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Topics Hospital discharge dispositions (see handouts)

Colorado Trauma Registry Colorado Trauma Network Prepared by Health and Safety Data Services July 2014. Topics Hospital discharge dispositions (see handouts) Difficult to code certain disposition scenarios Base reporting timeframe on the state application (admit vs. discharge date)

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Topics Hospital discharge dispositions (see handouts)

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  1. Colorado Trauma Registry Colorado Trauma Network Prepared by Health and Safety Data ServicesJuly 2014

  2. Topics • Hospital discharge dispositions (see handouts) • Difficult to code certain disposition scenarios • Base reporting timeframe on the state application (admit vs. discharge date) • Questions to the state – topics for discussion • ICD-10 impact on TR manual – potential topic for December meeting – looking for help! DRAFT

  3. Hospital Discharge Dispositions DRAFT

  4. Hospital Discharge Dispositions • Error on Example in TR manual (page 49; see handout) “If the patient came from a SNF and returned to the SNF after admission, the hospital discharge disposition should be SNF, not home” • Aligning with NTDB, Field value = 6, “home” refers to the patient’s current place of residence (e.g., prison, Child Protective Services) • Correct: patient returned home “If the patient came from a SNF and returned to the SNF after admission, the hospital discharge disposition should be HOME” DRAFT

  5. Hospital Discharge Dispositions • Situation: Difficult to code certain health care dc disp. • Is a new code needed for assisted living? • Should assisted living code to intermediate care facility (ICF)? • Should skilled nursing facility (SNF) and nursing home be combined? • How to code a pt who tx out of acute care but remained in the hosp? - Modified LTAC • Bottom line: • Need clarification for appropriate coding DRAFT

  6. Discharge Dispositions DRAFT

  7. Hospital Discharge Dispositions • Ideas from CMS https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE0801.pdf • Ideas from TJC http://manual.jointcommission.org/releases/TJC2012B/DataElem0247.html • Should assisted living code to ICF? • Is a new code needed for assisted living? • Should SNF and nursing home be combined? • How to code a pt who tx out of acute care but remained in the hospital? DRAFT

  8. Download to the State Trauma Registry (Admit vs. Discharge Dates) DRAFT

  9. Download to the State Trauma Registry • Reporting method on the state trauma application: • Should the data be based on admission or discharge date? • Most items discuss “number of patients admitted…” • Things to consider • For the state, neither method impacts our data analysis • Colorado Hospital Association (CHA) is based on discharge date • ‘Discharge’ – # of outcomes for the year • NTDB title reads “2014 Admissions” DRAFT

  10. Questions for State – Topics for Discussion DRAFT

  11. Questions for State DRAFT

  12. Questions for State • Documentation of drug presence • ED staff administer opiods vs. possible recreational/abuse use pta DRAFT

  13. Question for State • Are we able to identify the number of patients being discharged to jail? • Discharge dispositions • JAIL • HOME* • *NTDB: "home" refers to the patient's current place of residence (e.g., prison, child protective services, etc.) DRAFT

  14. ICD-10 Transition…Will require a rewrite of some sections of the TR ManualPerhaps start with Appendix V – ICD9 Codes – should be the largest section that needs changesWill need new codes, decision trees, Colorado specific rules, etc.Hoping to have a draft prepared for the December meetingAnyone interested in helping with the rewrite, please contact: scott.beckley@state.co.us DRAFT

  15. Contact us! • Health Facilities and EMS DivisionColorado Department of Public Health & Environment4300 Cherry Creek Drive SouthDenver, CO 80246-1530Phone: (303) 692-2980Fax: (303) 691-7720 www.coems.info DRAFT

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