TRUE OR FALSE
NURSING IS THE ONLY DISCIPLINE THAT REPORTS TO THE CM?
FALSE!
ALL CLINICAL FIELD ASSOCIATES REPORT TO THE CM.
100
Name two areas of the QRS team?
scrubbing and locking, education and coaching
100
Who oversees daily productivity?
Clinical managers/scheduler teams
100
What is the MV report and what should that tell us?
1- how many MV per week per month
2. sending in appropriate MV or reschedule request
3. Trends with specific clinicians
4. Why down coding may be a concern and that we may not be following our MV protocol
100
What is our process if a MV is sent in on a Tuesday?
If a MV is sent in before Friday it will show up as a MV even if we are able to make up the visit. Mon- Thurs scheduler notifications should be sent in to re-schedule the pt.
When this occurs we coach our associates that day to ensure we have a clean MV report each month.
200
WHO RUNS THE DAILY FLASH CALL AND WHAT IS ITS PURPOSE?
CM/SCHEDULERS
identify late paperwork submission
high acuity/complex patients
schedules/overlaps
important messages
potential missed visits
point care updates
200
How are we to document case conference and why is it so important
Interdisciplinary case conference is a condition or participation. Upon survey- the survey team will be reviewing how well we document the status of the pt. in region 3 & 4 ..the CM opens the case conf coordination note with what type and who attended. Each discipline is expected during or right after to document their assessment. CM will copy and paste into body of CF coordination note.
200
What should our CM's do before use of PRN or contract staff?
Ensure all FT associates are meeting productivity, working with all teams to look at areas to keep FT associates productive.
200
What is the Therapy Utilization report and how do we utilize it?
Pulling the TU report will highlight visits scheduled , visits missed and utilization to assessment. This is a great tool to review to ensure our assessments are at par with our freq.
200
What report should we pull if we want to assess time spent in the home? What are we seeing when there is much time spent outside of the treatment on documentation..what is that telling us and what should we do?
visit time audit report?
Point of service documentation is not being completed. If you are see a trend with clinicians- reach out to learn about why, support and coach to provide point of service documentation
300
WHO RUNS CASE CONFERENCE? REVIEW CASE CONFERENCE IN DETAIL WITH A MIN OF 5 EXPECTATIONS
What is the CM.
- discuss pt's up for recert
- discuss discharges and goals met
- discuss wound pt's weekly
- document case conference in the pt's chart
- discuss new SOC r/t disciplines, frequencies and pt needs
- discuss high acuity/utilization pt's
300
What is the stop before you lock process? How is this done in your agency?
A quality review of the assessment of our Oasis before we lock to ensure we have captured the true needs of the pt.
300
What is the responsibility of the clinician to ensure they are meeting productivity?
-turning their schedules in on time
- calling the pts the night before to remind them of their visits
- look at modifying daily schedule if MV occur
300
What is the Dashboard and why do we look at it? What other reports are given weekly that work in conjunction with the Dashboard to ensure we are proactive vs reactive?
bonus 200 points- What does GO BLUE mean?
Looking at the dashboard give us a quick review of where we are month to date as it relates to budgets episodes and HHRG.
Daily HHR tracker
Run rate report
300
When should therapists complete the Key Functional Sheet?
What is at all Oasis time points, evaluations and discharge
400
What needs to happen to have a clean close? Who manages the process?
All episodes need to be in the revenue recognized stage. DCS/QRS/CM work with the teams to ensure everything is in that is needed to recognize revenue.
400
When assessments do not match amongst disciplines what is our process? Name at least three items
1.Call interdisciplinary team to learn more about the pt.
2. Learn how the associate interprets how to answer the MOO question
3. have a true interdisciplinary discussion with treating clinicians
400
-What is a Missed Visit? When do they occur? What is our process?
EOB Fri or Sat
- MV note completed, dr. notified, and orders requested
400
What report is pulled each morning prior to flash and what do we do with it?
what is our expectation surrounding this report- clinicians.
The agent summary report- review for outstanding/late documentation.
24/48 hours
400
What is Region 3 & 4's expectation on SOC as it relates to high risk pts?
Same day Start or SOC within 24 hours
Added to High risk call list
Flagged SOC for Case conf- front loading visits
Multi discipline
500
Who runs case conference? How often, who attends and what is the expectation of our field clinicians?
CM's, weekly, all R's, be on time, come prepared, document their pt status in the coordination note that represents case conf discussion.
500
What drives utilization? If the HHRG does not match frequency...do we modify visits to fit the HHRG?
Clinical Need ONLY
NO. We reach out to our teams and learn about why. We then review the clinical scoring as it relates to the pts status and goals. Great opportunity to provide education.
500
How do we manage and prepare for meeting productivity?
clinician schedules
projections completed
CM first review, DCS then GM final (must approve contract)
Monday quick look back
500
What is the PAR report, why is it sent out and what is the expectations surrounding this report.
Be specific
TIM will be the judge for thumbs or down
500
T/F
The FTF and POC can be signed by 2 different physicians?
What is True as long as the FTF physician documents that care coordination took place and identifies the physician by name.