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At least 19 recordsLinked to original sources
PubMed1998

Medicare and Medicaid programs; salary equivalency guidelines for physical therapy, respiratory therapy, speech language pathology, and occupational therapy services--HCFA. Final rule.

This final rule sets forth revisions to the salary equivalency guidelines for Medicare payment for the reasonable costs of physical therapy and respiratory therapy services furnished under arrangements by an outside contractor. This final rule also sets forth new salary equivalency guidelines for Medicare payment for the reasonable costs of speech language pathology and occupational therapy services furnished under arrangements by an outside contractor. The guidelines do not apply to inpatient hospital services and hospice services. The guidelines will be used by Medicare fiscal intermediaries to determine the maximum allowable cost of those services.

Medicaid↗
PubMed1998

Medicare and Medicaid programs; salary equivalency guidelines for physical therapy, respiratory therapy, speech language pathology, and occupational therapy services; revised effective date and technical correction--HCFA. Final rule; delay of effective date and correction.

This document delays the effective date of the final rule on salary equivalency guidelines, published in the Federal Register (63 FR 5106) on January 30, 1998, from April 1, 1998 to April 10, 1998. In addition, we are making a technical correction in the preamble to the January 30, 1998 final rule.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1980

Magnitude of use and costs of in-hospital respiratory therapy.

Respiratory therapy services have expanded in the 3 decades since World War II and now account for approximately 3% of hospital expenditures. The types of services performed have changed; the number of intermittent positive-pressure breathing treatments has markedly decreased since peak usage in th early 1970s, whereas the use of ventilator care and incentive spirometry has increased. The continued increase in respiratory therapy costs may reflect both inflationary pressures and the labor-intensive shift to increased involvement in critical care units.

Hospitals, Community↗
PubMed1981

Medicare and Medicaid programs: schedules of guidelines for physical therapy and respiratory therapy services--Health Care Financing Administration. Final notice with a request for comments.

This notice amends the current schedules of salary equivalency guidelines for Medicare program reimbursement for the reasonable costs of physical therapy and respiratory therapy services furnished under an arrangement with a hospital or other provider. The schedules will be used by the program's fiscal intermediaries to determine the maximum allowable cost of such services. These schedules update the schedule published on October 6, 1978 (43 FR 46377), for physical therapy services, and those published on June 3, 1980 (45 FR 37527), for respiratory therapy services. In addition, these guidelines apply to reimbursement under the Medicaid program where they have been incorporated in the State plans or where States follow the Medicare principles of reimbursement.

Humans↗
PubMed1983

Medicare and Medicaid programs; schedules of guidelines for physical therapy and respiratory therapy services--HCFA. Final notice.

This notice establishes revised schedules of salary equivalency guidelines for Medicare reimbursement for the reasonable costs of physical therapy and respiratory therapy services furnished under an arrangement by an outside contractor except for inpatient hospital services paid for under the new prospective payment system or reimbursed under the rate of increase limits. The schedules are used by Medicare fiscal intermediaries to determine the maximum allowable cost of those services. We are revising the methodology used to establish the schedules, and we are updating the guideline amounts to account for increases in inflation. The guidelines also apply to certain State Medicaid programs. Under the prospective payment regulations and conforming changes implementing Pub. L. 98--21 (published September 1, 1983, 48 FR 39752), effective with cost reporting periods beginning on or after October 1, 1983, we eliminated the salary equivalency guidelines for physical and respiratory therapy services provided as inpatient hospital services. The guidelines will continue to apply to outpatient hospital services and to services furnished by other providers.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1981

Medicare and Medicaid programs; schedules of guidelines for physical therapy and respiratory therapy services: Health Care Financing Administration. Proposed notice.

This notice sets forth proposed schedules of salary equivalency guidelines for Medicare program reimbursement for the reasonable cost of physical therapy and respiratory therapy services furnished under an arrangement with a hospital or other provider. The schedules would be used by the program's fiscal intermediaries to determine the maximum allowable cost of such services. These schedules would revise the schedules published February 25, 1981, which were effective for services furnished on or after October 1, 1980. The revised schedules would apply to services furnished on or after October 1, 1981. For cost reporting periods beginning on or after November 1, 1981, the revised guideline amounts would be increased by an adjustment factor. (As explained in Supplementary Information below, some guideline amounts in these proposed revisions are lower than those contained in the schedules that were effective October 1, 1980. We are proposing, therefore, to have a transition period during which the higher of the revised guidelines or the October 1, 1980 guidelines would apply.) In addition, these guidelines would apply to reimbursement under the Medicaid program where they have been incorporated in the State plans or where States follow the Medicare principles of reimbursement.

Insurance, Health↗
PubMed1982

Medicare and Medicaid programs; schedules of guidelines for physical therapy and respiratory therapy services. Health Care Financing Administration. Notice.

This notice updates the current schedules of salary equivalency guidelines for Medicare program reimbursement for the reasonable costs of physical therapy and respiratory therapy services furnished under an arrangement with a hospital or other provider. The schedules were published in the Federal Register on February 25, 1981, and are used by the program's fiscal intermediaries to determine the maximum allowable cost of such services. They are being updated to account for increases in inflation. The guidelines also apply to certain State Medicaid programs as indicated in the Supplementary Information.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1991

[Non-respiratory therapy of adult respiratory distress syndrome].

Several approaches to non-respiratory management of adult respiratory distress syndrome (ARDS) are discussed. (1) Diagnosis and therapy of the underlying disease is a primary goal in order to avoid the ongoing process of lung injury. (2) Specific pharmacologic therapy for primary lung injury is not available even after 25 years of immunologic research, because no specific mediator has yet been identified as a primary pathogenic factor in ARDS, which is a heterogenous clinical syndrome. (3) Supportive therapy (i.e. improving right ventricular dysfunction and treating pulmonary arterial hypertension) should be emphasized. (4) The most important approach is to optimize prophylactic management to avoid nosocomial infection by eliminating unnecessary invasive techniques, changing the patients' positioning and conserving organ function. So far the latter approach seems to be the only way to improve survival in respiratory failure.

Anti-Inflammatory Agents↗
PubMed1989

[Continuous respiratory therapy of newborn and premature infants with respiratory disorders].

2216 newborns and prematures with respiratory distress of different underlying diseases were treated with long term respiratory therapy from 1. Jan. 1975 to 31. Dec. 1985. One part of the patients were born in our hospital, the other part of them were transported from outside. The rate of prematures was 81.2%. The respiratory therapy was applied in 1813 cases because of pulmonary diseases (group 1.), while in 403 cases the respiratory troubles were extrapulmonary in origin (group 2.). The diseases in the first group were as follows: hyaline membrane disease in 482 cases (27.30%), intrauterine pneumonia in 634 cases (34.64%), postnatal pneumonia in 291 cases (15.90%), meconium aspiration syndrome in 110 cases (6.01%), severe RDS-II in 158 cases (8.63%), pulmonary immaturity in 116 cases (6.35%), persistent fetal circulation in 21 cases (1.15%) and pulmonary aplasia on the left in 1 case (0.021%). In the second group the greatest part of the cases were treated for neurological disturbances. We discuss the indications of different types of respiratory therapy and the complications as well. The survival rate was in the first group 59.3%, while in the second only 16.9%. Therefore the respiratory therapy seems to be more effective in the pulmonary diseases of the newborns. The mortality rate and the rate of severe complications were lower among inborn babies because of the early application of the respiratory therapy.

Asphyxia Neonatorum↗
PubMed1998

Randomized controlled trial of physician-directed versus respiratory therapy consult service-directed respiratory care to adult non-ICU inpatients.

Although current evidence suggests that respiratory care protocols can enhance allocation of respiratory care services while conserving costs, a randomized trial is needed to address shortcomings of available studies. We therefore conducted a randomized controlled trial comparing respiratory care for adult non-ICU inpatients directed by a Respiratory Therapy Consult Service (RTCS) versus respiratory care by managing physicians. Eligible subjects were adult non-ICU inpatients whose physicians had prescribed specific respiratory care services. Consecutive eligible patients were approached for consent, after which a blocked randomization strategy was used to assign patients to (1) Physician-directed respiratory care, in which the prescribed physician respiratory care orders were maintained (n = 74), or (2) RTCS-directed respiratory care, in which the physician's respiratory care orders were preempted by a respiratory care plan generated by the RTCS (n = 71). Specifically, these patients were evaluated by an RTCS therapist evaluator whose respiratory care plan was based on sign/symptom-based algorithms drafted to comply with the American Association for Respiratory Care (AARC) Clinical Practice Guidelines. Appropriateness of respiratory care orders was assessed as agreement between the prescribed respiratory care plan and an algorithm-based "standard care plan" generated by an expert therapist who was blind to the patient's actual orders. The compared groups were similar at baseline regarding demographic features, admission diagnostic category, smoking status, and Triage Score (mean, 3.8 +/- 0.9 SD [RTCS] versus 3.7 +/- 1.0). Similarly, no differences were observed between RTCS-directed and physician-directed respiratory care regarding hospital mortality rate (5.7 versus 5.6%), hospital length of stay (7.9 +/- 9.0 versus 7.7 +/- 7.3 d), total number of respiratory care treatments delivered (30.3 +/- 30 versus 31.6 +/- 30.5), or days requiring respiratory care (4.2 +/- 5.2 versus 4.1 +/- 3.6). Notably, using both a stringent (S) and a liberal (L) criterion for agreement, RTCS-directed respiratory care demonstrated better agreement with the "standard care plan" (82 +/- 17% [S] and 86 +/- 16% [L]) than did physician-directed respiratory care (64 +/- 21% [S] and 72 +/- 23% [L]) (p < 0.001). Finally, the true cost of respiratory care treatments was slightly lower with RTCS-directed respiratory care (mean, $235.70 versus $255.70/pt, p = 0.61). We conclude that (1) compared with physician-directed respiratory care, the RTCS prescribed a similar number and duration of respiratory care services at a slight savings (that did not achieve statistical significance) and without any increased adverse events; and (2) compared with physician-directed respiratory care, RTCS-directed respiratory care showed greater agreement with Clinical Practice Guideline-based algorithms.

Adult↗
PubMed1981

Respiratory care protocol: an approach to in-hospital respiratory therapy.

The difficulty of delivering respiratory therapy according to currently accepted standards is an important problem in many hospitals. As a result of this problem in our hospital, we developed a new therapy delivery system--the Respiratory Care Protocol. In response to an order for Respiratory Care Protocol from an attending physician, a senior respiratory therapist evaluates the patient, prescribes specific respiratory therapy according to a protocol, and then daily re-evaluates the patient and makes appropriate therapeutic changes, including discontinuing respiratory therapy when appropriate. The Respiratory Care Protocol has been well-accepted by patients, physicians, and respiratory therapists, and by Joint Commission on Accreditation of Hospitals evaluation teams. We believe that our use of the Respiratory Care Protocol has led to improved quality and to the reduced cost of our in-hospital respiratory care.

Colorado↗