1. SEMTAC Colorado Trauma Registry Colorado Trauma Network Prepared by Health and Safety Data Services April 2014

2. Questions for State-1 REFERRING_CONSULT_DATE & REFERRING_CONSULT_TIME – This information is often hard to find, only used for lower level facilities. – What is the state after with these fields? EMS_TRACKING_NO – Track patient anywhere using a # from a band. Collect? DRAFT2

3. Questions for State-2 DATABASE_ID – For transfers…trauma registry number at previous facility. Takes a lot of correspondence. Utilized? AIS_CODE_REF – What are plans for use of this field? TRANSPORT_SEQ – Is this field to be valued according to January 2013 state registry clarification? DRAFT3

4. Questions for State-3 CONSULT_RESULT – This field is used to identify consult with a trauma surgeon only at another facility. The state indicated some time ago that this field would be removed; if so, do we need to collect it? CONSULT_COMMENTS – What information does the state want in this field? DRAFT4

5. Questions for State-4 HOSPITAL_ARRIVAL_TIME – EMS reports/ambulance v. ED documented arrival times can vary up to an hour or more. Currently auto fills to the ambulance arrival time so if it is off, it will extend our ED length of stay. – In other cases, the ambulance arrival time is LATER than our ED arrival time, so it will cause an edit. – We would like to propose that we use the ED arrival time instead of the arrival time from the ambulance report. Is this the state’s intention that we use strictly the EMS information? DRAFT5

6. Questions for State-5 Documentation of drug presence – ED staff administer opiods vs. possible recreational/abuse use pta ICD9_REF – Code from referring facility. Because not many facilities provide this info, is the state really using this information in any way? DRAFT 6

7. Questions for State-6 Discharge disposition (DC_DISPOSITION_CODE) – Examples from Pg 49 of Manual Come from SNF and returns to SNF – code as discharge to SNF *contradicts NTDS----SNF to SNF is HOME Example will be updated to match NTDS Are we able to identify the number of patients being discharged to jail? – Discharge dispositions JAIL HOME* – *NTDB: "home" refers to the patient's current place of residence (e.g., prison, child protective services, etc.) DRAFT7

8. Discharge Dispositions Situation: Difficult to code certain health care dc disp. – Is a new code needed for assisted living? – Should assisted living code to intermediate care facility (ICF)? – Should skilled nursing facility (SNF) and nursing home be combined? – How to code a pt who tx out of acute care but remained in the hosp? Bottom line: – Need clarification for appropriate coding 8DRAFT

9. Discharge Dispositions 9 DRAFT N#National ElementsCDPHE Elements 1Short-term g. hosp. for inpt careACUTE= acute hospital (N1) 2Intermediate Care FacilityICF = intermediate care facility (N2) 3Home under health sev.HH = home under care of home health agency (N3) 4Left against adviseAMA = left against advice (N4) 5ExpiredD = died after admission (NOT in the ED) (N5) 6Home w/ no home servicesHOME = home with no home health services (N6) 7Skilled nursing facilitySNF = skilled nursing (N7) 8Hospice careHOSPICE = hospice care (N8) 9RET. Rehab & Long-term 10Court/lawJAIL = jail, prison, or other detention facility (N10) 11Inpt. rehab or design. unitREHAB = rehabilitation (N11) 12Long-term care hospLTAC = long-term acute care 13Psy. Hosp/ psy unit of hosp.PSYCH = To inpatient psychiatric care…may be another facility or a division of the same facility. (N13) 14Another institution not defined elsewhere DSS = Dep. Soc. Serv. (N14) OTHER = Other (N14) ?N2 or ?N7 or…NHOME= nursing home ?N12 or…‘Long-stay’ patient scenario...Modify LTAC? ?N2 or ?N6 or ?new element or…Assisted living ?

10. Discharge Dispositions Ideas from CMS https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE0801.pdf Ideas from TJC http://manual.jointcommission.org/releases/TJC2012B/DataElem0247.html Should assisted living code to ICF? Is a new code needed for assisted living? Should SNF and nursing home be combined? How to code a pt who tx out of acute care but remained in the hospital? DRAFT10

11. Contact us! Health Facilities and EMS Division Colorado Department of Public Health & Environment 4300 Cherry Creek Drive South Denver, CO 80246-1530 Phone: (303) 692-2980 Fax: (303) 691-7720 www.coems.info 11DRAFT