Medicare to cover Cardiac Rehab...

I dunno who paid.....

by donr - 2014-04-20 09:04:02

..... for my Cardiac Rehab about 1-1/2 yrs ago, but it wasn't me. I did it at the hosp where our ER Doc Daughter works in Mississippi,

What I had was a modified Stage 2 - no ECG monitoring. The hosp assigned a therapist to me who watched me like a hawk, checking BP & HR frequently. They had no VISIBLE crash cart. The facility belonged to the hosp, but was in a bldg about 1-1/2 blocks away. They also had an indoor pool that hosted rehab patients all day long. I was working out w/ all the folks w/ all the other ailments requiring PT.

For the current session, it's Stage 3 & all they do is check BP before I start, once while exercising & after I stop & HR & respiration return to normal. This hosp has a large room dedicated to Cardiac & pulmonary rehab, w/ probably 45 -50 machines in it. Operated by a supervisory RN & at least half a dozen LPN's/techs who do BP's. All the Stage 2 clients wear ECG Telemetry units & one LPN monitors them on a computer continuously. They very wisely switch out the computer monitoring person about every 15 minutes.

The supervisory RN is a former USMC Drill Instructor - or at least acts like one straight out of the lore as to what they are like. She watches everyone like a hawk ready to dive & take her dinner. That includes all the other staff personnel. Every one of the staff wanders around the room chatting briefly w/ people like they were long-lost siblings & they can put a name to every one of us by the time we've been there 5 minutes. Once per month, ALL of us get a rhythm strip at least 12 beats long.

Amazingly, the Supervisory RN Knows something about PM's & can read an ECG. I asked her to measure out my AV Paced & sensed times & she whipped out a pair of sharp-tipped dividers & straight edge & measured them out like a HS student in a Plane Geometry class.

The other RN is a former member of my cardio's staff, so she also knows PM's. Both of them have years of experience as cardiac nurses.

Crash Cart is tucked into a small room & has a wheeled bed so they can whip any people who collapse onto the bed & hustle them off to the ER, which is in the same Bldg.
Lots of O2 bottles on wheels available.

A First Cass Outfit & operation.

The billing charge is $252 per month for a Stage 3 client, but they discount it 75% for those of us who self-pay. MOF - that's ALL of us, since Medicare will not touch a dime's worth of State 3 therapy. Dunno what any pvt Ins will cover. There have to be a BUNCH of us Medicare eligible (65+ Yrs old) just from the small sample of folks I've asked the ages of. Couple of WW-II vets - in their 90's; Korean War Vets - in their 80's & a smattering of 70's types.

The discounted cost is indicative of the whacko, unrealistic, artificial billing accounting going on. It is obvious to even the most casual observer that about $60 per month is too low a charge. For that we get 3 visits per week. Just the cost of the building & equipment has to exceed that income stream. But it does entice a lot of LOW demand patients to come in & add to the revenue. Revenue that pays for a significant part of the overhead of running the place. They have enough Stage 2 patients that the marginal increase in staff to cover the Stage 3 types is insignificant - so we are fitted in between the demands of the stage 2's just like sand fits in between the gravel in concrete.

Donr