THE ROLE OF THE THE ROLE OF THE RESPIRATORY THERAPIST IN A RESPIRATORY THERAPIST IN A

HOSPITAL BASED HME HOSPITAL BASED HME COMPANYCOMPANY

DIANNE L. LEWIS, MS,RRT,FAARCDIANNE L. LEWIS, MS,RRT,FAARC

HOSPITAL LIAISONHOSPITAL LIAISON

NCH HOME MEDICALNCH HOME MEDICAL

JOB DESCRIPTIONJOB DESCRIPTION

• ……the Hospital Liaison will independently the Hospital Liaison will independently assess, coordinate and facilitate the assess, coordinate and facilitate the discharge planning needs of all home discharge planning needs of all home medical equipment ,respiratory therapy, medical equipment ,respiratory therapy, enteral therapy, and infusion therapy IV enteral therapy, and infusion therapy IV orders per physician orders and the needs orders per physician orders and the needs of the patient, using standards of care, of the patient, using standards of care, policies and procedures outlined by HME policies and procedures outlined by HME industry, clinical, regulatory and industry, clinical, regulatory and reimbursement guidelines and in reimbursement guidelines and in accordance to governing hospital policies accordance to governing hospital policies

NCH HOME MEDICAL NCH HOME MEDICAL PRODUCTS AND SERVICES PRODUCTS AND SERVICES

• Oxygen Oxygen

• Respiratory – CPAP, Bi-level, Nebulizers, Respiratory – CPAP, Bi-level, Nebulizers, Suction machinesSuction machines

• Home Medical Equipment – walkers, Home Medical Equipment – walkers, wheelchairs, canes, commodes, beds,low wheelchairs, canes, commodes, beds,low air loss mattresses, alternating pressure air loss mattresses, alternating pressure pad w/pumppad w/pump

• Enteral formulasEnteral formulas

• Lifeline Response servicesLifeline Response services

GOALSGOALS

• Discharge planning performed in a Discharge planning performed in a timely and appropriate manner.timely and appropriate manner.

• Improve patient educationImprove patient education

• Ensure patient meets criteria for Ensure patient meets criteria for equipment/ services prior to dischargeequipment/ services prior to discharge

• Provide seamless careProvide seamless care

• Provide marketing servicesProvide marketing services

DISCHARGE PLANNINGDISCHARGE PLANNING

• Powerchart Powerchart orderingordering

• Order placed in Order placed in computercomputer

• Patient information Patient information availableavailable

• No phone calls or No phone calls or faxesfaxes

• Order received in Order received in HL office, HL office, warehouse and warehouse and Central distribution. Central distribution.

DISCHARGE PLANNINGDISCHARGE PLANNING

• Central DistributionCentral Distribution • Equipment storage Equipment storage walkers, cane, walkers, cane, commodes, etccommodes, etc

• Portable O2Portable O2

• Discharge patient with Discharge patient with equipment in 30 equipment in 30 minutesminutes

• One company can meet One company can meet most patient needsmost patient needs

• Over 100 types of Over 100 types of equipment availableequipment available

IMPROVE PATIENT IMPROVE PATIENT EDUCATIONEDUCATION• OXYGEN OXYGEN

• NEBULIZERNEBULIZER

• CPAPCPAP

• Hospital Liaison Hospital Liaison delivers portable O2delivers portable O2

• Show and Show and demonstratedemonstrate

• Discuss home Discuss home equipment to be equipment to be delivereddelivered

• Respiratory Respiratory therapist visit in therapist visit in homehome

ENSURE PATIENT MEETS ENSURE PATIENT MEETS CRITERIA FOR CRITERIA FOR EQUIPMENT/SERVICESEQUIPMENT/SERVICES• Diagnosis Diagnosis

• Height and weightHeight and weight

• Qualifying Spo2Qualifying Spo2

• Eliminate duplication of equipmentEliminate duplication of equipment

• Obtain necessary paperwork, ABN, Financial Obtain necessary paperwork, ABN, Financial Assistance, Financial ResponsibilityAssistance, Financial Responsibility

• Communicate with CM/SS if not the Communicate with CM/SS if not the preferred provider preferred provider

SEAMLESS CARESEAMLESS CARE

• NCH Healthcare System to NCH NCH Healthcare System to NCH AffiliateAffiliate

• Services / Equipment provided to all Services / Equipment provided to all Medicare, Medicaid, insurance, self Medicare, Medicaid, insurance, self pay and indigent.pay and indigent.

CHALLENGESCHALLENGES

• INDIGENT CAREINDIGENT CARE • National average National average for HMEs – 2.9 to for HMEs – 2.9 to 4%4%

• NCH Healthcare NCH Healthcare System – 7%System – 7%

• NCH Home Medical NCH Home Medical – 16%– 16%

INDIGENT CAREINDIGENT CARE

• NCH Hospital patients discharged – NCH Hospital patients discharged – 5000 to 60005000 to 6000

• North Collier (NCOL) Hospital North Collier (NCOL) Hospital patients discharged – 900 to 1000patients discharged – 900 to 1000

• NCH Referrals – @1100NCH Referrals – @1100• NCOL referrals - 186NCOL referrals - 186• NCH Hospital Indigent – 5%NCH Hospital Indigent – 5%• North Collier Hospital Indigent – 33%North Collier Hospital Indigent – 33%

INDIGENT CAREINDIGENT CARE

• Physician preference not patient Physician preference not patient preferencepreference

• CM/SS discharge process differentCM/SS discharge process different

• HL not always available for HL not always available for dischargesdischarges

CHALLENGESCHALLENGES

• BillingBilling • Billing performed Billing performed by hospital billing by hospital billing departmentdepartment

• Write offsWrite offs

• Lack of knowledgeLack of knowledge

• Contract with Contract with equipment equipment provider to do provider to do billing billing

MARKETINGMARKETING

• Sales Calls Sales Calls

• Health FairsHealth Fairs

• Educate office staff on paperworkEducate office staff on paperwork

• Educate hospital staff on NCH Home Educate hospital staff on NCH Home Medical Medical

• Maintain marketing supplies and Maintain marketing supplies and materialsmaterials

Other DutiesOther Duties

• Maintain inventory of equipment at Maintain inventory of equipment at both hospitals both hospitals

• Enter patient information/orders into Enter patient information/orders into MedActMedAct

• Weekend On-CallWeekend On-Call