Articles in Category: Dementia

Accountability and the RAC teams:

BY: Karlene Stefanakos, M.A., CCC-SLP on Sunday, 10 June 2012. Posted in All, Dementia, Speech Evaluation, Speech Pathology

As we have entered into the Medicare reform rollout period, which began last October 1, 2011, our lives are now characterized by increased stress due to company requested higher productivity levels, which in many cases will become a red flag to investigative teams seeking out fraud. Medical records of patients are now being copied for the RAC teams, and other investigative teams, and fines are being leveled because “perfection” is the rule of the law. Even we here at the Speech Team are altering our tests to include the patient’s name and date of evaluation on every single test page since RAC team reviewers require “absolute coherency” in every chart. The point being that a patient’s medical chart must read like a novel by non-medical accountants!  No more “off or low energy days” for any of us, even though we are human beings.


BY: Karlene Stefanakos, M.A., CCC-SLP on Wednesday, 25 January 2012. Posted in All, Dementia, Speech Pathology

From all parts of this country of ours I hear the frustrations of chaos as the Medicare reforms are rolled out. Human oxidative stress levels are rising, company productivity levels are encouraging therapist fraud, and the patient is paying the freight with less patient care. The simple question is, “Can’t we ever transition change without chaos?” The answer is a resounding “No, because too many people believe in greed.” Not to be outdone on the bottom line profit margin, after an 11% cut in Medicare, the “healthcare business” is working the frontline professionals to unheard of stress levels, and then expecting perfection  in the  human endeavor of patient care.

Dementia and Chemical Restraints

BY: Karlene Stefanakos, M.A., CCC-SLP on Monday, 12 September 2011. Posted in All, Dementia, Speech Pathology

Psychoactive (psychotropic/pharmacological) drugs are among the most frequently prescribed medications for the elderly in skilled nursing facilities and assisted living facilities designed for dementia residents. Psychoactive drugs are medications designed to alter behaviors through their tranquilizing effects, reduction of anxiety and depression, and sedative and hypnotic effects. CMS (Center for Medicare Services) has mandated that these medications are NOT to be used unnecessarily. The regulations state that an unnecessary drug is any drug when used in excessive doses (including duplicate therapy), for excessive duration, without adequate monitoring, without adequate indications for its use, in the presence of adverse consequences which indicate the dose should be reduced or discontinued, or any combinations of these reasons.” Duplicate drug therapy is defined as “any prescribed medication that duplicates a particular effect on an individual.”  This includes two or more drugs used in combination to produce a similar effect on behavior. Duplicate drug therapy should always be analyzed for accumulative adverse effects. (Long Term Care Guidelines, CMS, 1992).