Stuart Oertli, COO, Asks: “Are you Planning for the New LTACH Rules this Year?” What are your plans to combat a decrease in admissions and lost revenue?

The WoundCentrics Specialized Wound Services program, designed for Long Term Acute Care Hospitals, is proving to be an option to help hospitals flourish under the new LTACH rules.  Our focus on wound care services will improve quality wound care, improve clinical alignment for both patients and providers all while continuing to demonstrate a substantial return on investment for hospitals who contract with WoundCentrics.  

I would like to offer a couple of observations from our newest LTAC Hospital partner.  Prior to engaging WoundCentrics,  there was significant concern from both local administration and corporate leadership that the need for wound care would be greatly diminished as blended payments phase out starting this fall.  Additionally, there was no plan to admit primary wound DRG patients once true site neutral reimbursement began.

The argument against incurring a new expense for a specialized wound care program was that the LTAC Hospital currently had a very well respected, albeit a very busy, local wound care Medical Director in place.   He was affiliated with multiple Acute Care Hospitals and usually, rounded at the LTACH once or twice a week, typically at the end of the day or after 6pm.  Due to his busy day schedule, it was impossible for him to fully integrate with the hospital’s bi-weekly IDT team meetings, nor did he have the time to support the facility wound care nurse on a daily basis.

Additionally, the LTACH facility was already staffed with a well educated, employed wound care team already in place.  The facility had a strong corporate commitment to quality and decision support to assist the staff on the ground.  The local CEO was recently recruited from a major LTAC Hospital ownership group, with a great deal of LTACH experience and pushed to implement our Specialized Wound Services program and worked hard to receive the support from his corporate leadership and full buy-in from his clinical team.

Here is the ROI example I wanted to share: 

The WoundCentrics employed Nurse Practioner wound specialist started seeing patients under the management of the WoundCentrics program at this 38 Bed LTACH in early May.  During the first 2 weeks,  the clinical team identified and completed 7 unique wound debridements,4 of them on LTACH compliant admissions despite the fact that their current payer mix was about 50% site neutral, 50% LTACH compliant). 1 of the debridements was on a patient with a commercial payer who extended authorization due to the active wound care being provided and the final 2 were site neutral Medicare payers.

Four (4) of the wound debridements have been coded thus far and are shown below. I provide this information in hopes that ROI will be immediately evident: 

Patient 1: Admission DRG 207 (1.8542), Post-Debridement DRG 166 (2.4628). Revenue Increase $27,223.83 

Patient 2: Admission DRG 592 (0.9330), Post-Debridement DRG 570 (1.3477). Revenue Increase $18,550.32 

Patient 3: Admission DRG 207 (1.8542), Post-Debridement DRG 166 (2.4628). Revenue Increase $27,223.83 

Patient 4: Admission DRG 208 (1.1033), Post-Debridement DRG 166 (2.4628). Revenue Increase $60,813.02 

Total Revenue Increase from first two weeks of program = $133,811.00.

Assuming net of 50% after expenses (incremental costs are likely much less), the net revenue would be $66,805.50. We proposed a $7,500 monthly fee for single locations, and a corporate rate is available for multiple facilities.  Thus, the entire first year program cost was covered within 2 weeks of program implementation and before considering the additional benefits from commercial and site neutral revenue changes. 

During the third week, 2 additional unique debridements were completed bringing the total revenue increase from the first three weeks of the program to $195,975.29:

Patient 5: Admission DRG 699 (0.6746), Post-Debridement DRG 856 (1.5413). Revenue Increase $34,940.46

Patient 6: Admission DRG 207 (1.8542), Post-Debridement DRG 166 (2.4628). Revenue Increase $27,223.83

This early success with our Wound Services program has our new LTACH client off to a great start.  Continued focus on quality wound care and constant revenue cycle review with administration will provide the revenue to keep the facility financially viable and in position to offer their valuable services to patients in their healthcare community.

What is Your Plan to Survive the new LTACH Rules?

The WoundCentrics Specialized Wound Services program has provided quality wound care for all our facilities and the revenue example provided above repeatable and reliable. It is consistent with every LTACH facility where we have been able to implement our full program with the support of and in coordination with the locate wound care team.  We have historical performance data that shows we have achieved similar results (many times far better) in every single location where we've created an LTACH partnership.

If you are considering plans to attack lost revenue related to decreased volumes and full implementation of site neutral payments for LTAC Hospitals in the coming months, please contact us for more information on how the WoundCentrics Specialized Wound Services program might work with the Wound Care team in your facility. 

For more details about WoundCentrics visit our web site:                                                              Contact:  Ken Rideout, VP Development(281) 989-5398

Wound research collaboration

Though woundcare is now a well established specialty, fundamental questions remain unanswered with respect to the pathologies which result in non-healing wounds. WoundCentrics is helping to champion the cause of basic wound research by promoting provider involvement in active research.

Case in point is an exciting partnership between the US Army Institute for Surgical Research (ISR), and one of our clinicians, CEO Marcus Gitterle, MD. The ISR was founded to focus on the scientific aspects of wound healing, an issue that impacts countless warfighters and civilians annually. The capabilities of their primary lab in San Antonio, Texas, are without peer in this field.

To help advance the clinical science of wound healing, Dr. Gitterle began a long-term collaboration with the US Army, designed to harness the synergy between our large clinical footprint and provider expertise, and their best-of-breed laboratory expertise.

The first study under this collaborative agreement was launched in February, 2016. This study is expected to be the first complete study of the human wound microbiome, including all bacterial, fungal and viral components.

In addition, the study represents the first use of “transcriptomics,” in non-healing wounds, allowing researchers to analyze signaling between microbiome organisms, thought to be a potential source for healing interventions.

Our goal in this research collaboration is to help advance understanding of the complex role of the human microbiome in contributing to non-healing wounds, and ultimately to help identify solutions to wound healing challenges through this understanding.

We are aware that many organizations in woundcare pursue research affiliations, but these are predominantly relationships that create revenue, and the focus is predominantly on products, rather than fundamental scientific insight.

WoundCentrics is proud to facilitate important research that is not funded by industry, and which has the potential to significantly advance the science of wound healing.  It’s our way of “giving back.”

Antibiotic Stewardship Enters the Information Age

Antibiotic stewardship programs have now become commonplace but these programs are implemented in widely varying manners and show wide variations in impact, both clinically and financially.

WoundCentrics, LLC aims to improve the impact of antibiotic stewardship for all stakeholders, through a new product called ABX Steward (

Embodying best practices in information design, HIPAA compliance and clinical antibiotic stewardship policy, ABX Steward enables a pharmacy-based, clinical review of antibiotic prescribing down to the individual case level.

ABX Steward enables your pharmacy staff to conveniently submit clinical data electronically to our cloud-based infrastructure, where it is transmitted to our team of board-certified ID experts for timely review.

Within 24 hours of initiation of the review process, a formal recommendation is sent to the pharmacy where it can be placed on the patient’s chart for action by the prescribing physician.

Reviews are objective, timely and conform to best practices. Moreover, unlike traditional, on-site review programs, there are no cumbersome physician contracts, or monthly minimum charges, and information technology is leveraged appropriately to improve the efficiency of the review process.

We believe ABX Steward to be the future of antibiotic stewardship and it is available today!

The future of wound care in the long-term acute care hospital setting

A Note From Our CEO

The future of wound care in the long-term acute care hospital setting is a troubling concern. Without a clear vision and plan for dealing with impending changes to admission requirements for wounds and acceptance of IPPS patients, some fear that LTACHS will no longer be able to provide the critical capabilities they offer to patients with limb and life-threatening wounds.

The National Association of Long Term Hospitals (NALTH) is conducting a wound care symposium in San Antonio, TX on September 28-29, 2015. At this conference I will be giving a presentation specifically devoted to addressing these concerns. In this presentation I will show how viable and profitable wound care remains in the LTAC setting.  To attend this event, please go to the NALTH website:

My company, WoundCentrics, LLC has spent more than a year systematically preparing for these changes, so that our clients can continue to prosper, grow, and deliver impeccable care within their markets Let us show you how to plan for your facility’s future.

I look forward to seeing you in San Antonio.

Marcus Gitterle, M.D.
CEO, WoundCentrics

How aligned is your woundcare program?

In an insightful article in Becker Hospital Review, authors Lovrien, Peterson, and Salmon distinguish three types of provider alignment; namely Clinical Activity Alignment, Economic Alignment, and Alignment of Purpose, proposing that enduring success in a future healthcare market requires balanced emphasis on all three parameters of provider-hospital alignment.[1]

Woundcare is a critically important service line in the LTAC, with wounds representing a disproportionate share of discharge diagnoses, and a disproportionate share of CC and MCC diagnoses.

Forward thinking organizations have made development of Woundcare Departments a strategic focus. It’s no secret that the most successful LTAC organizations reap the rewards of high-functioning woundcare programs, in season and out, largely on the basis of provider alignment.

But how do we measure the parameters of alignment that predict successful, profitable woundcare programs? The answer is critical if a hospital, or health system intends to optimize, and maximize its woundcare opportunity.

Kurt Salmon, the strategic advisory firm whose analysts wrote the aforementioned article, offers a tool to help facilities and systems perform this sort of analysis, but it is not specific to woundcare. Let’s see if we can create some focused benchmarks using the framework, to help shed some light on alignment as it pertains to woundcare programs.[1]


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