Editor's Desk: It's been a big year (even without healthcare system reform)

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James M. Berklan, Editor
James M. Berklan, Editor

You better believe healthcare reform would be important to the long-term care community, no matter how many or few times the phrase “long-term care” might actually appear in any Congressional action.

But it isn't everything.

A brief review of some of the events in the LTC nurse's world in 2009 gives plenty of examples of other things worth focusing on.

Just ask any director of nursing about the Drug Enforcement Agency rules about needing a written prescription when ordering pain medication. (This because a pharmacy cannot take a verbal order from a “nurse” for a drug.)

The halls of Congress might teem with people who can flood or strip millions of dollars from the long-term care funding stream in a blink. But ask any DON what the effect of this DEA policy has been—and how her personal aspirin supply is holding up.

The crazy thing about it is a nurse can call a physician's office to request a prescription; a doctor can then give a non-registered nurse a verbal order and that person can then call the pharmacy and get a tech to fill an order.
Then, of course, there has been the run-up to the new MDS 3.0 and the new proposed rule for the RUGs IV system next year.

Those two acronyms, MDS and RUGs, are going to be making a lot of headlines in 2010, whether or not Congress moves anything reform-related this year, or even early next year (the smart bet).

Some experts believe the new RUGs rule will have sweeping, possibly devastating, effects on providers that rely heavily on Medicare reimbursement.

And who along the reimbursement line can overlook the rise in medical reviews this year? Medicare Part A pre-payment reviews in particular have been in the crosshairs.

Finally, when it comes to bedside care, what bigger topic is there than pressure ulcers? Whether it's the presence or just the threat of them, they cannot be very fair from a discussion.

The International Pressure Ulcer Prevention and Treatment Guidelines were released late this year. These guides are considered standard of practice, so you or your staff better be familiar with them.

These new rules may not technically qualify as reform. But they are certainly changing the way care is delivered.