Center for Status Integrity Overview

The center for status integrity (CSI) department was created through the Innovate process in 2011.

The new department subsequently opened in 2012, with the primary objective to work with physicians to insure that patients are placed in the appropriate status (e.g., inpatient versus observation) at all Premier Health hospitals.

Status assignment of either inpatient or observation is based on documentation of the following components:

  • The severity of the patient’s illness or condition
  • The types of services the patient receives, including diagnostics and treatment
  • The results of diagnostic procedures performed
  • The patient’s response to treatments given
  • The patient’s clinical history, including co-morbid conditions related to the presenting clinical condition
  • The patient’s risk for a significant clinical event or negative clinical outcome
  • Documentation by the physician addressing these components and the plan of care

Status assignment is an essential component of patient care. Status drives the way that we charge for services, the type of bill sent to the insurance company, the amount that we get paid for the services provided, our risk for Medicare audits including takebacks and fines, as well as the out-of-pocket expense for the patient in terms of co-pays and deductibles. The process starts with the physician writing an order for either inpatient or observation. The CSI RNs are alerted of the status order, and then review the patient’s medical record to insure that there is documentation to support the ordered status. If needed, the CSI nurse will contact the physician to discuss the case, and, if necessary, obtain an order from the physician to change the patient’s status. All status changes require an order from a physician. In addition, the CSI RNs may contact the patient’s bedside leader to discuss components of nursing care important to determining status assignment. Examples include advanced neurological and neurovascular checks, baseline oxygen saturation, orthostatic blood pressure, medication clarifications, details regarding blood administered, and validation of a patient’s pending discharge.

The CSI department is open 24 hours a day, 365 days a year, and is physically located at Miami Valley Hospital; however, it but reviews status for patients at all Premier Health hospitals. Employees who have questions regarding a patient’s status assignment are welcome to call the CSI department at (937) 208-6280.

If you have questions regarding the CSI department functions, please feel free to call the CSI Manager Diana Howley at (937) 208 -3378, or CSI Director Kimbra Kahle Paden at (937) 208-2095.

<< Back to the May 2014 Issue

Source: Premier Health Nursing

Content Updated: May 15, 2014

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