Nathaniel Haros

According to the Bureau of Labor Statistics, Nurse Practitioners are expected to see a growth rate of about 52% from 2019 to 2029—the quickest in the healthcare field, leading to more shortages. 📈 A Mercer Report in 2024 predicts almost every state will experience a shortage of NPs by 2028, with California and New York facing the largest deficits. This shortage could disrupt preventive care for patients due to the combined impact of physician and NP shortages. How can your organization address this challenge? Here are some key steps to consider: - Understand specific supply/demand risks by occupation and department - Strengthen your worker pipeline with internal and external solutions, focusing on diversity - Work on retaining your current talent - Evaluate job requirements, descriptions, etc., balancing automated tasks with those done by humans - Advocate for expanding Scope of Practice laws for NPs in your state (as appropriate). Preparing for the future and proactively addressing these shortages will be crucial for ensuring quality healthcare delivery. #NursePractitioners #WorkforcePlanning #TheTalentDoctor

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"Unlocking Innovation and Better Patient Outcomes through Diverse Staffing Partnerships" As the healthcare landscape continues to evolve, it's clear that diverse staffing partnerships are no longer just a nicety, but a necessity. At Hallmark Healthcare Staffing, we're proud to be a WBE/WOSB certified agency, committed to delivering exceptional staffing solutions that drive innovation, improve patient outcomes, and promote supplier diversity. The Benefits of Diverse Staffing Partnerships: Innovative Solutions: Diverse perspectives lead to creative problem-solving, enhancing patient care and operational efficiency. Improved Patient Outcomes: Staffing partnerships that reflect the communities they serve lead to more empathetic and effective care. Supplier Diversity: Partnering with diverse suppliers fosters economic growth, promotes social responsibility, and supports underrepresented communities. Competitive Advantage: Organizations prioritizing diversity and inclusion attract top talent, enhancing their reputation and market position. Join the Movement! By partnering with diverse staffing agencies like Hallmark Healthcare Staffing, you're not only advancing your organization's diversity goals but also contributing to better patient outcomes and a more inclusive healthcare ecosystem. Let's Connect! #DiversityInStaffing #HealthcareInnovation #SupplierDiversity #WBE #WOSB #HealthcareStaffing #InclusionMatters #PartnerWithPurpose

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A health system-wide approach to classifying patient messages paired with well-defined regional workflows can improve timely responses and substantially reduce physician inbox volume, a new study finds. #EHRManagement #PatientMessaging #Epic

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Among the many ethical challenges CDI professionals face is pressure to make their organizations and/or providers look better on paper, through elimination of diagnoses that might trigger a patient safety indicator (PSI) or other quality measure. In some organizations the pressure to improve quality scores is stronger than CC/MCC/HCC capture. But there is a compliant way to do the work. Review your denominator exclusions, query when appropriate, and get them documented. Doing so removes these patients appropriately from the measure. This work is critical for the new CMS quality measure, Thirty-day Risk-Standardized Death Rate among Surgical Inpatients with Complications (Failure-to-Rescue), recently introduced in the FY 2025 IPPS final rule. The Failure to Rescue measure is defined as the percentage of surgical inpatients who experienced a complication and then died within 30-days from the date of their first OR procedure. Failure-to-rescue is defined as the probability of death given a postoperative complication. This measure is publicly reported, meaning that anyone with access to a computer will see how many surgical inpatients with complications passed away within 30 days of their procedure at a given hospital. Weighty stuff, and not a good look if you’re performing pooly. But the good news is, all the reporting details are freely accessible, down to the very ICD-10-CM codes that move patients out of the denominator. Following are the broad category exclusions: ·     Cardiac Event ·     Congestive Heart Failure ·     Hypotension/Shock/Hypovolemia ·     Pulmonary Embolus/Deep Vein Thrombosis/Phlebitis ·     Cerebrovascular Accident (CVA)/TIA ·     Coma ·     Seizure ·     Delirium/Psychosis ·     Nervous System Complications ·     Pneumonia/Pneumonitis  ·     Pneumothorax/Effusion ·     Respiratory Compromise/Bronchospasm  ·     Internal Organ Damage/Perforation  ·     Peritonitis ·     GI bleed and blood loss ·     Sepsis ·     Deep wound infection or wound complication ·     Renal dysfunction ·     Gangrene/amputation ·     Intestinal obstruction/ischemia ·     Retained foreign body ·     Pressure injury ·     Orthopedic complication ·     Hepatitis or jaundice ·     Pancreatitis ·     Necrosis of bone (thermal or aseptic) ·     Osteomyelitis ·     Disseminated intravascular coagulation (DIC) ·     Pyelonephritis ·     Postprocedural/Transfusion Complication These must be reported as present on admission and match the listed ICD-10-CM exclusion codes. See link below for complete details. Other examples of ICD-10-CM codes resulting in exclusion from the measure include Z66: Do Not Resuscitate (DNR) status, and Z51.5: Encounter for palliative care. This measure is risk adjusted too, with age, comorbidities, or preoperative ‘do not resuscitate’ orders impacting reporting. In general, the accuracy of a patient’s comorbidities with supporting documentation allows appropriate coding of the patient’s complexities.

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JJ Part A and Part B Targeted Probe and Educate Active Medical Review List All CDI professionals must sign up for their Medicare Administrative Contractor list-serve to stay informed of updates to Medicare regulations & specific announcements geared towards the local region where the hospital operates. Pertinent relevant updates impacting the CDI profession include additions to the CMS Traegt Probed and Educate Program. From the Palmetto GBA website regarding TPE: "The Centers for Medicare & Medicaid Services (CMS) Targeted probe and Educate (TPE) program is designed to help providers and suppliers reduce claim denials and appeals by identifying provider errors, helping correct them, and preventing future errors. Medicare Administrative Contractors (MACs) have been tasked by CMS to identify high denial rates or unusual billing practices and work one-on-one with those providers to reduce claim errors and payment denials; MACs are also expected to review items and services that have high national error rates and are at a financial risk to the Medicare program." Notice in Palmetto GBA's JJ Part A and Part B Targeted Probe and Educate Active Medical Review List several common MS-DRGs DRG 470 - Major Joint Replacement DRG 291-293 Heart Failure and shock with or without CC/MCC DRG 682- 683 Renal Failure DRG 870–872-Septicemia or Severe Sepsis Greater than 96 hours These reviews incorporate elements of medical necessity, proper coding, & clinical validation. CDI must embrace the importance of situational awareness. Situational awareness requires a mindset beyond CC/MCCs, number of records reviewed, CMI, physician query rate, physician query response rate, etc. CDI must be aware of medical necessity denials, and clinical validation denials, taking a proactive preemptive denial avoidance approach to chart review. This approach by its very nature includes awareness of published MAC TPE Reviews & MAC published Medical Reviews. Being proactive entails conducting proactive audits of specific DRGs under review, ensuring documentation supports medical necessity, principal & secondary diagnoses are validated, and coding is accurate and compliant. Why wait to be a target for MAC review when proactive activity is more effective, warding off continued inaccurate/missing documentation, coding, and billing. Review payer denial letters involving clinical validation, incorporate payer-specific clinical criteria into physician documentation training, & consider creating dot phrases that contain payer-specific clinical criteria. An example is sepsis, subject to frequent denial due to "not meeting" Sepsis 3 criteria CDI- it is critical to be proactive versus reactive- stop chasing diagnoses and work with providers to become better documentarians, supporting diagnoses & warding off medical necessity & clinical validation denials. #CDI, #TPE, https://lnkd.in/eVHCtq3Q

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Bridging the gap between clinical and financial worlds is the goal of CDI and coding, but it’s much easier said than done. One way to reconcile this schism is through data—objective numbers that don’t lie, but can speak to both sides of this seemingly irreconcilable chasm. Associate Director of Coding and CDI at Yale New Haven Health (YNNH) Leif Laframboise believes in the power of data and uses it to structure the work of the coding and CDI departments under his oversight. But he marries that with a candidness and leadership style I admire, and an inner strength that has allowed him to persevere with a disability that might have ended the career of another. Leif is not just a data lover but an all-around good dude that I got to know a little bit during my ACDIS days, and I’m pleased to have him on this episode of Off the Record. We discuss: ·     An overview of the CDI and coding departments at YNNH ·     Broad departmental KPIs, with present on admission as a north star in a sea of competing quality programs ·     YNNH’s unique reporting structure to both finance and the chief medical officer, and how that works in practice ·     Why and how Leif embraces data—what he looks for, how he uses it to drive improvements, educate providers, and focus his team’s chart reviews ·     His thoughts on how CDI and coding must evolve with changing times ·     His disability and how he’s worked around it in a visible leadership role ·     Our first Foreigner selection on the OTR Spotify playlist (about time)

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Preparing for New CMS Staffing Rules With new CMS staffing rules on the horizon, nursing homes must adapt and ensure compliance while maintaining quality care proactively. Here are some steps to prepare: Evaluate Current Staffing Levels: Conduct a thorough assessment of your current staffing to identify gaps and areas for improvement. Enhance Recruitment Efforts: Leverage various recruitment channels to attract qualified staff. Consider an RPO (Recruitment Process Outsourcing) solution for a cost-effective and efficient approach. Invest in Training and Development: Provide ongoing training to ensure your staff is well-equipped to meet the new standards. Optimize Workforce Management: Implement strategies to enhance staff scheduling and utilization, balancing workloads effectively. Focus on Retention: Create a positive work environment to retain your top talent and reduce turnover rates. Explore International Staffing Options: Including foreign-trained clinicians in your staffing strategy can provide a long-term solution to stabilize your workforce. Preparing now not only ensures compliance but also enhances the quality of care for your residents. Let's work together to navigate these changes smoothly and cost-effectively! What steps are you taking to get ready for the new rules? #Healthcare #NursingHomes #CMS #StaffingSolutions #WorkforceManagement #QualityCare #CostEffectiveStrategies

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Reducing nurse labor costs while maintaining high-quality patient care is a critical challenge. Optimized scheduling doesn’t just save costs - it leads to better work-life balance for nurses, reduces burnout, and ultimately improves patient outcomes. By leveraging data-driven insights and creating a supportive environment, healthcare organizations can manage costs effectively while ensuring their staff feel valued and supported. #HealthcareLeadership #LaborCosts #WorkforceOptimization #Nursing https://lnkd.in/gtsy55J5

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A physician #recruitment playbook is a guide your team can use to effectively deploy best practices. Helping them achieve success when #recruiting and retaining physicians who fit in with your organization’s mission and values. Download it here: #recruitment #recruit #recruiting #recruitingsoftware #recruitmentplatform #healthcarerecruitment #healthcarerecruiter #physicianrecruitment #recruitmenttechnology #recruitmentstrategy #recruitmentprocess

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Financial Stability in the Face of Staffing Challenges Hospital CFOs are grappling with a significant issue: maintaining financial stability while managing escalating staffing costs. The latest discussions have pinpointed several pressing concerns: Labor Costs: Rising wages and benefits for clinical staff. Retention: High turnover rates impacting budget predictability. Cost-Effective Staffing: Balancing internal, per diem, and international hires to optimize costs without compromising care quality. Technology Investments: Allocating funds for new staffing technologies that promise long-term savings but require upfront investment. As we tackle these financial hurdles, it's crucial to find innovative solutions that not only manage costs but also enhance patient care and staff satisfaction. How is your organization navigating these challenges? #HealthcareFinance #CFOChallenges #HospitalManagement #StaffingSolutions #FinancialStability #MedPro

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CMS Staffing Rule Key Points: https://lnkd.in/dgVZUxQa 1. HPRD for RNs is 0.55 and for Nurse Aides is 2.45 2. In addition, facilities must include an additional 0.48 HPRD using any combination of nursing staff, (LPNs/LVNs, RN's, NA's). 3. An RN will be required on site 24/7. 4. CMS now requires that a good faith effort be made to support hiring and recruitment, and stresses the need to have contingency planning in place. Apploi can help. :-) 5. The rule will be implemented in phases: Staffing Plan/Facility Assessment for all- 90 days Non-Rural Facilities: 24/7 RN & 3.48 HPRD- 2 years RN 0.55 HPRD & NA 2.45 HPRD- 3 years Rural Facilities: 24/7 RN & 3.48 HPRD- 3 years RN 0.55 HPRD & NA 2.45 HPRD- 5 years

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Challenges and Solutions for Inpatient Capacity Management - HIT Consultant Title: Challenges and Solutions for Inpatient Capacity Management #CriticalChallenges In a recent report on inpatient capacity management, several critical challenges were identified. These challenges include inefficient patient flow, lack of real-time data, and inadequate communication among healthcare teams. #InefficientPatientFlow One of the major challenges in inpatient capacity management is inefficient patient flow. This can lead to bottlenecks in the system, increased wait times, and decreased patient satisfaction. Healthcare IT solutions can help streamline patient flow and optimize resource utilization. #LackofRealTimeData Another challenge highlighted in the report is the lack of real-time data. Without access to up-to-date information on bed availability, staffing levels, and patient status, healthcare providers may struggle ai.mediformatica.com #health #management #report #staffing #discharge #healthsystems #healthcare #leantaas #insights #provider #staffingshortages #aipowered #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/4dv4UyJ)

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Next up! Health Info Sharing is vital for efficient patient care. Denise O'Hora Webb is walking us through how to operationalize full compliance info sharing and avoid being a info blocker! #HIMSSOregon24 #HIMSS HIMSS Oregon Chapter

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More PSAOs are choosing to opt out of punitive contracts, offering new opportunities for independent pharmacies. If you're looking to start a Medicare Agency, but couldn't get everything set up in time, don't worry. You can still participate this year and retain your patients in your pharmacies. Join our upcoming webinars to learn how you can refer patients to our agents, who will enroll them in plans keeping them in your pharmacy. Understanding your payer mix is crucial for the survival of your business. Mark your calendars for our next two webinars on the referral portal: Monday, September 16th at 8:30 pm Eastern and Tuesday, September 17th at 9:00 am Eastern. If you want to discover how this process works, simply click the link below and RSVP for your preferred session. Let's ensure your pharmacy thrives next year!

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Goals and Gratitude (G&G) Monday: Goal: set appointments to explore new emr. Current emr was fine to start with. But current emr charges per user, ordering labs not integrated, and I want a more rpm friendly emr. Gratitude: This is a random one: jackets/coats. I don’t mean designer, fancy jackets/coats. I just mean jackets/coats in general. As the winter months are coming in NYC, I can’t help but think how uncomfortable and, in more extreme environments, how unsafe life would be without a basic way to preserve body heat in these environments. #remotepatientmonitoring #electronichealthrecord #telemedicine #telehealth

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I’ve led Oxford’s Healthcare Technology group for over 15 years, and the one constant in healthcare is change. We understand that consulting and staffing partners need to evolve as well to effectively support their healthcare clients. As you consider your organization’s strategic plan for the next five years, what services do you prioritize in your consulting partners? Breadth of services – HIT, IT, Cloud, ERP, Security etc. Advisory services Candidate pool of 7-10+ year SMEs with quick access to resumes Contract to hire and/or direct placement offerings Managed services Volume discounts or set pricing Other.... #consulting #healthcaretechnology #HIT

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💡💡Great insights from our #MDaudit #2023Benchmarkingreport Case accuracy in professional and hospital billing present significant revenue opportunities.... With national staffing shortages impacting the field of healthcare; technology, automation, and analytics have become important catalysts for billing compliance departments as leaders look to increase productivity despite fewer staff members. Operational efficiency and coding accuracy become key drivers for financial effectiveness. Billing compliance teams are doubling down on auditing coders and tracking case accuracy rates for E&M and procedure services across professional and hospital billing. As you will see in subsequent pages, a single percentage increase in accuracy rates will mean cleaner claims during initial submission and in turn millions of dollars in reimbursement in a timely manner. 1. Case accuracy describes the accuracy of the total claims being audited 2. Code accuracy describes the accuracy of codes (E&M, CPT/HCPCS or DRG) in the claims being audited

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