Armed Polite Society
Main Forums => Politics => Topic started by: AZRedhawk44 on April 02, 2020, 12:52:27 PM
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With a naval hospital ship deployed in San Diego and New York City to assist with COVID-19 treatments, I got to wondering:
Lay folk being treated in hospitals get billed, even during a pandemic. Charting happens, and bills are created that go to either insurance or the patient.
Will lay folk who are treated in these naval hospital ships be billed? Or will they be treated without all the ICD/CPT coding and insurance documentation and such? Do military medical staff document treatments the same way that civilian hospital staff do?
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I'll bet whatever hospital or hospitals the mercy ships are backstopping will dream up appropriate billing, even if they incurred no direct costs in treating hospital ship patients.
Yes, my cynicism is showing.
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I believe both ships are on the East Coast right now. Or at least the 2 I've heard about.
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I believe both ships are on the East Coast right now. Or at least the 2 I've heard about.
I think we only have two. One is in NY, the other is in CA.
https://en.wikipedia.org/wiki/List_of_United_States_Navy_hospital_ships
https://www.npr.org/sections/coronavirus-live-updates/2020/03/18/817881133/u-s-navy-hospital-ships-to-deploy-to-new-york-west-coast
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I believe both ships are on the East Coast right now. Or at least the 2 I've heard about.
One is in NYC, the other is moored at Long Beach.
They will figure out a way to bill, maybe.
bob
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California has to find a way to pay for that train.
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California has to find a way to pay for that train.
Which one, the bullet train to nowhere or the one the crazy guy tried to ram USNS Mercy with?
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I don't know about the billing, but I believe both are actually being used as backstops for non COVID patients. People are complaining that Mercy only has 20 patients on it so far...because they're getting tested before they can be admitted.
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I don't know about the billing, but I believe both are actually being used as backstops for non COVID patients. People are complaining that Mercy only has 20 patients on it so far...because they're getting tested before they can be admitted.
Which only makes sense.
Proper isolation for an infectious patient means a room that's "negative pressure." That means the ventilation system exhausts slightly more air than it supplies. The result is that when the door is opened, air moves from the corridor into the room rather than pushing potentially contaminated air out of the room into the corridor. City hospitals generally have at least some such rooms. A military hospital ship is probably more oriented toward treating physical injuries rather than infectious diseases. I doubt the ship has any negative pressure rooms or wards, and I doubt that a ship's ventilation system can be easily adjusted to create such.
I know a guy who is an IT manager for Yale-New Haven hospital in (naturally) New Haven. A few years ago Yale built a new building specifically for treating cancer patients, the Smilow Cancer Center. My friend told me that Yale has emptied the top three floors of Smilow and is converting them to treat only Covid-19 patients. Why? Because the rooms on those three floors are all negative pressure rooms.
Dealing with something like Covid-19 is the opposite of treating people with suppressed immune systems. In those cases, the goal in positive pressure rooms, to prevent bugs in the corridor from getting into the room when the door is opened.
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My company is working with a local hospital system to setup negative pressure rooms for Covid-19 overflow.
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My company is working with a local hospital system to setup negative pressure rooms for Covid-19 overflow.
Got any inside skinny on how they're doing it? I was talking with a friend on Friday about this. He works for a hospital, and neither of us has any notion of whether a typical hospital's HVAC system has the flexibility to switch rooms from positive pressure to negative pressure. I sort of this it's not easy. Yale has emptied all the patients out of three floors of their shiny new cancer center and is designating those three floors as Covid-19 floors, because those three floors are already negative pressure.
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Which only makes sense.
Proper isolation for an infectious patient means a room that's "negative pressure." That means the ventilation system exhausts slightly more air than it supplies. The result is that when the door is opened, air moves from the corridor into the room rather than pushing potentially contaminated air out of the room into the corridor. City hospitals generally have at least some such rooms. A military hospital ship is probably more oriented toward treating physical injuries rather than infectious diseases. I doubt the ship has any negative pressure rooms or wards, and I doubt that a ship's ventilation system can be easily adjusted to create such.
I'm not sure that is something that can be done quickly anywhere, it is much more than just flipping the airflow, you have to have filters and such to prevent the pathogens from being exhausted into the atmosphere and some way to continually monitor the difference in pressure from the outside of the room to the inside. I doubt any of that comes easy or cheap.
bob
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Generally I'd blame *expletive deleted*it like this on just every day incompetence abut damn...
https://www.foxnews.com/us/coronavirus-patients-delivered-comfort-ship-new-york-mistake (https://www.foxnews.com/us/coronavirus-patients-delivered-comfort-ship-new-york-mistake)
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Positive pressure is easier than negative from my HVAC/R experience. Return air is almost always undersized to start with.
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I'll bet whatever hospital or hospitals the mercy ships are backstopping will dream up appropriate billing, even if they incurred no direct costs in treating hospital ship patients.
Yes, my cynicism is showing.
"Patient referral fee."
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I have to ask. Why is the towards the bow topside cross a funny shape?
edit: never mind, figured it out. The reason why was clearer in other photos.
https://www.businessinsider.com/military-trying-to-make-hospital-ship-usns-comfort-more-useful-2020-4
(https://i.insider.com/5e876d6c29d6d9410e3c6a45?width=1300&format=jpeg&auto=webp)
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Positive pressure is easier than negative from my HVAC/R experience. Return air is almost always undersized to start with.
Correct. And for most systems, most of the air in circulation is recycled, for energy conservation. A typical building's HVAC system exhausts a percentage of air to the atmosphere and mixes a corresponding percentage of fresh, outdoor air into the supply stream. On a large project I was involved in recently, the air being supplied throughout the building was 20% outdoor air, which means 80% was recirculated. Toilet rooms are 100% exhaust -- that air can't be recirculated.
With a negative pressure system for infectious diseases, you certainly don't want to be recirculating air from the rooms. That means the system has to be capable of being adjusted so that ALL the air from the patient rooms is exhausted to the exterior. That has corresponding impacts on the supply air system, as well as on the heating and cooling plant.
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Correct. And for most systems, most of the air in circulation is recycled, for energy conservation. A typical building's HVAC system exhausts a percentage of air to the atmosphere and mixes a corresponding percentage of fresh, outdoor air into the supply stream. On a large project I was involved in recently, the air being supplied throughout the building was 20% outdoor air, which means 80% was recirculated. Toilet rooms are 100% exhaust -- that air can't be recirculated.
With a negative pressure system for infectious diseases, you certainly don't want to be recirculating air from the rooms. That means the system has to be capable of being adjusted so that ALL the air from the patient rooms is exhausted to the exterior. That has corresponding impacts on the supply air system, as well as on the heating and cooling plant.
You should see how we did it on submarines. =D
We used high pressure air to blow the tanks to sea. since venting that used air overboard would put noise and bubbles in the water possibly causing the boat to be detected, after the tanks were blown overboard that air was vented back inside the boat through charcoal filters. Always a fun and enjoyable evolution.
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You should see how we did it on submarines. =D
We used high pressure air to blow the tanks to sea. since venting that used air overboard would put noise and bubbles in the water possibly causing the boat to be detected, after the tanks were blown overboard that air was vented back inside the boat through charcoal filters. Always a fun and enjoyable evolution.
Thanks. I SO did not need to know that.