Did you know ALTERNACARE has an INFUSION SUITE to serve your patients?
We are currently providing Remicade and IVIG infusions in the suite. Give us a call with your next patient needing IV therapy.
Conveniently located off I-35 and 119th St. in Olathe.
Please notify ALTERNACARE if your patient’s status changes from home bound status.
Infusion visits are typically managed differently from home health visits in regard to home bound patients.
Please visit our Alternacare web site: www.alternacare.net
TPN or ENTERAL?
Those of us that have been around the home infusion industry for many years remember when patients were placed on TOTAL PARENTERAL NUTRITION (TPN) without much thought related to the functioning of the gut. As a matter of fact, the first home infusion patients were TPN patients that Home Health Care of America serviced in 1979.
Today we are finding that physicians are looking for alternative means of providing nutrition to patients at home. Dietitians are very involved with patients in the hospital as well as those going home and their input is making a difference. As we all know, if the gut is functioning, use it. ENTERAL patients come home every day from area hospitals and do very well. Alternacare takes the time to contact these patients regularly to check their supplies as well as a verbal nutrition screen between the Pharmacist and the patient. Medicare and Medicaid typically cover both supplies and formula. On the other hand, commercial payors tend to consider the formula food and do not provide coverage except for the pump and supplies to administer the formula.
So why do we still use TPN and who should you refer your patients to when considering knowledge and expertise? TPN is an excellent source of nutrition when a patient has no other option. Many patients with short bowel and other diagnoses rely on TPN as their sole source of nutrition. Short term use of TPN can be indicated for patients with Pancreatitis, Crohn’s Disease, Weight Loss, Cancer and other diagnoses. When a patient is receiving TPN for short term situations, it is important to know when to convert the patient to an enteral or oral diet based on clinical indicators as well as patient feedback. The challenge that most physicians, and other individuals who refer patients home, face is how do I assess the knowledge of the home infusion company that will be taking care of my patient.
Alternacare continues to place nutrition very high on our priority list for internal and external education. It is important for us to educate the community on the positive outcomes of TPN as well as the potential complications. It is also important for our staff to read peer review journals, attend conferences and network with other clinicians to stay on top of the latest information. Societies such as the American Society of Parenteral and Enteral Nutrition (ASPEN), the Crohn’s and Colitis Foundation (CCFA) and the OLEY Foundation all offer information for patients and clinicians that we have found to be useful. We also spend the time necessary to thoroughly review a patient’s insurance situation prior to bringing a patient on service. Many payors, including Medicare, require proof of medical necessity for TPN coverage. In some cases, the patient has to meet specific criteria in order to qualify for coverage. In the next newsletter, we will cover some of the criteria required by different insurance companies.