[Dysphagia] Medicare holidays

[LOBSTERPAM at aol.com (LOBSTERPAM@aol.com)]

In a message dated 2/14/05 7:45:28, connorswa@ph.upmc.edu writes:

<< While I appreciate the pragmatics of reimbursement and staff 
satisfaction/recruitment, if we omit number three from discussions are we sufficiently 
patient-focused? >>

My sense is that a balance is required.  If we are 110% patient focused, to 
the exclusion of making any attempts to keep staff happy, you can risk losing 
staff.  If staff is unhappy, they'll go elsewhere, and at least around here, 
they can.  There are multiple SLP jobs advertised on a weekly basis.  I know of 
staff who left positions because they were required to work to make up 
holidays - and didn't get overtime because they were salaried.  There were plenty of 
jobs available where they didn't need to do that.  There is the idea that 
patients ALSO want and deserve a day off for a holiday, especially in a SNF  
setting when it is not a diagnostic issue but that this is their home and that they 
shouldn't have to work every day.   Obviously the patients are the reason 
we're here and all that, but the reality is that if conditions are such that 
staff doesn't want to stay, your patients end up getting even less care.  There's 
a local rehab hospital that has 3 or 4 vacancies now, and has had them for 
several months.  They have horrendous turnover; we get patients from there and 
it's evident that the care isn't good.  Their rehab staff is working till 6 and 
7pm to meet quotas.  So they leave.

I also know that when I've covered for therapists, it was based on a 
Sunday-through-Saturday schedule, and I was only required to see patients who were in 
a window.  In those cases, it seems the reimbursement bottom line was the 
issue.  Perhaps that was company policy; perhaps it was more locally determined.

psmith