ORTHOTIC FITTER COURSE Module 9 Facilities Management FACILITIES

ORTHOTIC FITTER COURSE Module 9 Facilities Management

FACILITIES MANAGEMENT • Agenda • Patient education • Documentation • Physician communication • HIPAA • • Billing errors First impressions Sales floor ethics • Fitting room • • Universal precautions • Equipment • Courtesy • CMS update • Ethics • Facility accreditation

FACILITIES MANAGEMENT - DOCUMENTATION Documentation

FACILITIES MANAGEMENT - QUOTE Documentation “You’re never finished ‘til the paperwork is done. ”

FACILITIES MANAGEMENT – SOAP Documentation • SOAP notes • Subjective • Objective • Assessment • Plan

FACILITIES MANAGEMENT – INTAKE INTERVIEW Documentation • Intake interview • Take patient history • Obtain and record measurements

FACILITIES MANAGEMENT – PATIENT EVALUATION Documentation Intake interview • Patient evaluation • • • Manual examination: • Skin condition • Strength • Range of Motion (ROM) Observe: • Gait • Balance/coordination • Present device

FACILITIES MANAGEMENT – Dx-Rx CORRELATION Documentation • Intake interview • Patient evaluation • Dx-Rx correlation • Analyze evaluation data • Determine solution • Correlate to Rx • Explain advantages and disadvantages • Agree on expectations

FACILITIES MANAGEMENT – LMN/CMN Documentation • Intake interview • Patient evaluation • Dx-Rx correlation • LMN/CMN • Required by most state aid agencies

FACILITIES MANAGEMENT – INSURANCE COVERAGE Documentation • Intake interview • Patient evaluation • Dx-Rx correlation • LMN/CMN • Insurance coverage • Patient responsibilities • Copies of everything

FACILITIES MANAGEMENT – QUALITY ASSURANCE • Documentation • Patient education • Intake interview • Follow-up program • Patient evaluation • VERIFY PATIENT CARE (delivery receipt) • Dx-Rx correlation • LMN/CMN • Insurance coverage • Quality assurance • Organized files • By subject • By sequential date

FACILITIES MANAGEMENT - CONFIDENTIALITY HIPAA • Confidentiality

FACILITIES MANAGEMENT - HIPAA Health Insurance Portability and Accountability Act

FACILITIES MANAGEMENT - PRIVACY HIPAA • Privacy • Defines WHO is authorized to patient information • PHI = Patient Health Information • Requires a designated Privacy Official

FACILITIES MANAGEMENT - SECURITY HIPAA • Privacy • Security • Control of access to PHI

FACILITIES MANAGEMENT - CONSENT HIPAA • Privacy • Security • Consent • Agreement to use PHI during course of treatment • “Notice of Privacy Practices” replaces consent form

FACILITIES MANAGEMENT - AUTHORIZATION • • • HIPAA Privacy Security Consent Authorization • Use of PHI for other than course of treatment

FACILITIES MANAGEMENT - ADMINISTRATIVE • HIPAA • Training procedures • Privacy • Termination procedures • Security • Information access • Consent • Authorization • Administrative • Written policies and procedures • Written “Notice of Privacy”

FACILITIES MANAGEMENT – THINGS TO DO HIPAA • • Privacy • Security • Consent • Authorization • Administrative • Things to do: • Review all business practices TRAIN all staff and document it Limit access to office space and files • Billing is compliant •

FACILITIES MANAGEMENT – BILLING ERRORS Billing Errors • DMERC hot buttons: • Signed delivery tickets • Signed pick-up tickets • Billing statements • CMN(s) • Physician’s orders • Patient correspondence • Photo or description • Service/repair records • Patient DOB

FACILITIES MANAGEMENT – FITTING ROOM Fitting Room • Fitting room basics: • • Exam table Step stool Chair Stool Table Mirror Forms Tools

FACILITIES MANAGEMENT - TOOLS Fitting Room • Fitting room basics • Tools: • Tape measure • Stay bender • Bending irons • Gloves • Grease pencil • Goniometer

FACILITIES MANAGEMENT - COURTESY Fitting Room • Fitting room courtesy • Open lesion issues can preclude fitting

FACILITIES MANAGEMENT - ETHICS Fitting Room • Fitting room ethics • If ducks went hunting…

FACILITIES MANAGEMENT – EFFECT OF MEDS Fitting Room • Fitting room ethics • Effect of meds?

FACILITIES MANAGEMENT - GENDER Fitting Room Ethics • Same gender • Opposite gender

FACILITIES MANAGEMENT – PATIENT EDUCATION Patient Education “A life isn’t significant except for its impact on other lives. ” - Jackie Robinson

FACILITIES MANAGEMENT – MUTUAL GOALS Patient Education • Mutual goals

FACILITIES MANAGEMENT – APPLY/REMOVE Patient Education • Mutual goals • Apply/Remove

FACILITIES MANAGEMENT – CLEANING/CARE Patient Education • Mutual goals • Apply/Remove • Cleaning/Care

FACILITIES MANAGEMENT – FOLLOW-UP Patient Education • Mutual goals • Apply/Remove • Cleaning/Care • Follow-up

FACILITIES MANAGEMENT – PHYSICIAN COMMUNICATION Physician Communication

FACILITIES MANAGEMENT - MARKETING Physician Communication • Via patient • CC clinical notes • Dictate letter • Share in-services • Attend seminars MARKETING!!!

FACILITIES MANAGEMENT – FIRST IMPRESSIONS First Impressions

FACILITIES MANAGEMENT - APPEARANCE First Impressions • Neat appearance including: • Shoes • Fingernails • Professional attire

FACILITIES MANAGEMENT – LAB COAT First Impressions Neat appearance • Lab coat in fitting room • • Modest necklines

FACILITIES MANAGEMENT – BE HELPFUL • Be Helpful • ________________ • ________________ • ________

FACILITIES MANAGEMENT – OFFER OPTIONS • Be Helpful • ________ • Offer Options • ________________ • ________

FACILITIES MANAGEMENT - EXPLAIN • Be Helpful • Offer Options • Explain Features • ________________ • ________

FACILITIES MANAGEMENT - REFER • Be Helpful • ________ • Offer Options • ________ • Explain Features • ________ • Refer to Physicians • ________

FACILITIES MANAGEMENT - DIAGNOSE • Be Helpful • Diagnose • Offer Options • ________ • Explain Features • ________ • Refer to Physicians • ________

FACILITIES MANAGEMENT - PROMISE • Be Helpful • Diagnose • Offer Options • Promise Cures • Explain Features • ________ • Refer to Physicians • ________

FACILITIES MANAGEMENT - OFFER • Be Helpful • Diagnose • Offer Options • Promise Cures • Explain Features • Offer Prognosis • Refer to Physicians • ________

FACILITIES MANAGEMENT - PLAY • Be Helpful • Diagnose • Offer Options • Promise Cures • Explain Features • Offer Prognosis • Refer to Physicians • Play Physician

FACILITIES MANAGEMENT – UNIVERSAL PRECAUTIONS Universal Precautions • Learning objectives • Identify risk situations • Learn precautions • Regulation adherence

FACILITIES MANAGEMENT - AGENDA Universal Precautions • Agenda • Government agencies review • Definitions • Applications list • Specific precautions • Information sources

FACILITIES MANAGEMENT - AGENCIES Universal Precautions • Agencies • CDC - Centers for Disease Control • OSHA - Occupational Safety and Health Administration

FACILITIES MANAGEMENT - DEFINITION Universal Precautions • Definition • Measures taken to prevent transmission of blood-borne organisms • HIV • Hepatitis B • Other

FACILITIES MANAGEMENT - BACKGROUND Universal Precautions • Background • Early to mid 1980 s – HIV / AIDS • 1983 – CDC • 1985 – CDC • 1991 – OSHA • 1996 – CDC update • 1999 – OSHA update • 2003 – ? ? ?

FACILITIES MANAGEMENT – APPLY Universal Precautions • Apply to: (partial list) • Blood • Semen and vaginal secretions • Cerebrospinal fluids • Synovial fluids • Amniotic fluids • Any fluid containing blood

FACILITIES MANAGEMENT – DO NOT APPLY Universal Precautions • Do not apply to: (unless blood present) • Feces • Nasal secretions • Sputum, saliva • Sweat, tears • Urine • Vomitus

FACILITIES MANAGEMENT - PRECAUTIONS Universal Precautions • Precautions: • Wear gloves (double? ) when hands may come into contact with fluids

FACILITIES MANAGEMENT – PRECAUTIONS, 2 Universal Precautions • Precautions: • Wear gloves (double? ) if breaks in skin or mucous membranes

FACILITIES MANAGEMENT – PRECAUTIONS, 3 Universal Precautions • Precautions: • Avoid direct patient care if your own skin is broken

FACILITIES MANAGEMENT – PRECAUTIONS, 4 Universal Precautions • Precautions: • Wash hands immediately after removing gloves

FACILITIES MANAGEMENT – PRECAUTIONS, 5 Universal Precautions • Precautions: • Wear protective garment if there is a potential for getting splashed by blood

FACILITIES MANAGEMENT – PRECAUTIONS, 6 Universal Precautions • Precautions: • Wash hands immediately and thoroughly with soap following contact with blood or other body fluids

FACILITIES MANAGEMENT – PRECAUTIONS, 7 Universal Precautions • Precautions: • Use “sharps containers”

FACILITIES MANAGEMENT – PRECAUTIONS, 8 Universal Precautions • Precautions: • Use disposable ventilation device for CPR

FACILITIES MANAGEMENT – PROGRAM ANNUAL REVIEW Universal Precautions • Program annual review • Basic work practices • Personal protective equipment • Administrative controls

FACILITIES MANAGEMENT – MORE INFORMATION Universal Precautions • For more information: • Contact OSHA and CDC on the web

FACILITIES MANAGEMENT – CMS UPDATE CMS Update - Pending Guidelines for Reimbursement • Person fitting must be ABC, BOC or “other qualified practitioner” • Must be facility employee • Facility must be accredited • Operate within 50 mile radius

FACILITIES MANAGEMENT – FACILITY ACCREDITATION Facility Accreditation • Requirements for facility accreditation: • Certified practitioner in charge • • No more than two facilities within 35 miles of each other Defined business type • O&P, HME, DME, Pharmacy

FACILITIES MANAGEMENT - PHYSICAL REQUIREMENTS Facility Accreditation • Requirements for facility accreditation: • Physical requirements • ADA compliant • Rooms chair accessible • Reception separated from clinical areas • Workshop separated from clinical areas

FACILITIES MANAGEMENT – PATIENT AREAS Facility Accreditation • Requirements for facility accreditation: • Patient areas • Privacy • Chair with arm rest • Exam table with disposable cover • Walking devices available • Protective supplies available

FACILITIES MANAGEMENT – LAB/REPAIR AREA Facility Accreditation • Requirements for facility accreditation: • Lab/repair area OSHA approved • All equipment • Air standards • Flammable materials storage • Blood-borne pathogens standards • Safety supplies and equipment • Safety manual and training

FACILITIES MANAGEMENT – RECORD KEEPING Facility Accreditation • Requirements for facility accreditation: • Record keeping • Medicare Best Practices standards • Report and document all variances • Follow “need to know” criteria • Signed consent criteria • Locked files or room

FACILITIES MANAGEMENT - INSURANCE Facility Accreditation • Requirements for facility accreditation: • Insurance • General liability • Malpractice • Product liability • Other, as required by state or best-business practices

FACILITIES MANAGEMENT – QUALITY ASSURANCE. Facility Accreditation • Requirements for facility accreditation: • Quality assurance • Follow all HIPAA regulations • Both oral and written instructions • Signed receipts for all products, services and education • Method for anonymous complaints • Follow-up on regular basis

FACILITIES MANAGEMENT – COMPLIANCE OFFICER Facility Accreditation • Requirements for facility accreditation: • Compliance officer • Code of ethics and procedures • Personnel procedures • Employee handbook • Federal and state regulations • Staff education and training • Annual review and update

FACILITIES MANAGEMENT - CODES New effective July 2005: (as of 1 -28 -05) No prosthetics or custom orthotics unless: • Medical Supply Company w/ Orthotics Personnel – Code 51; Medical Supply Company w/ Prosthetics Personnel – Code 52; Medical Supply Company w/ O&P Personnel – Code 53; Orthotics Personnel – Specialty Code 55; Prosthetics Personnel – Specialty Code 56; Orthotics, Prosthetics, & Pedorthists – Code 57; Physical Therapist – Specialty Code 65; Occupational Therapist – Specialty Code 67; • All Physician Specialty Codes • •

FACILITIES MANAGEMENT – NATIONAL PROVIDER IDENTIFIER National Provider Identifier • Through January 2, 2006 • • January 3, 2006 through October 1, 2006 • • Legacy or NPI with legacy October 2, 2006 through May 22, 2007 • • Use only current (legacy) provider number Legacy and/or NPI May 23, 2007 • NPI only

FACILITIES MANAGEMENT - SUMMARY • Patient education • Summary • Physician communication • Documentation • First impressions • HIPAA • Sales floor ethics • Billing errors • Universal precautions • Fitting room • CMS update • Facility accreditation • Equipment • Courtesy • Ethics

FACILITIES MANAGEMENT. This workforce product was funded by a grant awarded by the U. S. Department of Labor’s Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U. S. Department of Labor. The U. S. Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. Produced 2016. HOPE Careers Consortium is a partnership of five institutions of higher education that is building exciting new programs that will provide valuable career education and training in the Orthotics, Prosthetics, and Pedorthics (O&P) sector. The five institutions are: Baker College—Flint, Michigan; Century College—White Bear Lake, Minnesota; Oklahoma State University Institute of Technology—Okmulgee, Oklahoma; Spokane Falls Community College—Spokane, Washington; and St. Petersburg College—St. Petersburg, Florida. Although the authoring institution of this educational resource has made every effort to ensure that the information presented is correct, the institution assumes no liability to any party for any loss, damage, or disruption caused by errors or omissions. Except where otherwise noted, this work by St. Petersburg College is licensed under the Creative Commons Attribution 4. 0 International License. To view a copy of this license, click on the following link: Creative Commons Licenses 4. 0.