can document the tobacco status by saying current or former. There is a section for “years using oral tobacco” and then document your intervention. Also, if you want to ask registry a question or request a new feature/ report a bug, press the enter button after an entry and you will be directed to a “Provide Feedback” pop-up.
A: You can document the tobacco status by saying current or former. There is a section for “years using oral tobacco” and then document your intervention. Also, if you want to ask registry a question or request a new feature/ report a bug, press the enter button after an entry and you will be directed to a “Provide Feedback” pop-up.
Q: Is “referral to specialist” the appropriate option to select when patient is given a quit-line 1-800 # card.
A: Under the AACVPR Registry Definitions the “Referral to Specialist” is a referral to a tobacco treatment program or specialist outside of the CR program. For the AlabamaQuitnow.com program, a healthcare provider can refer a patient to the program either online or fax a referral (after a paper form has been signed by the patient). This would be considered a referral to specialist. If you are giving them a card to act on themselves, this would be considered counseling.
A: Under the AACVPR Registry Definitions the “Referral to Specialist” is a referral to a tobacco treatment program or specialist outside of the CR program. For the AlabamaQuitnow.com program, a healthcare provider can refer a patient to the program either online or fax a referral (after a paper form has been signed by the patient). This would be considered a referral to specialist. If you are giving them a card to act on themselves, this would be considered counseling.
Q: Patient admitted, attended one session, called to say he wouldn’t be back. Do you do 1 ITP or 2?
A: We do the initial ITP, and then it immediately starts the next page of the ITP, so the note about patient calling and not coming back would be on the 2nd page. – Jeanne Carlson
A: We (EAMC) complete the initial ITP on admission, then also complete a d/c ITP when the patient called stating they are not returning.—Jennifer Murphy
A: We do the initial ITP, and then it immediately starts the next page of the ITP, so the note about patient calling and not coming back would be on the 2nd page. – Jeanne Carlson
A: We (EAMC) complete the initial ITP on admission, then also complete a d/c ITP when the patient called stating they are not returning.—Jennifer Murphy
Q: If a patient is unable to increase HR secondary to age/ability………when to discharge from program?
A: As an EP I look at more than just their HR in regards to discharge. You also need to look at how the patient is mentally and physically progressing, BP trends, etc. - Samuel Sneed
A: HR as the end-all indicator of anything! Discharge is dependent on patient goals, program goals, risk factor modification, time is up…… so many things. – Jeanne Carlson
A: As an EP I look at more than just their HR in regards to discharge. You also need to look at how the patient is mentally and physically progressing, BP trends, etc. - Samuel Sneed
A: HR as the end-all indicator of anything! Discharge is dependent on patient goals, program goals, risk factor modification, time is up…… so many things. – Jeanne Carlson
Q: In Registry: For Comorbidities area, how is “actively managed” defined? Meds or MD follow-ups?
A: Here is the Registry definition so either would apply: Select any comorbid conditions for which the patient is currently being treated. A past history of cancer that is in remission or has been surgically removed would not be included.
A: Here is the Registry definition so either would apply: Select any comorbid conditions for which the patient is currently being treated. A past history of cancer that is in remission or has been surgically removed would not be included.
Q: In Registry: For Diagnosis of COPD, CHF, stable angina; what is the best event date? Do we find first possible or most recent visit when dx is noted?
A: From the definitions page:
Enter the date of the hospital admission. For patients who are referred to CR with stable exertional angina or heart failure and who were NOT hospitalized, enter the date of the physician consult that prompted the referral.
A: From the definitions page:
Enter the date of the hospital admission. For patients who are referred to CR with stable exertional angina or heart failure and who were NOT hospitalized, enter the date of the physician consult that prompted the referral.
Q: In Registry: For Heart Failure as CV history…..any instance noted (check box in CV history)?
A: Yes, check for any history of any heart failure
A: Yes, check for any history of any heart failure
Q: In Registry: For Heart Failure Status (DHF, SHF, combined) should this be selected on everyone with acute history or diagnosed CHF (Primary Dx) patients?
A: Should be selected for either of these reasons
A: Should be selected for either of these reasons
Q: In Registry: Dementia as a condition on info page is described as such & “other organic psychotic condition”. Does this include bipolar and schizophrenia?
A: I would think you would be safe putting bipolar and schizophrenia under other psychotic condition. - Samuel Sneed
A: I would think you would be safe putting bipolar and schizophrenia under other psychotic condition. - Samuel Sneed
Q: In Registry, should we include EF on every patient listed on HF page or should we use HF page for patients with primary dx only?
A: Looking through the Registry resources, I saw no clear answer to this but in my facility I use this for primary diagnosis only.
A: Looking through the Registry resources, I saw no clear answer to this but in my facility I use this for primary diagnosis only.