GROWTH AREAS

 

According to the United States General Accounting Office (GAO), Medicare daily payment rates to skilled nursing facilities (SNFs) have increased in every predominant type of care since FY 2001. Our main focus will be on 3 growth area categories pertaining to respiratory care; 1) Extensive Services, 2) Special Care, and 3) Clinically Complex.

 

1) Extensive Services:

patients who have had the following specific medical or skilled nursing care needs in the past 14 days—intravenous medications, tracheostomy care, ventilator/respirator support, suctioning, or intravenous feeding in the last 7 days.

 

2) Special Care:

patients who have any of the following clinical conditions: multiple sclerosis, cerebral palsy, quadriplegia with high ADL dependency, surgical wounds or open lesions, pressure or stasis ulcers on two or more body sites or have a fever in combination with dehydration, pneumonia, vomiting, weight loss, or tube feeding. It also includes patients who require specific medical and skilled nursing care, such as radiation therapy and respiratory therapy.

 

3) Clinically Complex:

category includes patients who have any of the following clinical conditions: comatose, burns, systemic infection (septicemia), pneumonia, internal bleeding, dehydration, dialysis, or paralysis on one side (hemiplegia) in combination with a high ADL dependency. It also includes patients receiving chemotherapy, tube feeding of at least 26 percent of daily calorie intake and 501 milliliters of fluid, being treated for foot wounds or transfusions, receiving injections 7 days per week for diabetes while their condition is somewhat unstable, or those who have received oxygen therapy in the last 14 days. The group also includes patients with unstable conditions.