1 TRIFACTS SUMMER Tri-State Society for Cardiovascular and Pulmonary Rehabilitation EDITOR: Denise Sheffield RN Phone President. Nadine Greco Kathy Thumma passes the Gavel to new President elect Nadine Greco. Greeting fellow Tri-State members! If you were unable to make our 30th annual TSSCVPR symposium in Somerset, Pennsylvania, you missed a great line of speakers. Every discipline in both the cardiac and pulmonary rehab field was represented. Once again, hats off to the symposium committee for a job well done. I feel that I gathered enough pearls of wisdom to make a necklace. As I drove home from the symposium on that Saturday, the weather was uncooperative at best. There was a torrential downpour. After twenty minutes the rain stopped and the sun appeared. I searched for a rainbow and there it was right in front of me. Being a photographer, I pulled over and took a few pictures. I reminded myself to look up what PRESIDENT S rainbows symbolize. Well, rainbows symbolize a new beginning. I thought how appropriate with my new position as your president. I am both excited and humbled to be representing all of you and the programs you represent within our organization. Many thanks for all the well wishes I received at the meeting from attendees I never met before and members of the Board as I start my presidency. In conclusion, as we approach the start date of accepting heart failure patients in our programs some advice: remain calm, utilize your updates / correspondence from TSSCVPR and AACVPR as a resource, don t forget to breathe and find time to play. CORNER
2 Meet our New President Nadine Greco MS Nadine has been in cardiac rehab for 29 years as an exercise physiologist/cardiac rehab coordinator. She graduated from LCCC with an Associates Degree in Health and Physical Education in 1978 then went onto East Stroudsburg University and graduated with a BS in Parks and Recreation in She obtained her MS in Cardiac Rehab in 1985 from East Stroudsburg and another MS from Marywood University in 1994 in Foods and Nutrition. She started the Cardiac Rehab program 22 years ago at Wayne Memorial Hospital in Honesdale PA and continues as their coordinator today. Nadine has been an associate professor at various local colleges teaching Anatomy and Physiology, Exercise Physiology and Basic Nutrition classes. Her hobbies include: bike riding (road and mountain bike), photography - as the one above, following Penn State sports teams and reading. At present she thoroughly enjoys her two Shiz Tzu dogs named Macy and Zelbie. 30th Annual TSSCVPR Symposium a Success Feed back from attendee s positive The staff that attended enjoyed the symposium and had a wonderful time. The topics and the speakers were very informative and enjoyable. The venue was great and the food was wonderful! We look forward to participating again next year. THE WINNERS ARE: EDUCATIONAL BOARD FIRST PLACE: SUSAN KEEPER MEET YOUR METS After attending a PCNA seminar and hearing the importance of achieving 500-1,000 MET minutes per week for cardiovascular health, Ephrata Community Hospital s Cardiac Rehab initiated a Quality Improvement indicator to measure how effective they were at achieving their goal. They created an educational board and a brochure that assists patients in logging their activities and MET minutes, helping patients take an active role in maintaining cardiac health and meeting the goal of MET minutes per week.
3 EDUCATIONAL BOARD 2nd PLACE: Ohha Melhyk Bryn Mawr Hsopital Sweet Killer
4 CLINICAL PROJECT POSTER 1st PLACE: Kevin Goodwin UPMC Shadyside Chin Ups to Chin Up: Facilitating Depression Recognition and Treatment among Patients Affected by Heart Disease Based on research done by UPMC s Evidence Based Practice and Research Council, it was felt that the Cardiac Rehab at UPMC provided a unique opportunity to pilot a project correlating the relationship between depression and individuals with heart disease. The staff elected to use the PHQ-9 screening patients over a period of time allowing staff to facilitate treatment and monitor effectiveness of any interventions. Based on the results of this project, they will continue to screen patients for depression using the PHQ-9 and UPMC may choose to use the tool in other departments
5 CLINICAL PROJECT PPOSTER 2ND PLACE: Kathy McGarvey UPMC Altoona Improving Patient Outcomes in Outpatient Cardiac Rehab "The Winners"
6 DISTINGUISHED SERVICE AWARD WINNER KATHY THUMMA Kathy, Thank you for your dedication to TSSCVPR and Congratulations it is well deserved!
7 BASKET RAFFLE OH HOW FUN "Good Job" Sue McKinney Special Events Chair.
8 Highlight Pictures from the Symposium Vendors
9 Expanded Rehab Facility in Barbados Offers World-class Rehab The TSSCVPR Caribbean Chapter is alive & well at the Heart & Stroke Foundation of Barbados! The soon to be 30 year old year old outpatient cardiac rehab program there (founded 1985) is a free-standing facility owned & operated by the Foundation, the equivalent of our American Heart Association. The HSFB building is located about 3 blocks from the island s 800 bed Queen Elizabeth Hospital, where a new cardiac surgery suite is nearing completion. HSFB offers a Cardiac Disease Prevention & Rehabilitation Program (CDP&R), a postacute Stroke Rehab program, a primary prevention program for people with cardiac risk factors, & a year-long maintenance program for graduates of all of the above. In addition to its exercise related programs, HSFB is the island s provider of BLS/ACLS training courses for both healthcare professionals & the public. In 2013, the HSFB facility was totally remodeled & expanded to accommodate the growing volume of participants in all of its programs. The enlarged exercise gym, now apporx sq. ft., contains state of the art equipment, including arm & leg exercise machines, strength training equipment, & an 8-channel Q-Tel telemetry monitor (see adjacent photos). Two interview/exam rooms, a stress testing room, & an office for the Medical Director, who is onsite at least 2 days each week, were also added. And, thanks to a generous donation from a program participant, a resource center was included to enable patients to review books, journals, models, posters, etc. onsite or to take home the various learning materials. Dr. Janelle Bryan, Falicia Goodridge (fitness instructor), Teon Angus-Baptiste(nursing assistant), & nurses Rekeima Brewster & Rosanna Springer patients in stroke rehab, and just over 100 graduates in the maintenance program. The CDP&R program operation follows AACVPR guidelines and is quite similar to programs in the states. It was originally certified in 2011, submitted for recertification earlier this year, and is eagerly awaiting AACVPR s 2014 decision. Across the eastern Caribbean, the HSFB program has become known & respected as the model cardiac rehab facility in the islands. As the burden of cardiovascular diseases increases among Caribbean populations, one of the Foundation s next goals is to become the training center to support replication of its prevention & rehabilitation programs on other islands. The HSFB Board & staff extend an open invitation to all TSSCVPR members to come visit anytime! The remodeled facility was re-opened in September & dedicated to its two visionary founders, Trevor Hassell MD, cardiologist, & Dru Symmonds, retired business executive, both of whom remain active with the Foundation today. Current staff includes nurses, exercise specialists, a physiotherapist, & a dietitian, some of whom are shown in the attached photo. Current patient volume includes about 25 cardiac patients in the monitored (phase 2) rehab, about an equal number in the non-monitored prevention group, a slightly higher number of
10 Tri State Society for Cardiac & Pulmonary Rehabilitation May 19, 2014 TO: All TSSCVPR Members FROM: TSSCVPR Professional and J12 MAC Associates Reimbursement Committee ATTENTION MEDICARE UPDATE ATTENTION 1. Novitas Readiness to Pay for Heart Failure Cardiac Rehab Charges After nearly 2 months of persistent effort, TSSCVPR has established communication with the appropriate personnel at Novitas Solutions Inc., the Medicare Administrative Contractor (MAC) for our mid-atlantic area (Medicare Jurisdiction L = PA, NJ, DE, MD, DC). (Formerly known as J12) Novitas has informed us that while they are aware of the mid-february Decision Memo announcing coverage of Heart Failure, they have not yet received official instructions from CMS headquarters regarding the release of the final National Coverage Determination (NCD) that expands coverage of cardiac rehab to include chronic Heart Failure (HF) patients. The nearly 30-page NCD that accompanied the February announcement was clearly marked as a proposed document vs. a final edition. Specifically, Novitas stated that we have not been provided the effective date to begin processing claims for that service. Therefore, they cannot yet pay for cardiac rehab bills on HF patients. Any bills submitted before their to-be-announced official notification date will be denied & returned. Those bills can be resubmitted & will be paid after the acceptance date is announced. Novitas suggested that such notification may occur sometime in June. As a result: TSSCVPR is advising that cardiac rehab programs target a July 1st start date for taking HF patients into cardiac rehab programs. By the time bills are generated/submitted on those patients, Novitas should be ready to reimburse without further delay. We will notify you if any unexpected delay beyond that date. Thank you for your patience in waiting for this guidance to make the reimbursement process for this new population as painless as possible for all parties concerned. The lesson here is that, on a functional level, there is a large difference between coverage & payment within the Medicare system. Please watch the TSSCVPR website, for posting of the Novitas readiness date. 2. Hospital Readmission Penalties for COPD & CHF On May 14th AACVPR sent out their latest Health Policy Update. In that report they listed a number f ICD-9 codes that could be targeted for Medicare audits of 30-day hospital readmissions of COPD & CHF patients. The report included an important disclaimer: Please note that the posted ICD codes are NOT intended to represent ICD codes that are acceptable diagnosis codes on CR claims for HF patients. TSSCVPR would like to reiterate that the list of codes shown, both for CHF & COPD, is NOT to be used as rehab qualifications. In fact, few of the code numbers shown are acceptable for either Cardiac Rehab or Pulmonary Rehab services. ATTENTION MEDICARE UPDATE ATTENTION