SELECTING TELEVISIONS FOR A HEALTHCARE FACILITY
This article is prompted by another client request. It is one that I have been putting off writing so that I could do additional “research”. In fact, I have been struggling to complete this article because I was looking for exactly the right answers. After working with another client yesterday, and helping that client make TV selections, I had a revelation! THERE IS NO “RIGHT” WAY TO DO THIS! No matter what decision you make, some aspects of the decision are likely to be compromised.
OK, now that I have gotten that out of the way, let’s get productive and talk about making the “BEST” decision.
CATEGORIES OF TELEVISIONS
TV’s are manufactured for specific applications. All of us have gone to Best Buy or Costco and gazed at the array of BIG screen, flat panel TV’s that are offered in plasma, LCD and now LED … All of those TV’s were made specifically for the RETAIL market. Retail TV’s are designed with features you and I want so we can use them in our homes. What is generally not understood is that there are also special televisions made with certain features for other applications; for the hospitality market, the long term care market and for use in hospitals.
I’m not going into a lot of detail here, but I do want to address some of the differentiating features.
Let’s start with “commercial” TVs. The commercial TV evolved from the demands of an industry that has been buying and using TV’s for more than 50 years, the HOSPITALITY industry (hotels and motels). Hospitality buyers have forgotten more details about buying and owning TV’s than the health care industry (a relatively new participant in this market) has had the opportunity to absorb. We can take some hints from the hospitality industry’s experience though and cobble onto some of the features on which they will not compromise … and by the way, the hospitality industry has NEVER been know for “wasting a dollar” so it is safe to assume that their standards are steeped in value.
Features of commercial TV’s are:
- Special software that allows you to program one TV and then “one touch program” all the other TV’s with that same remote. Think about this feature in the health care context of having “pre-tuned” a control for a foreign language preference, one for sports and one for programs of medical interest. When a new patient/resident moves in to the facility, you can “one touch” the TV to be specific to that patient/resident’s preferences.
- Warranty. Some commercial TV manufacturers who “toughen” their commercial product also offer special extended warranties in the commercial environment. In almost all cases, delivering a retail grade TV for use in a commercial environment VOIDS the manufacturer’s warranty. BEWARE!
- Limits on sound adjustments to avoid noise pollution.
- The TV always turns “on” to a specific channel. This is a great feature if the facility has invested in a personalized channel receiver and uses the channel for daily announcements and other information. Individual patient/resident schedules can even be displayed on a specific TV screen only. This is similar to the ability to check your hotel bill from the TV in your room.
The” Long Term Care TV” is a relatively new addition to the line-up of TV choices (as is the LTC industry in providing TV’s for residents). Two features have been added to the commercial television to create the LTC TV:
- A simplified hand control for a less “sophisticated” user.
- Discrete IR which eliminates “cross talk” between two television remotes in the same room.
The” Acute Care” TV (hospital grade) has all of the above features and adds a PILLOW SPEAKER option and better INFECTION CONTROL by utilizing a “sealed” cleanable case for the monitor. There are also some higher end features available (read higher priced) that also allow for DC powered systems and eventual conversion to touch screen and interactive applications.
SCREEN SIZE
So, putting all the “this is a guy thing” jokes aside, screen size is a function of the distance of the patient/resident to the television screen. There are formulae on the internet to readily help you calculate correct size screen. There is one additional important twist that everyone needs to understand about screen size and that is that when television went “digital”, the aspect ratio changed from 4:3 to 16:9 (we went widescreen). Almost all NEW flat panel televisions have been sized to optimize the 16:9 ratio. Some older flat panel television such as the 20”, now render a much smaller picture (for the 20” TV, about the equivalent of a 16-17” monitor) because the 20” TV was designed to optimize the 4:3 ratio.
MOUNTING THE TV
So now we have selected our TV … what else is there left to do besides setting it up?
Oops! Did I forget to tell you that we don’t recommend that you select the TV first? We need to figure out HOW and WHERE to mount the TV, and AFTER THAT pick the best TV option. My analogy for the commercial TV selection process (and to a lesser degree, buying a TV for your home) is taken from the early days of personal computing (and yes, I was there…). Often, people would rush out to buy a computer only to learn later that the software they wanted to run was not compatible with the computer they had just purchased. The same problem now arises with commercial TV’s … If you buy 22” TVs and then find out that the only practical place to mount them is clear across the room, you will be disappointed with the result because no one can see the picture that far away.
There are lots of TV mounting options to consider and then, once you select the option you want, there are then multiple styles of mounts; wall mounts, ceiling mounts, fixed mounts, articulating mounts, adjustable mounts, you name it mounts, to consider. Space available and construction of your building dictate the best choices for mounts. And even though almost all TV’s come with a table base included, we do not recommend using the table base in a commercial application. The table base is not secure from theft and is prone to being knocked over. WARNING: Some TV mounting systems can cost more than the television. Much more!
NOISE POLLUTION
The hospital grade unit has the only “built in” solution to noise pollution by providing the pillow speaker option and commercial and Long Term Care Grade TV’s can be programmed to “cap the volume”. There are a number of third party products that look like they have some promise to provide” personal sound” alternatives while working with other than just the hospital grade TVs. It is a little too soon to name any one of these the “panacea” for the industry. Keep in touch with Health Care Source and we will let you know as soon as we have a remote speaker product to endorse.
OTHER COOL STUFF
Don’t forget to ask us about single patient use hand controls.
AND LEST WE FORGET! THE REGULATIONS
In California we must take OSHPD regulations into account. If you are adding televisions as part of an OSHPD approved remodel, they will want details about the TV and the TV mounting device you have selected. As a point of reference, most 26” or smaller commercial TV’s weigh less than 20 lbs.
More important to regulatory considerations in the long term care use of televisions are the new CMS “Home Like Environment” guidelines. The long term care industry was beginning to trend toward an “acute care” approach to mounting their televisions on “swing away” mounting arms attached to the wall or the ceiling.
Unfortunately, the swing away arm mount is not anything that you would ever see in a home like environment. They are, oh how can I be kind here?…. quite ugly, invasive and very institutional in nature. I do not see now how this mechanism could be disguised, and so, given the new CMS guidelines, I don’t think the “articulating arm” is a practical mounting application for a Skilled Nursing facility’s televisions.
CONCLUSION
So now do you see why I said; “THERE IS NO RIGHT WAY TO DO THIS”?
We think the “BEST” way for our client to make a good decision regarding TV selection is to establish values and then measure the choices against those values.
Why are you purchasing the TV’s for the facility? Is it for competitive marketing reasons? Is it for patient/resident satisfaction (an amenity)? Is it to offer diversion to the patient/resident? Is it some other reason/reasons?
If the client has weighed their values to determine what is most important to them and then shares that decision with one of our HealthCare Source staff, then with our expertise and experience, we can together quickly identify the “best solution” and opt for the “best value” in televisions, mounts and accessories.
WHAT SERVICES SHOULD I EXPECT FROM A HEALTH CARE DEALER?
This article was written at the request of one of our clients. The e-mail inquiry, which was sent to “The Boren Report”, pointed out that there is a lot of confusion as to who is and who is not a dealer. Also, in the e-mail message the client asked about what they were paying for when they purchased from a dealer instead of purchasing factory direct.
Nobody said writing my “blog” would be easy, and this is indeed a challenging question to answer. Given that there are entire books written about how “distribution channels” function, I am going to try and answer the question in a concise and somewhat generic manner. My goal is to provide the buyer with enough information to help determine whether or not they are getting their money’s worth when they employ a dealer.
A BASIC DEFINITION:
A DEALER: A dealer is an individual or a company who purchases product from a manufacturer and then re-sells it to the end user. The dealer’s selling price to the end user includes a “mark up” on his cost to pay for any additional “value added” services that the dealer could provide to an end user. Some dealers will unbundle their services and allow the buyer to “shop” for only those services they need. Other dealers will only offer a fixed package of services. And then, there are those dealers that charge a mark up and offer the end user very little in return. Hopefully this article will help protect you from the latter.
You may ask me, what is confusing about this definition of a dealer? I think people are finding the dealer relationship confusing because, in practice, some companies who operate in the health care “distribution channel” WANT it to be confusing. On opposite ends of the distribution scale, we see well known manufacturers who are acting as dealers and well known dealers who like to appear as though they are a “factory direct” source. No wonder there is confusion.
To get closer to a working definition of a dealer, let’s examine and define a list of “value added” dealer services that the buyer might get with the products they buy.
PRODUCT SPECIFICATION:
Product specification, especially in health care equipment is CRITICAL. Health Care is one of the most highly regulated industries in the world and answers to a matrix of Federal, State, regional and private regulators. Errors and omissions in product specifications can lead to a host of problems. A knowledgeable dealer should have a good grasp of these issues and help you make the right selections. We recently worked with a facility which was making a purchase of new furniture. The dealer (a national supplier) that they were planning to use was not aware of the California Air Resources Board standards for toxic emissions from furniture (this is a VERY real health issue) and had specified non-compliant products for this facility. The CARB regulation went into effect in California on January 1, 2009, eight months ago. The dealer in question was clearly out of touch with State and regional requirements. Had the facility made the planned purchase, they would have had significant liability exposure in case of resident illness.
Some dealers will also help the buyer with color recommendations and fabric selection or they will refer the buyer to a qualified health care designer to assist in this process. When you think about the fact that you want your capital equipment purchases to last for seven to fifteen years, and that you will be looking at them for that long, GOOD design is a GOOD investment.
FINANCING:
Out of the specification frying pan and into the financing fire! Financing is one of the benchmark services of dealers. Manufacturers do not finance … dealers finance! If you think you are getting financing from a factory, then one or more of three things is probably happening: 1. The factory is using a third party financier 2. The factory is actually a dealer and passing themselves off as a manufacturer 3. You are paying a financing fee which is pocketed by the manufacturer. When you finance through a dealer, especially a local dealer, the terms are generally more transparent and negotiable. Always consider obtaining your financing independent of ANY third party.
ORDERING:
There is lots of paperwork and legal mumbo jumbo involved in placing an order, especially for capital equipment. A knowledgeable dealer should handle this process for you and make sure you get the product you intended to buy.
EXPEDITING:
Expediting is the “are we there yet?” of dealer services. Keeping track of when product is shipping, if it is shipping on schedule, checking with the factory regularly regarding the order status, and alerting the end user ahead of time that their shipment will be arriving on a given day is the expeditors’ job. This is another valuable dealer service.
RECEIVING:
What do you mean you are in the “middle of survey” and you have no place to park a 75’ long truck, much less receive the shipment? A full service dealer will receive the merchandise for you at his dock until YOU are ready to take delivery. Also, when you take “direct shipment” you are technically responsible for freight damage once product leaves the factory (that what FOB means). When you purchase through a dealer, the dealer assumes that responsibility for you. Look closely at this issue anytime a dealer wants to “drop ship” product into your facility.
INVENTORY:
A full service dealer will immediately un-package and inspect your shipment. The buyer has a VERY limited window to report errors, omissions and damage. Too often the staff at a facility do not have the time to “get around to doing this inspection”, and by the time they do, it is too late. Plus, if there is a problem with the product, that “problem” is not sitting in the middle of your facility, waiting to be resolved.
STORAGE:
Is your re-modeling project running behind schedule and you are not ready to take delivery? A full service dealer will store and protect you product until you are ready to take delivery.
ASSEMBLY:
Does that product that arrived in the box look like an “erector set” when you opened it? A full service dealer will have qualified staff toassemble your product for you.
DELIVERY:
A full service dealer will deliver your purchase to your door with trained staff and an appropriately sized vehicle.
INSTALLATION:
A full service dealer will install the products you have purchased using “bonded” employees who may safely enter your facility.
REMOVAL:
A full service dealer will have an empty truck when the installation is complete. Most will haul away cartons and packing materials and often any old product you want to dispose of.
CONCLUSION:
So, how about it? Using this article and the inclusive list of dealer services as your scale: 1. Was your most recent purchase transaction made with a manufacturer or with a manufacturer acting as a dealer or with a dealer 2. If it was a dealer, were they a full service dealer, and 3. If you are paying for dealer services, are you getting the dealer services you are paying for??????
And for our client who asked this question, please let me know if I have answered to your satisfaction.
What can I say? These changes will significantly alter how a facility looks and operates! I am still thinking through the implications of these changes and how they will impact the care providers, the manufacturers who service the industry and the products that HealthCare Source represents.
One customer has already commented that they felt mitigated by the length of time that it will take for these guidelines to take hold. I explained that, operationally this is true, but HealthCare Source looks at the guidelines from a “capital equipment perspective” with purchases having a useful life of 10 years or more. If you are spending capital dollars TODAY then you need to at least take these guidelines into account, even if you say NO to implementing them.
My initial reaction is that some of the guideline changes have real merit. Some of the guideline changes are going to be difficult for the industry to address. And at least one of the guideline changes MUST have been written by some Senator’s “idiot love child”, because no one with intimate knowledge the industry would initiate a guideline like this. This one guideline, if interpreted and implemented as written, with no further thought, has the potential to return a disaster on the scale of New York’s 1911 Triangle Factory debacle.
I “betcha” you want to know which I think it is!
Before we go there, I can’t just let the industry “off the hook” in this matter. These guidelines are printed for comment in advance of adoption. Why are we dealing with these issues after they have already been implemented and why are they such a surprise to everyone I talk to about them? The most common response I have gotten from industry professionals is; “They can’t do that!”.
Back to the business at hand! Let’s start with the short list of what items the guideline RECOMMENDS be “banned” from the long term care environment.
- Banned - Overhead paging and piped in music.
- Good call! No one cares to know that the Administrator has a phone call and no one “lives” in an elevator.
- Besides that, the person who is assigned to pick the playlist generally has terrible taste in music.
- Banned - Meal service on trays in the dining room.
- Good call! It’s tough enough for some residents to maintain an “interest in food” without making the servings look like “fast food”.
- Banned – Institutional signage labeling workrooms and closets.
- Hmmm. There are areas that need signs, either to keep people out or to get people in. One good example is a public restroom.
- Banned - Medication Carts.
- Another Hmmm. I can clearly see the objection to the “monster” medication carts that serve 50 residents, weigh hundreds of pounds and block the hallways … but facilities are not required to use those carts except for the fact that this may be the type of cart that is provided to facilities by their pharmacy at no charge.
- Is this a really a legitimate regulatory change or is it an obtuse way for CMS to address what some consider an ongoing “Safe Harbors” violation? The guidelines recommend that “medications could be stored in the resident room” instead of in carts, but they do not address how the facility should deal with narcotics or refrigerated medications in this situation.
- If this guideline is implemented, a facility will need to completely alter how they address med storage and med delivery. Double hmmm.
- Banned – Audible Alarms and Call Systems.
- A double good call. See my previous posting addressing wireless call systems.
- Banned – Mass purchased furniture.
- Are you kidding me??? On the surface this looks …. OK. And then you start thinking about the ramifications, and I am not talking about the design issues, those points can be addressed by a professional designer! I am talking about both Residents and Operators bringing toxic, flammable junk furniture into the health care environment.
- Has no one read about off shore furniture that contains dangerous levels of formaldehyde gasses? … this guideline could place that dangerous furniture right under resident’s noses!
- And this same guideline is asking that we use “home like” curtains and bedspreads. Well I’ve got news for you, this stuff along with “furniture from home”, BURNS! This CMS guideline could turn the Skilled Nursing environment into a fire trap. Did ANYONE talk to a Fire Marshall about this guideline?
- YES! We want to provide a “home like” environment, but at what cost? The Skilled Nursing environment IS an institution and it is the job of the care giver and CMS to keep residents safe inside this institution. “Home like” should be an IMAGE, not a function. If this guideline is misunderstood and misapplied by a “well meaning” caregiver, the resident safety net will break down.
- California, fortunately, has a number of environmental regulations that conflict with THIS CMS guideline. CA TB 133 flammability standards, CARB toxic emission standards and other fire safety regulations are in effect in this market. Other states may not have this protection in place.
- Banned – Large centrally located nurse stations.
- Hmmm. This guideline may be putting the “COMPUTER CART before the horse”. On the surface I think this guideline will be a good idea but a lot of things need to happen before it will work. These include the implementation of MDS 3.0 and mobile assessment, RUGS IV, full computer automation in the facility, the installation of a facility wide wireless, encrypted, internet connection and the acquisition of a “work station on wheels” for each nurse.
- Oh yeah, and some place to store the workstations and re-charge them when not in use.
Please read these guidelines to see if you agree or disagree with me. I look forward to your comments!
Here is the guideline … Chapter and Verse:
F252
(Rev. 48; Issued: 06-12-09; Effective/Implementation Date: 06-12-09)
§483.15(h) - Environment
The facility must provide--
§483.15(h)(1) - A safe, clean, comfortable and homelike environment, allowing the resident to use his or her personal belongings to the extent possible;
Interpretive Guidelines: §483.15(h)(1)
For purposes of this requirement, “environment” refers to any environment in the facility that is frequented by residents, including (but not limited to) the residents’ rooms, bathrooms, hallways, dining areas, lobby, outdoor patios, therapy areas and activity areas. A determination of “homelike” should include the resident’s opinion of the living environment.
A “homelike environment” is one that de-emphasizes the institutional character of the setting, to the extent possible, and allows the resident to use those personal belongings that support a homelike environment. A personalized, homelike environment recognizes the individuality and autonomy of the resident, provides an opportunity for self-expression, and encourages links with the past and family members. The intent of the word “homelike” in this regulation is that the nursing home should provide an environment as close to that of the environment of a private home as possible. This concept of creating a home setting includes the elimination of institutional odors, and practices to the extent possible. Some good practices that serve to decrease the institutional character of the environment include the elimination of:
Overhead paging and piped-in music throughout the building;
Meal service in the dining room using trays (some residents may wish to eat certain meals in their rooms on trays);
Institutional signage labeling work rooms/closets in areas visible to residents and the public;
Medication carts (some innovative facilities store medications in locked areas in resident rooms);
The widespread and long-term use of audible (to the resident) chair and bed alarms, instead of their limited use for selected residents for diagnostic purposes or according to their care planned needs. These devices can startle the resident and constrain the resident from normal repositioning movements, which can be problematic. For more information about the detriments of alarms in terms of their effects on residents and alternatives to the widespread use of alarms, see the 2007 CMS satellite broadcast training, “From Institutionalized to Individualized Care,” Part 1, available through the National Technical Information Service and other sources such as the Pioneer Network;
Mass purchased furniture, drapes and bedspreads that all look alike throughout the building (some innovators invite the placement of some residents’ furniture in common areas); and
Large, centrally located nursing/care team stations.
Many facilities cannot immediately make these types of changes, but it should be a goal for all facilities that have not yet made these types of changes to work toward them.
CALIFORNIA TECHNICAL BULLETIN 133 FLAMMABILITY STANDARDS (CA TB 133)
This commentary is written at the overwhelming request of our staff at HealthCare Source. Even though CA TB 133 has been in regulatory effect since March 1, 1992, our staff receives more questions about this standard than any other regulatory matter. Let’s see if we can answer some of those questions and lay to rest some misunderstandings.
WHAT IS CA TB 133?
CA TB 133 is one of two standards commonly used in the manufacture of commercial furniture. The other one is CA TB 117.
WHAT IS THE DIFFERENCE BETWEEN THE TWO STANDARDS?
CA TB 117 is the most common flammability standard for commercial furniture. It is used by manufacturers nationwide. CA TB 117 allows manufacturers to build furniture by selecting from an array of components that are pre-approved to be “CA TB 117” compliant. Frames, foam and fabric are the typical components. By complying with the CA TB 117 standards for all components, the manufacturer’s end product is predicted to burn slowly or not at all.
But CA TB 133 is a standard that measures only the completed product. A common misconception is that there are CA TB 133 approved fabrics. There are no CA TB 133 components! The CA TB 133 standard measures the compliance of the finished product in an actual burn test of that specific product (I won’t get into how the manufacturers achieve that testing standard in this article). Not only does the CA TB 133 standard measure the “flame spread” but it also measure the gasses given off by the burning furniture, and in doing so, corrects a major flaw in the CA TB 117 standard.
A flaw in the CA TB 117 standard? When the manufacturer selects the components that go into the CA TB 117 finished product, the frame material, the foam and the fabric might not burn but CAN create a pervasive toxic smoke that will kill faster than the fire. And so CA TB 133 measures the finished products to also protect from the off gassing of burning furniture.
WHO DOES CA TB 133 APPLY TO?
OK … here comes the list. Prisons, HOSPITALS, HEALTHCARE FACILITIES, BOARD and CARE, CONVALESCENT HOSPITALS, licensed child care facilities, stadiums, auditoriums, public assembly areas of hotels and motels used by 10 or more persons.
ARE THERE EXEMPTIONS TO CA TB 133?
Yes there are! Any fully sprinklered building serving the businesses listed above MAY be exempt, with the blessing of the local Fire Marshall. Not all buildings are rated as the same risk in case of fire. ONLY THE LOCAL FIRE MARSHALL CAN GRANT YOU AN EXEMPTION.
BUT BEFORE ASKING FOR AN EXEMPTION…
…You should know about the history of the Dupont Plaza fire in Puerto Rico. On New Year’s Eve in 1986, three disgruntled employees set a fire in some new furniture which was scheduled to be installed. The idea was to scare away hotel guests. The stacked furniture reacted to the fire like “stacked pallets at a college pep rally”. The fire burned higher and hotter than anyone imagined. The result was 97 deaths and 140 injuries, and one of the largest liability suits of its time.
The most interesting part of the litigation was that the CA TB 133 flammability standard was used as the “due diligent” standard of the day, even though CA TB 133 did not go into effect in California for five more years.
PLEASE take the time to contact your risk manager and determine whether or not pursuing a CA TB 133 exemption is “worth it”.
REGULATIONS AND REIMBURSEMENT DOMINATE THE HEALTH CARE PURCHASING DECISION
We all know that the health care is one of the most heavily regulated businesses in America. On top of that, the health care provider deals with a dizzying array of ever changing reimbursement systems; insurance, local, state and federal.
By the time the health care facility manager has spent his capital equipment budget on regulatory and reimbursement driven equipment and services, there isn’t much budget left to spend on discretionary items.
But, have you ever stopped to think how the regulatory and reimbursement systems impact manufacturers?
Having been the head of purchasing for two different multi-billion dollar health care companies, thousands of health care products have come across my desk over the years. To deal with that volume of contacts (all of whom wanted a lot of my time) I developed some qualifying criteria based on current and pending regulatory and reimbursement guidelines. Those five categories were:
Never going to be! This doesn’t mean these aren’t good products or good ideas. It means that either they don’t have a regulatory or reimbursement application or the manufacturer is selling in the wrong health care distribution channel. I believe there are four distinct health care distribution channels. Look at hospital type beds for example. There are hospital beds, long term care beds and home health (DME) beds. All these beds are, generically speaking, “hospital beds”. Yet, each style bed is pretty much worthless to the other two distribution channels.
Potential! These are products that may not have current regulatory or reimbursement support but pending changes or operational efficiencies make them attractive to know about and support. I always try to keep one of these in the HealthCare Source basket of products (more on this later).
Current commodity. HoHum… These are the products and manufacturers who currently have a regulatory or reimbursement niche, but are also engaged in the toxic, downward spiral of copying other manufacturers and then value engineering that product. “Value engineering”, there is a term that has become an oxymoron at the hands of some health care manufacturers. Too often the purpose of the product is lost in the process of copying and value engineering. Also, gimmicks are often proffered as solutions by these companies.
Innovative Alternative! These are products developed by manufacturers who have a current regulatory or reimbursement niche, AND they are seeking/finding innovative new ways to fill the niche, AND they are constantly developing new products to be current with our ever changing industry. These are also the manufacturers who “deliver value” not “engineer” it. HealthCare Source draws the majority of its manufacturers from this category.
Used to be. Due to regulatory or reimbursement changes, some products and manufacturers become obsolete. Sad, but true!
So we all know that Dennis prefers to spend his time with products in the Potential and Innovative Alternative categories … get on with your story Dennis!
I thought that those of you who are interested in product development, might like to keep watch on a product that MAY transition from the “Potential” category to a “double hit” regulatory AND reimbursement “Innovative Solution”.
The product, Live-Vu, is a low band width, remote, medical assessment system. If you want to know more about the product you need to schedule a demo.
What you need to know for this article is that this product is a unique, well tested, innovative solution. It is well channeled in the Long Term Care distribution segment, but because it did not match up to regulatory or reimbursement criteria, the manufacturer was left to fighting for that very small pool of discretionary dollars that is available at the end of the budget year.
AND THEN, ALONG CAME RUGS-IV!
RUGS-IV (resource utilization groups) is the new MediCare reimbursement companion to MDS 3.0. Both are scheduled to be implemented nationwide in October 2010.
What is intriguing is that CMS is planning to run a demonstration test of the RUGS-IV program starting in October of this year. Four states will participate in that test program.
The demonstration is called NHVBP (Nursing Home Value Based Purchasing). As I understand the program (no one really knows yet, it’s brand new), RUGS-IV is a value calculation that includes four new domains: Staffing, Appropriate Hospitalization, MDS outcomes, and survey deficiencies. Again, as I understand it, superior NHVBP ratings will pay incentive bonuses to the facilities getting superior ratings.
So what is the big deal?
Live-vu is a unique product that should help facilities to be 100% compliant within the “appropriate hospitalizations” domain. If true, that application hits the perfect nexus of product, regulations and reimbursement!
Hey, there is a lot more to learn about the RUBS-IV and MDS 3.0 systems, and this initial assessment by HealthCare Source is based only on what we have read about the program, so far … but like I said, it will be fun to watch.
I’ll keep you updated as things progress.
