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1. Number Value Notes SurveyVersion D2C or D2C Discharge Survey with two nursing shifts D3C D3C Discharge Survey with three nursing shifts Facilityl D 6 digits Facility s Medicare provider number as printed in bar code upper left corner of survey page 1 SurveyI D 6 7 digits Survey ID as printed in bar code upper right corner of survey DatePrinted mmddyyyy As printed in bar code lower right corner of survey page 1 Q1 0 5 Q2 0 5 Q3 0 5 Q4 0 5 Q5 0 5 omit this when uploading D2C surveys Q6 0 5 Q7 0 5 Q8 0 5 Q9 0 5 Q10 0 5 Q11 0 5 Q12 0 5 Q13 0 5 Q14 0 5 Q15 0 5 Q16 0 5 SurveyI D 6 7 digits Survey ID as printed in bar code upper right corner of survey Q17 0 5 Q18 0 5 Q19 0 5 Q20 0 5 Q21 0 5 Q22 0 5 Q23 0 5 Q24 0 10 Q24 Reason text SurveyI D 6 7 digits Survey ID as printed in bar code upper right corner of survey Q26 memo DischargeSurveySafetyComments USER FEATURES II D PSI SCAN UPLOAD 18 ITRA ourconts user manual Gm a amp ES Sf amp SYSTEM l1 USER FEATURES Discharge Survey File Format Continued Name or Survey Question Number VELTS Notes Q27 DischargeSurveyComments memo Q28 1 3 Q29 loro 1 checked O0 not checked Follow Up Survey File Format Name or Survey Question Number urveyVersion F F Follow Up Survey as printed in bar code lower
2. Add User Bed Count Custom Data Fields WN Facility Settings 5 Recently Modified Assessments FACILITY ADMINISTRATOR FEATURES III FACILITY ADMINISTRATOR FEATURES 52 Gm amp 2 Gf amp SYSTEM LITY ADMINISTRATOR FEATURES 6 Patient Satisfaction Instrument An explanation of the functions of each link follows If you have a My Facility link on your homepage and you do not see all of these links on your Manage Facility screen you are either a Site Administrator or an Organization Administrator not a Facility Administrator L Add User Facility administrators are responsible for managing all user accounts for their facility This includes multiple sites if your facility has more than one location operating under a single Medicare provider number Each user should be given their own user account with a unique username and password but all users from your facility will use the facility s Medicare provider number as part of their login Each user should also be given a set of user privileges that corresponds to their duties on the LTRAX system Privileges can be combined to ensure that each user has the unique combination of user privileges they require in order to perform their job There is no limit to the number of user accounts a facility can have To add a new user from your Manage Facility screen click Add User You will see the following fields Site If your facility has more than one site select the
3. Correct Admit Correct Discharge On an assessment that has been marked as Accepted by CMS click the respective Correct button to make changes to LTCH CARE Tool information that has already been transmitted to CMS When making corrections to an admission record that has an associated discharge record you ll first need to click Edit Admit then click Correct Admit NOTE The Correct button is not necessary when making changes to the LTRAX data items that don t affect the LTCH CARE Tool such as any field not identified by an LTCH CARE Tool item number Braden and Vent assessments or Wound assessment information TRA Heh user 1a ua j SSESSMENT FEAT Gea amp ES Sf aAa SYSTEM that won t change information on the SKIN CMS tab On records in which both the admission and discharge assessments have been marked as Accepted by CMS If a correction is made on an admission assessment to patient demographic information that is shared with the discharge record e g patient name birth date gender admission date SSN the CMS Transmit File screen will auto correct the discharge record and prompt you to submit the corrected discharge For example An admission record is completed transmitted to and accepted by CMS eA discharge record is completed transmitted to and accepted by CMS eA correction is made on the admission record to a field that is shared by the discharge record e g patient name admit date SSN gender birth
4. Accepted is not the date that CMS received and accepted the assessment you can also edit this date manually for both the admission and discharge records on the CMS I NFO tab on the assessment itself NOTE If you need to edit and re submit any assessments you must create a new download file containing the edited assessments after you have processed those assessments in Step 3 and corrected the errors Once you have selected the appropriate status for each assessment click Update Then click HOME to return to the home screen QUICK REVIEW FOR CREATING CMS TRANSMIT FILES Step 1 Confirm Valid Assessments Select the Confirm radio button only for those assessments that you are transmitting to CMS All others should be marked Leave Click Confirm Step 2 Download CMS Assessments File Download the file to your computer s hard drive or your local network in order to transmit it to CMS using the CMSNet software Refer to the CMS documentation for how to transmit your files Step 3 Accept Reject Assessments Referring to the CMS final validation report process your downloaded assessments by marking them either Accepted or Rejected Select Leave to not process an assessment Verify the transmission date and click Update USER FEATURES II D CMS TRANSMIT FILE 11 TR LTACH ssm USer Manual mm e E EZ ag a SYSTEM Il USER FEATURES 2 Data Download Custom Template The Data Download Cus
5. Gea amp ES Sf amp SYSTEM NOTE If you are designating the user as a facility administrator this privilege is unnecessary and redundant Sub Administrator Privileges Non admin user can perform Clinical Assessment advanced maintenance functions This privilege allows a user who is not an LTRAX facility administrator to Revert an admission assessment back into a pre admit assessment for example on accidentally admitted assessments NOTE This privilege is not necessary if the user has facility administrator privileges Non admin user can copy assessments from their facility to other facilities in their organization This privilege allows a user who is not an LTRAX facility administrator to duplicate a pre admission screening into a different facility than the one in which the original pre admission screening was created NOTE This privilege can only be assigned by an LTRAX organization administrator It is not necessary if the user already has organization administrator privileges Assessment Privileges User can view assessments belonging to ANY facility in their organization This privilege gives the user the ability to see patient assessments at any facility in their organization This does not include the ability to create or edit assessments Users with this privilege will be able to select from a drop down list of their organization s facilities at the bottom of the LTRAX home screen in order to display that facility
6. ASSESSMENT WARNINGS ERRORS AND COMPLETION CHECKING The data entry screens on LTRAX include a variety of built in checks which look for data entry problems ranging from simple typos such as invalid dates or Social Security numbers to logic routines such as verifying that a patient s admission date is later than their birth date but earlier than their discharge date to item completion that doesn t meet the specifications in the LTCH QRP Manual such as wound reverse staging Some problems trigger a warning message alerting the user to review the suspect data Other problems trigger errors that will not allow data to be saved at all In both cases a message is displayed at the top of the screen detailing the problem encountered Error messages are displayed at the top of the assessment screens with a red header when either an invalid value has been entered or the Complete Admit Complete Discharge button has been clicked on the MGMT tab and errors were found during the completion check Errors will prevent an assessment from being marked as complete Warning messages are displayed at the top of the assessment screens with a gray header when any information triggering a warning has been entered Warning messages do not prevent the completion of an assessment and the display of these messages can be hidden by clicking the Hide link at the top of the assessment screens Hiding the warning messages on one assessment will hide them for all assessments
7. E P S I Tab 7 Assessment Warnings Errors And Completion Checking 8 Assessment Tools LTCH CARE DATA SET The data collection fields required for the LTCH CARE Data Set are incorporated into the LTRAX clinical assessment screens on pre admission admission and discharge records These fields are identified by the LTCH CARE Tool number preceding the field name or section For example on the D PAY tab the patient name section is labeled A0500 Legal Name of Patient The admission and discharge assessment screens offer links to the respective sections of the LTCH CARE Quality Reporting manual for on screen reference when completing those fields You can find more information about the LTCH CARE data set on the LTCH Quality Reporting website here http www cms gov Medicare Quality Initiatives Patient Assessment Instruments LTCH Quality Reporting index html ASSESSMENT FEATURES V ASSESSMENT FEATURES 69 LTACH TR wrons user Manual m a amp ES ag a SYSTEM V ASSESSMENT FEATURES ACCESSI NG PATI ENT ASSESSMENTS Access to the assessment screens on LTRAX is controlled by a combination of user privileges All information about the assessment screens in this section is provided assuming the highest level of privileges If you don t see all of the buttons screens or functions described in the following text you most likely do not have the privileges necessary to view or do w
8. but only for the selected MDC The same filters available on the Facility Report are available on the MDC Report except for Denial Reason DRG REPORT Admission assessments with a DRG are included in the DRG Report Click on DRG Report to view a list of all DRGs To collapse the list to display only DRGs with admissions at your facility check the box labeled Hide codes with zero admission assessments Clicking on an individual DRG will give you a report structured like the Facility Report but only for the selected DRG The same filters available on the Facility Report are available on the DRG Report except for Denial Reason ITRAX 22 Il USER FEATURES as Ag amp SYSTEM PATIENT REPORT The Patient Report lists denied pre admission assessments returned by your search filters Click on Patient Report to view your denied patients For each denial record the report displays where present the date the pre admit was marked denied patient last and first names birth date admission type admit from payer and denial reason You can click on a column header in the list to sort the list by the selected column in ascending order Click the column header again to sort the list in descending order 3 HCAHPS Outcomes LTRAX HCAHPS Outcomes Reports are available to LTRAX users with the privilege to view outcomes reports or Patient Satisfaction outcomes reports for their facility or organization To get to the HCAHPS Outcomes R
9. no information on denials is available at the MDC level so this filter does not appear when you are filtering the report by a selected MDC or when viewing the Patient Report DRG The DRG drop down shows you admissions by selected DRG Because DRG is not collected on the pre admission screening no information on denials is available at the DRG level so this filter does not appear when you are filtering the report by a selected DRG or when viewing the Patient Report REPORT OUTPUT FACILITY REPORT Referrals by Referring Physician If your facility has configured the Referring Physician custom field this table displays a list of the referring physicians with counts and percentages of denials admissions and referrals for each physician with an accompanying graph showing total referrals by physician Percentage values for denials and admissions are calculated against the total number of denials and admissions while the referrals conversion percentages are based on the total number of referrals from each physician You can click on a column header in the table to sort the list and graph by the selected column in ascending order Click the column header again to sort the list and graph in descending order You can click on a physician s name to filter the report by the selected physician along with your other filters Referrals by Referring Facility If your facility has configured the Referring Facility custom field this table displays a l
10. screen and their functions is as follows Print Admission Form Discharge Form On the PAS Tool click Print to pop up a window from which you can print a PDF version of all of the PAS Tool data entered To print a PAS Tool from an admission clinical assessment click on the PRE ADM tab and then click PRINT PDF N ASSESSMENT FEATURES V A LTRAX CLINICAL ASSESSMENT GENERAL INFORMATION TRA asg S amp SYSTEM LTACH OUTCOMES car On an admission or discharge record click Admission Form or Discharge Form to pop up a window from which you can print the respective LTCH CARE data set record When printing a discharge form the form that prints will be the form for the type of discharge created for the patient planned unplanned or expired The Discharge Form button does not appear on the MGMT tab until after the discharge record has been created There is currently no print option for the complete LTRAX patient record which includes wound and vent assessments Admit On a PAS Tool assessment click Admit to create an admission assessment from the pre admit record On a discharge assessment click Edit Admit to unlock the admission assessment fields in order to make any necessary changes Edit Admit On a discharge assessment click Edit Admit to unlock the admission assessment fields in order to make any necessary changes Discharge On an admission assessment click Discharge to create a discharge assessment from the
11. top of the screen When you click the PRINT PDF button it will open a new window displaying a PDF version of the report NOTE This requires Adobe Reader software If you don t already have Reader installed on your computer you can get the latest version from the Adobe website here http get adobe com reader The reports are also available as an Excel spreadsheet Click the OPEN EXCEL button near the top of the screen to either open the comma separated csv file as an Excel spreadsheet or save the csv file to your computer ane HCAHPS OUTCOMES REPORTS DRILL DOWN LEVELS Facility Ranking Report For users belonging to organizations with more than one facility the Facility Ranking Report allows you to concurrently display the outcomes for facilities for any single HCAHPS measure A drop down menu at the top of the table allows you to select the measure to display To access the Facility Ranking Report your user account must have the privilege to view organization level Administrative and or Clinical outcomes reports or you must be an Organization Administrator with Patient Satisfaction Outcomes privileges In addition to the drop down menus for all reports as described above in HCAHPS Outcomes Reports General Information the Facility Ranking Report contains drop down menus that allow you to drill down by diagnosis and if appropriate view site level outcomes The Detail Level menu allows you to display HCAHPS data for all
12. Admit you will retrieve all available assessment data for current admission records However if you select only Admit and you are looking for historic time periods your search will probably not return any assessments since presumably those patients would have since been discharged and their assessments would be in a discharge state Payer This option controls whether your file will include Medicare assessments Non Medicare assessments or both You can select one or both of these options by checking the appropriate boxes Make a payer selection for each kind of record you are downloading Completion Status This option controls whether you will pull Complete or Incomplete assessments or both You can select one or both of these options by checking the appropriate boxes Make a completion status selection for each kind of record you are downloading This is only applicable to admit and discharge records Transmission Status This option controls whether you will pull assessments that are Not Accepted by CMS Accepted by CMS and or Filed or both You can select any combination of these options by checking the appropriate boxes Make a transmission status selection for each kind of record you are downloading This is only applicable to admit and discharge records Select A Date Range This option enables you to download by a specific date range The first drop down allows you to filter for assessments based on date Crea
13. HL7 Messages The LTRAX HL7 Message Report is a live report of LTRAX message processing instantly reflecting whether LTRAX accepted or rejected incoming HL7 messages The HL7 Message Report can be viewed by users with the privilege to view HL7 reports on LTRAX ITRAX H E E BZ G4 4 SYSTEM MSS jane II USER FEATURES REPORT FILTERS Use the report filters to determine the parameters of your desired report Click Refresh to display the report with the updated selections Facility Use this drop down menu to generate an HL7 message report for all facilities in the organization or a single selected facility NOTE This drop down menu shows only for users at multi facility organizations with organization level access to LTRAX HL7 reports Time Period The time period fields allow you to select the messages displayed in the report based on processing dates Enter start and end dates for the desired date range The date range defaults to the past seven days Message Type This drop down menu allows you to choose the types of messages included in the report You can select a single message type or select All NOTE The message types received and processed for your organization or facility depend on many factors including the messaging capabilities of any systems sending information to LTRAX Not all message types may be processed for your organization or facility Message Status Make a selection to view messages that were Accep
14. SCAN UPLOAD 15 LTACH TR ourcomes user Manual GE amp ES Sf amp SYSTEM Il USER FEATURES records you do not need to pad the empty fields after the existing data in a record with your delimiter The first non alphanumeric character following the SurveyVersion field is assumed to be your delimiter ERROR CHECKING The PSI Scan Upload performs data validation checks as it imports records Records that include any data that do not pass the validation checks will not be imported Any such problems encountered during the import process will be detailed in the system message sent to you once the import has finished eye IDENTIFYING MATCHING RECORDS Patient Satisfaction Survey records are linked to assessments using the Survey ID that appears in the upper right corner of each survey page This ID is also the LTRAX Assessment UniquelD and is included in the record once for each survey page so Discharge Survey records will include three survey IDs Service Recovery Survey records will include two survey IDs and Follow Up Survey records will have one Survey ID The redundant Survey IDs in each Discharge and Service Recovery Survey record are based on the scannable forms and structured as such to prevent import of mismatched survey pages If all Survey IDs in a record do not match the record will not be imported If an existing survey is found in LTRAX and the record in the upload file is different the new survey record will ove
15. This same scenario would be true if the choice were just completely removed It is therefore recommended that great care be taken when editing facility custom items once assessments have been saved using those options Values are not case sensitive meaning that if you change x Dr Xavier to X Dr Xavier and then load an assessment where x Dr Xavier had been selected the drop down will identify that as X Dr Xavier and will save the uppercase X to the database if the Attending Physician field is in edit mode CONVERTING FREE TEXT ENTRY FIELDS TO DROP DOWN FIELDS An existing free text entry field can be switched to a drop down simply by making the choice on the admin screen For more information see the Configuring Custom Drop Downs section of this user manual NOTE When converting a text entry field to a drop down if your goal is to match values in the new drop down to values that had been typed into the text field you will need to do an inventory of all of your existing values in order to identify all the previously entered options This will offer an opportunity to identify and correct any typos or other data variances in the assessments before finalizing the list of allowable values for your drop down 4 Facility Settings The Facility Settings screen stores information about your facility including identification numbers address and billing information It also allows you to configure a passw
16. We recommend perusing the existing list before logging a report so the list doesn t grow unnecessarily long with duplicates You can sort the list by Date Created Date Modified Severity Status or Screen Name using the Sort By drop down at the top of the screen You can also filter the list to view only new reports only reports that you have posted or all reports not marked as Fixed Closed or Not a Bug POST NEW REQUEST If the request or suggestion you want to log isn t already in the enhancement requests click Post New Request You ll see a drop down list at the top of the screen with five options for severity Enhancement Request Low Doesn t interfere with work Medium Mildly interferes High Bad incorrect functioning Critical Major problem of system prevents work data loss Choose the severity option that best describes your report If you are making a suggestion or request use Enhancement Request Type in a short description of the request and select the screen on which it appears In the full description box enter a detailed description Be as specific as possible the more information you give the better the chance we can find a solution or incorporate your suggestion When you have entered in all of the information click Post Report Your bug will appear in the list of bugs with a status of New NOTE If you encounter a problem that requires immediate attention please send
17. a message to the Support account through the Send Message link on your LTRAX USER FEATURES I I F ENHANCEMENT REQUESTS 50 TRAXES Gea amp ES Sf amp SYSTEM Il USER FEATURES home screen or call LTRAX support staff at 202 872 1033 rather than posting a request II G LTRAX User Forums We created the LTRAX Forums Bulletin Board the Internet version of a message corkboard to allow users to communicate with other users at other facilities and to provide an easy way to gather feedback on planned LTRAX improvements and reports It works much the same as a community message board Any LTRAX user can browse through all the messages in the forums post a new message or reply to another user s message so that LTRAX users can share thoughts tips questions and experiences with other LTRAX users Since the LTRAX forums are only available from within the LTRAX application only active users can access the forums To access the forums log in to LTRAX and click User Forums The forums home page displays links to each forum representing the following main topics General and LTRAX Software Under each forum or main topic are individual threads or sub topics which may correspond to a particular aspect of the main topic Users can create their own new threads under a forum read and or reply to other users messages and edit or delete messages they have posted previously To browse the forums click one of the forum names on
18. admission assessment Clicking Discharge will open a list from which you can select the type of discharge record you need to complete Planned Unplanned or Expired Edit Discharge On a discharge assessment click Edit Discharge to lock the admission fields unlocked by clicking Edit Admit see above and return to editing discharge assessment fields Change Form On a discharge assessment click Change Form to switch to a different discharge assessment type NOTE Changing to a different discharge assessment type will delete any previously saved information not applicable to new discharge assessment type Complete Admit Complete Discharge Click the respective Complete button to run a completion check on the admit or discharge assessment If the assessment is complete i e for the type of assessment all required fields have been filled out the complete button will disappear and the assessment status will change to complete If the assessment is NOT complete flags next to the tabs that represent the sections with missing or incomplete data will turn red and a list of all missing information will be displayed Xmit Ready On a complete admission or discharge assessment click Xmit Ready to place it in the queue for transmission to CMS Assessments marked Xmit Ready will appear in Step 1 on the CMS Transmit File screen Xmit Remove On an assessment marked Xmit Ready click Xmit Remove to remove it from the CMS transmission queue
19. all of the individual files If you have software that can unzip files and you are comfortable with using it you can click on the ZIP file link to download all of the individual files in one easy step Otherwise you can click on each file link to download each file separately When you click on a link to download a file you should be prompted to save the file to your disk computer You can change the filename if you wish when you Save it to your computer Make a note of where on your computer you save the file so you can find it after your download After you ve downloaded your file and unzipped it if necessary you can refer to the instructions on the File Downloads screen for help with importing your file into Excel Links to the files that you create are available on the Custom Template download screens for 7 days after they were created E y y y O SST FILE STRUCTURE If you specified that your file should include a header record the first record in the file is the header record containing column names each separated by your selected delimiter The fields are included in the order you specified using the Arrange Selected Fields box The USER FEATURES II D DATA DOWNLOAD CUSTOM TEMPLATE LTACH ITR oros user manual 2 Se Ss SYSTEM II USER FEATURES facility custom field names listed in the file header are those defined in the Element Name box on the custo
20. and count of admission records transmitted to CMS where pressure ulcers were present total and broken down by stage Because this is a count of records with pressure ulcers and not a sum of pressure ulcer counts at each stage the sum of the individual stage breakdowns may exceed the total displayed under Any because some records may contain multiple pressure ulcers at different stages Only records where the count for at least one type of pressure ulcer is greater than zero are included in the Any group PRESSURE ULCERS DISCHARGE TRANSMISSIONS Discharge Transmissions The percent and count of admission records transmitted to CMS during the selected time period total and broken down by type Planned Unplanned and Expired based on discharge date Planned amp Unplanned Discharge Transmissions Pressure Ulcers Assessed The percent and count of planned and unplanned discharge records transmitted to CMS with complete Skin CMS data Planned amp Unplanned Discharge Transmissions Pressure Ulcers Not Assessed The percent and count of planned and unplanned discharge records transmitted to CMS with incomplete Skin CMS data Incomplete is defined as question M0210 Yes but no counts of PUs stage 2 3 or 4 were entered on Skin CMS M0300 B1 C1 D1 or no counts of new worsened PUs were entered on Skin CMS M0800 A B C OR M0210 unspecified i e not answered Planned amp Unplanned Discharge Transmissions with P
21. as your start date Effective Date End Enter the last date your facility had or will have this number of beds MM DD YYYY If this bed count is current and is not expected to change use a date far in the future Facility Beds Enter the number of patient beds covered by this date range When you have entered in all of your bed count data click Save You will see your new bed count value appear on the Bed Count screen NOTE Completion of all fields is required for configuration of your bed count EDITI NG A BED COUNT To edit a bed count click on My Facility gt Bed Count From your list of bed counts select the radio button to the left of the bed count you wish to edit and then click Edit Make your changes on the edit screen and click Save Changes NOTE If your facility s bed count changes do not edit the existing bed count value or you will affect the accuracy of your occupancy calculations on your dashboard report for assessments within its effective date range Instead edit the current bed count s end date and create a new bed count to appropriately reflect the date that the change takes effect To delete a bed count click on My Facility gt Bed Count From your list of bed counts select the radio button to the left of the bed count you wish to delete and click Delete then click OK to confirm deletion 3 Custom Data Fields Custom data fields provide a way for facilities to expand the information collected with
22. button to move selected fields or sections from the Select Available Fields box into the Arrange Selected Fields box NOTE Alternatively you can use the LTCH CARE Sets All Admit Discharge links above the Arrange Selected Fields box as shortcuts to download the respective groups of LTCH CARE Tool fields from the current LTCH CARE Tool Clicking the respective links will place the list of admit discharge or all LTCH CARE fields into the Arrange Selected Fields box Arrange Selected Fields This box allows you to arrange the fields in the order in which you want them to appear in your download file To move a field up or down in the list click on the field name then click the up or down arrow to the right of the box To remove a field from the list click on the field name and click the X button to the right of the box NOTE All records downloaded will include the seven fields that are always displayed at the top of the Arrange Available Fields box Those fields are Provider ID Assess Unique ID Assess Type Last Name First Name Birth Date and Admit Date Records that are currently This option refers to the record s current state For example if you select Planned Discharge you will retrieve all available assessment data admit and discharge for assessments currently in a planned discharge record state and which meet your other search criteria If you select
23. by users with the privilege to create pre admission screenings and or assessments II C LTRAX Messaging System Send Message You can communicate with other users at your facility and or organization through the LTRAX internal messaging system This system works independently of Internet email and gives users a convenient centralized and secure means of communicating about LTRAX and other work related subjects View Messages If you have received any messages through the internal messaging system a list of those messages appears on your homepage in a table titled Messages The date the message was sent the name of the sender the subject of the message whether it contains an attachment an asterisk indicates that the message includes an attachment which is usually a patient assessment and the message status read or unread all appear in the table To read the message click on any one of those text fields If your message includes a patient assessment as an attachment you can view and edit the assessment from the Read Message screen by clicking on either the patient name or Edit Assessment on the left side of your screen ITRAX 2 E 8 2 Sf amp SYSTEM Il USER FEATURES You can reply to a message by clicking Reply from the Read Message screen Once you have typed your reply click Send Message to send the message You can delete a message from either the Read Message screen by clicking Delete or from your LTRAX ho
24. choose to display line number each row in your assessments lists will begin with a number representing the row number Name This is the default for the link you use to actually select an assessment If you choose not to display the patient name the selection link will default to whatever data is in the first column If there is no value in that column for an assessment you will not be able to click on that assessment so make sure that the first column is one that will always have a value such as Creation Date if you are not displaying the patient name N ASSESSMENT FEATURES V B DI SPLAYI NG PATI ENT ASSESSMENTS ON THE LTRAX HOME SCREEN 82 TRA LTACH OUTCOMES ag S amp SYSTEM Admission Type This column displays the Primary Admission Type if recorded on the ADMIT tab of the patient s assessment Assessment Reference Date This column displays the relevant Assessment Reference Date as recorded for LTCH CARE Item A0210 on either the ADMIT tab Admission Assessments or the DISCHG tab Discharge Assessments Assessment Status Separate columns display the assessment status for the Admission and Discharge assessments contained in a record Possible assessment status values are Complete The COMPLETE button was clicked and the assessment satisfied all completion requirements xmit Ready The XMIT READY button was clicked and the assessment is in the queue for inclusion into a CMS submission file The assessment is
25. date In these cases the CMS Transmit File screen will auto correct the discharge record adjust the correction number as appropriate and mark the record as XMIT READY so that it can be included in your next CMS transmission file Lock Click Lock to prevent users from making any changes to the record Unlock On a locked assessment click Unlock to open the record up for edits again Re Screen On PAS Tool assessments click ReScreen to create another PAS Tool assessment attached to the originating PAS Tool assessment to be used to capture updates or changes in the patient s condition in subsequent screenings prior to admission Alter PAS Tool Record On assessments that began as PAS Tool assessments click Alter PAS to unlock the pre admission screening for the selected admission in order to make any necessary changes Duplicate PAS Tool Record On PAS Tool assessments or assessments that began as PAS Tool assessments click Duplicate PAS to create a completely separate PAS Tool assessment for a new admission This is especially useful in cases where a patient is initially denied but then rescreened later for admission or when a patient leaves the facility and returns as a new admission When you click Duplicate PAS a list of checkboxes appears which allows you to control which sections from the previous screening will copy forward to the new one Users with organization level administrator privileges can also use this functional
26. date recorded as LTCH CARE item A0220 on ADMIT TR Th a2 32 a SYSTEM Discharged The patient s discharge date recorded as LTCH CARE item A0270 on DISCHG An Admission Assessment with no associated Discharge Assessment may show a blank in this column File Created The date a CMS transmit file was created containing that record A blank value in this column may indicate that the assessment has not yet been included in a CMS transmit file or that the assessment was prepared for transmission outside of LTRAX Transmission Date The date entered into LTRAX as the date the assessment was accepted by CMS This value is set when an assessment is marked as Accepted by CMS on the CMS Transmit File screen and it can be viewed and edited on individual assessments on the CMS I NFO tab NOTE It is up to each facility to accurately record the Transmission Date based on information returned from CMS after each file submission Days Late This column shows the best possible estimation of whether an assessment has passed the CMS deadline for submission based on key dates entered into the assessment LTRAX will check the following dates in reverse order when determining whether the assessment is late Admission or Discharge date A0220 or A0270 Assessment Reference Date A0210 and Completion Date Z0500 The combination of color coding and numbers in the Days Late column shows whether an assessment is coming due or past due e If an as
27. displays any detail or explanatory notes returned after LTRAX processed the message For rejected messages the column may include information explaining why LTRAX could not accept the message Facility The name of the facility that generated the message Provider ID The provider ID of the facility that generated the message NOTE Information displayed in the report is taken primarily from incoming messages A blank space in any column may indicate that the information was not contained in the message sent to LTRAX II F Enhancement Requests LTRAX is continually enhanced and refined in response to user input to better serve the needs of all users If you have a suggestion or recommendation for how you think the system might be improved or if you find a problem a bug in the system you can log your suggestions or problems in Enhancement Requests The Enhancement Requests screen is available to all users through the Enhancement Requests link on the LTRAX homepage VIEW ENHANCEMENT REQUESTS To access the Enhancement Requests screen log in to LTRAX and click Enhancement Requests on your homepage You ll see a list of all reports on file including when each request was posted the severity of any bugs the name of the screen in question the subject which is a brief description of the request or bug and its current status fixed in progress etc You can read a detailed description of each report by clicking on the subject line
28. either the button at the bottom of the screen labeled Next Assessment Management any one of the tabs on the left side of your screen or the HOME button under the LTRAX logo at the top of your screen to save the information If there is no activity on LTRAX for 2 hours or so e g if you don t move to another screen or refresh the current screen for 2 hours the system will assume you are no longer working on LTRAX and will automatically end your session If you think you may stay on one P S I screen for a long time save your data at regular intervals by clicking on the P S I tab to refresh the screen When you are finished entering survey results click the LOG OUT button in the green toolbar in the upper right corner of your screen SS SS UUM SCANNABLE SURVEYS All HCAHPS surveys are scannable Completed surveys can either be entered by hand into LTRAX or scanned and then uploaded in a data file Scanning these surveys requires use of third party hardware and software which will involve extensive set up and testing by someone at your facility Alternatively LTRAX offers a survey scanning service Please contact LTRAX support at assistance LTRAX com for more information NOTE Prior to January 1 2013 LTRAX offered a proprietary Patient Satisfaction System Facilities that subscribed to the LTRAX PSS can contact LTRAX for access to their historic survey data ASSESSMENT FEATURES V F LTRAX PATIENT SATISFACTION SYSTEM 89
29. entry portion of the sections or screens V B Displaying Patient Assessments on the LTRAX Home Screen The first screen that you come to when you login to LTRAX is the LTRAX home screen also referred to as the launch screen Users with the privilege to view patient assessments will see assessments lists displayed on this screen You may see rows of patient names displayed in different tables labeled Pre Admit Assessments Admission Assessments and Discharge Assessments The display of each table is controlled by a checkbox If you see one of the table labels displayed with no assessments appearing below it make sure the box is checked The screen will automatically refresh if you check or uncheck a checkbox to show or hide a table NOTE You will not see a table if you do not have at least one patient record to match the table type e g if you have no Pre Admit Assessments that table will not appear In addition to the checkboxes a number of other user selectable options control which assessments are displayed how many assessments are displayed per list and what information is displayed for each assessment These options appear in the box below all displayed assessments as drop downs input boxes and a List Options link The options you select are applied to all available assessments tables and can be used in any combination The options are also sticky meaning that the LTRAX system will remember which options you selected the last
30. established when the account is created by an LTRAX representative Please keep this hierarchy in mind when signing up your facility for the LTRAX service and when creating user accounts and assigning privileges INTRODUCTION I C EXPLANATION OF THE ORGANI ZATI ON FACILI TY SITE HI ERARCHY 3 LTRAX 238 user ma asg a SYSTEM I D LTRAX Support If you can t see the website http www ltrax com 1 Confirm that your computer has a live Internet connection The easiest way to do this is to check a few other websites Note Do not use internal websites such as your facility s homepage for this test These sites may be visible to you from your local network and not the Internet If you can t see any websites on the Internet contact your IT department for assistance If you can see other websites but can t see www trax com email assistance ltrax com and describe your problem in as much detail as possible An LTRAX support representative will respond shortly If you can see the website but can t log on 1 Type your facility s Medicare provider number into the box provided on the login screen and click Forgot your password The contact information for your LTRAX facility administrator s will appear If you are the only LTRAX administrator for your facility email assistance ltrax com and include your name and your facility s Medicare provider number in the message An LTRAX support representative will re
31. family should be given a printed copy of the survey to complete Once completed the survey should be returned in a sealed envelope or by other such discreet means to the person or department responsible for data entry Physicians staff and other administrative employees should not be allowed to see the completed survey You can find a sample cover letter that you can customize and include when you give patients their surveys here https ltrax com help PSI DischargeSurveySampleLetter doc hee SS SS SSS SS See PRINTING SURVEYS In order to print patient satisfaction surveys you will need the privilege User can view all assessments for their facility includes all sites If you do not have this privilege contact your LTRAX facility administrator and ask them to adjust your user privileges The survey forms print out as pdf documents which requires Adobe Reader software If you don t already have Reader installed on your computer you can get the latest version from the Adobe website here http get adobe com reader ASSESSMENT FEATURES V F LTRAX PATIENT SATISFACTION SYSTEM 88 TR LTACH L MAA ysm User Manual V ASSESSMENT FEATURES To print out a patient satisfaction survey from your LTRAX home screen select the patient s assessment from the list of patient assessments and then click the P S I tab on the left side of your screen Click the PRINT button below the survey header to pop up a window with the
32. for reference select the font type and the size you want from the drop down lists then click the Save button at the bottom of your screen The screen will refresh and you will see your font selection applied Then click Back or HOME to view your new font display 5 a J m Ti USER FEATURES TR h m a amp ES Sf amp SYSTEM Functional Settings This is where you will find any additional customization options for controlling the display and functionality of LTRAX From the My Account menu click Functional Settings All of the Save buttons on this screen work to save any changes you make so it doesn t matter which one you click Current options include Signature To enable the use of an electronic signature enter your signature into the Signature box as you would like it to appear wherever electronic signatures are allowed then click Save Currently only the physician signature field on the PAS Tool is configured to allow electronic signature Pre Admission Screening PDF Margins This setting allows you to control the size of the margins on the Pre Admission Screening PDF to allow enough space to affix labels to printed PAS Tool assessments The default values allow for 5 in all four margins but you can selectively modify the size of any of the margins To change a margin type your desired margin size in inches into the appropriate box and click Save Use the I nternet Connection Monitor The PAS Tool includes a
33. for your facility for various time periods dating back to the initial release of LTRAX in April 2011 including individual months and calendar year quarters as well as trailing 30 60 90 and 180 day calendar year and fiscal year periods Your facility is shown compared to your geographic region and the nation as a whole Drop downs at the top of the drill down reports screens allow you to select different time periods payers and regions Records are included in a time period based on varying dates depending upon the measure For example of Admissions counts the number of patients admitted during the selected time period based on the admission date while of Discharges counts the number of patients discharged during the time period based on discharge date and Referrals counts the total number of Referrals based on either Admission Date or Date Denied depending on the status of the record See the Outcomes Reports Measures section below for information on individual measures The Medicare payer selection only includes assessments where the primary payer is B Medicare B CM Coinsurance Medicare M Medicare or MR Medicare Replacement Non Medicare includes all other payers and records where payer was omitted Many of the comparisons include weighted and unweighted national and regional numbers The weighted numbers are benchmarks which use DRGs to volume adjust national or regional practice patterns to e
34. included surveys from your facility for your selected time period and payer compared to national and regional benchmarks l1 USER FEATURES HCAHPS OUTCOMES REPORTS REGIONS See Outcomes Reports Regions above HCAHPS OUTCOMES REPORTS MEASURES Summary Table Discharges in Sample This displays the number of discharges for the time period and payer selected Surveys Returned This displays the number of surveys returned Surveys must have at least one response recorded to be counted among the returned surveys Survey Return Rate This displays the number of surveys returned as a percentage of discharges Average Age This displays the average age of the patients who returned surveys Gender Split This displays the gender split male and female of the patients who returned surveys Case Mix Index This displays the average case mix index of the patients who returned surveys which is calculated by averaging the DRG payment weight for each patient s discharge MS LTC DRG A higher number indicates a higher average acuity Average Box Percentages This table displays survey outcomes with national and regional averages for comparison using the HCAHPS methodology The measures in the HCAHPS Average Box Percentages report are the measures developed by HCAHPS for reporting patient survey results Some of the measures combine several survey questions into a single measure For a survey to be included in a composit
35. left corner of survey Facilityl D 6 digits Facility s Medicare provider number as printed in bar code upper left corner of survey SurveylD 6 7 digits Survey ID as printed in bar code upper right corner of survey DatePrinted mmddyyyy As printed in bar code lower right corner of survey Ql 0 1 Q2 0 5 Q3 0 1 Q4 0 5 Q5 0 1 Q6 0 5 Q7 0 5 Q8 1 5 SurveyI D 6 7 digits Survey ID as printed in bar code upper right corner of survey page 2 Q9 1 5 Q10 1 7 Q11 1 3 Q12 0 1 Q13 1 5 USER FEATURES II D PSI SCAN UPLOAD 19 LTRAX 282 user man asg S amp SYSTEM II E Reports Outcomes If you have been granted access to view Administrative or Clinical outcomes reports you will see the Reports header on the left side of your LTRAX homepage Depending on your user privileges under this header you may see any combination of the following options 1 2 Outcomes Referrals Outcomes HCAHPS Outcomes Transmissions HL7 Messages NOTE In order to access any of the outcomes reports you must have the appropriate reports viewing privileges If you cannot access the outcomes reports contact your facility s LTRAX administrator and ask them to grant you the User can view all Administrative level reports for their facility privilege and or the User can view all Clinical reports for their facility privilege OR for patient satisfaction outcomes re
36. patient assessments These fields can be used to store patient or associated information that is not a standard part of the LTRAX patient assessments such as patient contact information or attending physician All custom data elements appear in assessments on a tab labeled CUSTOM with the exception of two special custom fields Referring Physician and Referring Hospital When configured properly as drop downs these two fields appear on the REFERRAL PAYER tab in the pre admission screening as well as on the CUSTOM tab If you have no custom data elements the CUSTOM tab does not appear Any user with organization or facility administrator privileges can create and manage custom data fields Creation of these items is optional and the data stored in them are available to your facility or organization in patient assessments and in downloads coming soon You can access your custom data in the following ways On the CUSTOM tab on an individual assessment Via assessment downloads coming soon ADDING CUSTOM FIELDS To add a custom data field click on My Facility gt Custom Data Fields then click Add Element Then complete the following input fields Element Name Type in a simple name which will be used to identify the field FACILITY TRAXE user ma as a SYSTEM ADMI NI STRATOR FEATURES Description of element Type in a longer more user friendly description which will be displayed on the CUSTOM tab on assessments This ca
37. patient days during the selected time period for discharged patients with at least one wound assessment Discharged Patient TRA MS irons E amp 82 Sf amp SYSTEM Days Wound patient days are counted starting from the first wound assessment date through the discharge date NOTE In any given time period it is possible for a facility to have Wound Patient Days and no Wound Patients if the patients were discharged during a subsequent time period Ventilator Patient Rate Patients Percentage and count of patients on mechanical ventilation discharged during the selected time period calculated as the number of patients with an admit vent assessment Discharges in Sample Ventilator Patient Rate Days Percentage and count of patient days for discharged patients who were on mechanical ventilation calculated as the sum of patient days during the time period for discharged patients with an admit vent assessment Discharged Patient Days NOTE In any given time period it is possible for a facility to have Vent Patient Days and no Vent Patients if the patients were discharged during a subsequent time period Discharge Destination Categories The percentage and count of patients discharged to one of a group of discharge settings during the selected time period with weighted case mix adjusted and unweighted national and regional comparisons For more information on the weighted calculations please see the Weighted vs U
38. patient s admission date recorded as LTCH CARE item A0220 on ADMIT Discharged The patient s discharge date recorded as LTCH CARE item A0270 on DI SCHG An Admission Assessment with no associated Discharge Assessment may show a blank in this column Status The status of the assessment Incomplete for an assessment that is still in progress and has not passed the LTRAX completion check e Complete for an assessment that has passed the LTRAX completion check but has not yet been accepted by CMS Complete xmit Ready for an assessment that has passed the LTRAX completion check and been marked XMIT READY but has not yet been placed into a CMS transmission file Complete xmit Prepared for an assessment that has passed the LTRAX completion check and been placed into a CMS transmission file but has not yet been marked Accepted by CMS e Complete Accepted by CMS for an assessment that has been marked as Accepted by CMS Missing Fields The incomplete fields that CMS has identified for outcomes measure calculations that were not completed on the assessment The column displays the item number and the tab where the field is located Click the hyperlinked Missing Fields column header for more detail about each of the fields that may be itemized in that column Notes Any notes entered in the Notes section of the QRP override acknowledgment checkbox on an assessment s Mgmt tab appear in this column 5
39. patients at each facility or to narrow the display to patients within a single Major Diagnostic Category DRG MDC or Diagnosis Related Group DRG To change the detail level select DRG MDC or DRG from the Detail Level menu Then a second drop down menu will appear allowing you to choose a specific MDC or DRG If any of the facilities within your organization have more than one site associated with a single Medicare Provider ID you can use the Facility Ranking Report to see the sites compared to each other Choose the appropriate facility by Medicare Provider ID from the Facility drop down menu at the top of the screen If the facility has multiple sites you will see an additional checkbox appear on your report labeled Your facility also has site level outcomes Check the box to see the HCAHPS outcomes for that facility s sites displayed in facility ranking style For each measure you will see your facilities outcomes displayed with variances from the organization and the nation The variance shows each facility s divergence from the organization and national average for the measure Variances are calculated by subtracting the organizational or national average outcome from the facility outcome and then dividing by the organizational or national outcome USER FEATURES II E HCAHPS OUTCOMES WwW io TR surcoune Gea amp ES Sf amp SYSTEM user manual Facility Report Your Facility Report displays all available measures for all
40. pdf survey document In the pop up window menubar click File then Print to print out your survey NOTE Each printed survey form displays a unique ID number in the upper right corner which is used to identify the assessment record that the survey is associated with If you are printing multiple surveys and the number doesn t change from survey to survey stop printing and go to the Adobe website to download and install the latest version of Adobe Reader http get adobe com reader Then reprint the surveys and check the numbers again a ENTERI NG COMPLETED SURVEYS In order to enter completed patient satisfaction surveys you will need either the privilege User can create edit Clinical assessments OR User can create edit patient satisfaction surveys only If you do not have one of these privileges contact your LTRAX facility administrator and ask them to adjust your user privileges To enter a patient s survey responses into LTRAX scroll to the bottom of your LTRAX home page Below your assessments display options is a box labeled Patient Satisfaction Survey ID Enter the number from the upper right corner of the survey form into the box and click Load Referring to the patient s answers on the completed survey printout fill out the patient s survey on LTRAX If the patient skipped any questions on the survey select Not Answered When you are finished entering all of the patient s answers click
41. the selected time period based on discharge date For qualified interruptions in stay interruption days are subtracted from length of stay and thus are not included in the average Average Age The average patient age at admission during the selected time period based on discharge date Gender Split The counts and percentages of male and female patients during the selected time period based on discharge date Case Mix Index CMI The average DRG payment weight for the selected time period based on discharge date Higher numbers indicate increased average acuity Payment weights for each DRG are available from the CMS website here https www cms gov Medicare Medicare Fee for Service Payment PCPricer index html ITR Aleth E 8 2 Sf amp SYSTEM PRESSURE ULCERS ADMISSION TRANSMISSIONS Admission Transmissions The percent and count of admission records transmitted to CMS during the selected time period based on admission date Pressure Ulcers Assessed The percent and count of admission records transmitted to CMS with complete Skin CMS data Pressure Ulcers Not Assessed The percent and count of admission records transmitted to CMS with incomplete Skin CMS data Incomplete is defined as question M0210 Yes but no counts of PUs stage 2 3 or 4 were entered on Skin CMS M0300 B1 C1 D1 OR M0210 unspecified i e not answered Admission Transmissions with Pressure Ulcers The percent
42. the surveys imported state the number of successfully processed surveys and detail any problems found with specific surveys You can access your messages from your LTRAX homepage For more information on viewing USER FEATURES II D PSI SCAN UPLOAD 16 LTACH TR ourcomes user Manual Gm a E ES SS amp SYSTEM Il USER FEATURES your messages please see View Messages under the LTRAX Messaging System Send Message section of this manual You can print out the entire message so you can refer to it when reviewing your imported data The easiest way to do this is to pull up your message and press Ctrl A to select everything on the page then copy Ctrl C and paste Ctrl V into Notepad If you paste into Microsoft Word you will want to delete the images before printing Then print out the document FILE STRUCTURE The first field in each record is the SurveyVersion field which indicates the kind of survey Valid SurveyVersion values are S Service Recovery Survey F Follow Up Survey D2C Discharge Survey with two nursing shifts D3C Discharge Survey with three nursing shifts Your facility s discharge survey configuration will dictate which of the discharge survey file formats is right for you To check your facility s configuration on LTRAX log in and click My Facility gt Patient Satisfaction Instrument The link for the discharge survey template at the bottom of that page will indicate
43. their organization These fields can be used to store patient or other information that is not part of the patient assessment itself such as patient contact information or physician name For instructions on creating and managing custom data fields please refer to the Custom Data Fields section of this manual under Facility Administrator Features co ORGANI ZATION ADMINISTRATOR FEA LTACH ITR ocon user manual E 8 82 Sf amp SYSTEM V ASSESSMENT FEATURES V ASSESSMENT FEATURES V A LTRAX Clinical Assessment General Information Following is some general information about patient assessments on LTRAX If you will be working on patient assessments on LTRAX it is recommended that you review both this section and the sections on displaying assessments on the home screen and individual assessment types that follow Below is a table of contents for the Clinical Assessment General Information section of this user manual with links to the respective subsections This section is structured as follows 1 LTCH CARE Data Set 2 Accessing Patient Assessments 3 Creating New Assessments 4 Editing Existing Assessments 5 Working In Multiple Browser Windows Or Tabs 6 An Important Note About Saving Assessment Data 7 Assessment Tabs Navigation A Mgmt Management Tab B Pre Adm Tab C CMS Info Tab D Files Tab
44. to your computer s hard drive To begin click the CMS Transmit File link on the left side of the LTRAX home screen NOTE If you do not see the CMS Transmit File link you will need to contact your facility s LTRAX administrator and ask them to grant you the privilege User can download assessments from their facility After clicking on CMS Transmit File you will see the following NOTE All images were captured from a session using the Internet Explorer 7 web browser If you are using a different browser or browser version the appearance may be slightly different from what you see here Functionality however is the same SSS OS a7 STEP 1 CONFIRM VALID ASSESSMENTS This initial step allows you to choose the assessments you want to send to CMS The following is an example of what you might see Step 1 Beiter Confirm the assessments you wish to include in your transmission file You can include multiple assessments in one CMS transmission file Select Confirm to include an as download file Select Leave to keep an assessment in Step 1 excluding it from the download file yo Make a selection for each assessment and click Confirm Action Name Birth Date Admit Discharge Assess Type C Leave Confirm Transmit CMS 05 05 1955 09 01 2012 Admit Confirm Only Complete assessments that have been marked Xmit Ready will appear in Step 1 as available for transmission to CMS To mark an assessment as Xmit Rea
45. until you click the here link at the top of the assessment screens to display the warnings again The requirements for completion of LTCH CARE Tool records are determined by the type of assessment admit discharge unplanned discharge expired LTRAX follows the submission specifications for LTCH CARE data for each kind of assessment Where the submission specifications differ from the instructions in the LTCH QRP Manual for assessment completion LTRAX follows the more conservative guidelines CMS has two sets of requirements for data the minimum data set that must be present in order for a record to be accepted into the QIES ASAP database and the data set required under the LTCH Quality Reporting Program If any items belonging to the CMS minimum data set are missing from a record in LTRAX you will not be able to complete and send the record to CMS until the missing information has been entered Items belonging to the QRP dataset can be omitted However failure to submit QRP items may result in a 2 across the board reimbursement penalty for your facility for the applicable QRP year For records that must be transmitted with incomplete QRP items LTRAX offers an override checkbox that appears on the MGMT tab when you click Complete Admit Complete Discharge If any QRP items have not been completed you will see a warning message like this CMS LTCH Quality Reporting Program data are missing Warning This may result in Medicare payment redu
46. yarn user manual asg a SYSTEM III B Manage Facility Screen sssssssssssoscsesessesee 52 fe N ol all Wis oraceuc eaeoe aa aa a ae a ao ee 53 A Bo CAIN ear ERAEN ERSE ERN 57 Be Custom Data FICIOS ssis 448 dict datatthoitdeeseteireardoneaieareer enews 58 4 Facility Settings lt 2 is hshiee hag hie id hadiieassmaseianvaavervewtess eee 61 5 Recently Modified Assessments 00 ccc cece eee e ete eee e eerren 62 IV ORGANIZATION ADMINISTRATOR FEATURES IV A Organization Administrator General Information 63 IV B Manage Facility Screen 0 ccc ccc ccc cece ee eee eee 63 LAdd User 15 615 55 503 SiG o0 sie 6 SUSUR AG LRE AG REBEL DN Dae Rw ER ESCE 64 2 Custom Data Fields ose 2 cidun deena mad wanes owe ate OA erence ete eines 68 V ASSESSMENT FEATURES cnc uccewewwscteeseesueeneet V A LTRAX Clinical Assessment General Information 69 V B Displaying Patient Assessments on the LTRAX Home Screen 79 V C Pre Admission Screening PAS Tool Assessments 85 V D Admission And Discharge Assessments 0ee0005 86 V E Interruptions in Stay Leave of Absence LOA 87 V F LTRAX Patient Satisfaction System 0c cee wees 88 IT R ourconts user manua INTROL asg S amp SYSTEM I INTRODUCTION LTRAX is a combined data collection tool and outcomes engine built specifically for long term acute care hospitals LTRAX merges administrative cli
47. LTACH TRA wrons user Manual RAX User Manual updated 6 17 2014 TABLE OF CONTENTS I INTRODUCTION I A About This User Manual 0 cece cece cee eeeee 1 I B General Guidelines to Follow when Navigating the LTRAX Website1 I C Explanation of the Organization Facility Site Hierarchy 2 LD LIRAX Supper cx i540 eka SSS SS ow ASHEN S44 CES 4 HUSER FPEAIURE mn ar ILA LOGGING IN 62 c050 sanat RENEE ee wees ewes ESERE RENES 5 ED B MyAcCO nt soso ascents Sagano ahaa asa a acai fa aide sas ata sav acta serra tao eyo Jos 3 II C LTRAX Messaging System Send Message 6 6 II D File Transfer CMS Transmission Downloads Uploads 7 LCMS Transmit Fle euenire EEA AE E EE E E 7 2 Data Download Custom Template n 0 ccc cece eee eee enes 12 3 PSI Scan Uploader arraste niunie eee e e ETE EEE EERE 15 ILE Reports Outcomes sssssssssessssososoosososeeee 20 LOUCOS torar eieaa O eee TEE A 20 2 Referrals QuicOmes s3 4 20di06 ieedadseddocsnta tandems oe tea Soe oaeiai 35 Se FICAPIPS OUO ES raan EERE ENEE EERE OE Seed i a 38 Chy canile ati ene ee ae E er E A E A S E E N ee 42 De HL M SSAGES piee aars sted Reem oem er eee 48 IL F Enhancement Requests cc ccc cece cece ccc cces 50 I G LERAX User Orns s 5 0 5c0cdacdavcasdawdssewadeawwaces a 51 II FACILITY ADMINISTRATOR FEATURES II A Facility Administrator General Information 52 LTACH ITRA
48. M wee user E Bf YW amp SYSTEM HANC II USER FEATURES liberation checkbox on the Vent Weaning assessment This measure excludes terminal weans Ventilator Patient Wean Success Rate The percentage and count of patients whose Ventilator Weaning Outcome was Patient liberated with no subsequent vent return date This measure excludes terminal weans Ventilator Terminal Wean Patients The percentage and count of patients with a vent weaning assessment where Terminal Wean is Yes Weaning Outcome The percentage and count of the outcome of each vent weaning attempt as identified by the Outcome selected on each vent weaning assessment Reason for Failed Wean The percentage and count of the reasons for vent wean failure as identified by the Reason Weaning Failed selected on each vent weaning assessment where the selected Outcome was Weaning failed Ventilator Status At Discharge The percentage and count of discharge vent assessments grouped by status as identified on each vent discharge assessment 2 Referrals Outcomes The LTRAX Referrals Outcomes reports allow users with outcomes reports privileges to view denials admissions and referrals trends for their hospital The data for the reports come from denied pre admission assessments and admission assessments that began as pre admission assessments Unlike the Administrative and Clinical Outcomes Reports the Referrals Outcomes are generated in re
49. OTE This privilege is not necessary if the user has the privilege User can create edit Clinical assessments and cannot be combined with other special limited privileges such as User can create edit patient satisfaction surveys only TRAX orons user Manual p F B a amp EZ 824 A SYSTEM IV ORGANI ZATI ON ADMI NI STRATOR FEATURES User can create edit patient satisfaction surveys only This allows users who do not have the privilege User can create edit Clinical assessments to enter patient satisfaction survey results Such users will be able to view assessment data only for the surveys they are entering but they will not be able to change any assessment data other than the patient satisfaction survey responses If the user needs to print surveys for distribution to patients they will also need the privilege User can view all assessments for their facility includes all sites NOTE This privilege is not necessary if the user has the privilege User can create edit Clinical assessments and cannot be combined with other special limited privileges such as User can create edit pre admission assessments only Once you have entered all of the user account information and made your privilege selections click Save to create the account and return to the Manage Facility screen 2 Custom Data Fields Organization administrators can create and manage custom data fields for all of the facilities in
50. Pacific Alaska California Hawaii Oregon Washington ES MM WEI GHTED VS UNWEI GHTED NUMBERS Some measures offer Weighted and Unweighted calculations Unweighted numbers are the raw unadjusted values of the indicated measures Weighted calculations adjust the national and regional values to match the case mix at your facility For comparison purposes weighted measures minimize the effect of case mix when comparing your facility to the nation or your region Weighted numbers are created by calculating the average value for each DRG for the nation and region for a given measure then volume adjusting the averages to match the actual case mix volumes at your facility For example we calculated the weighted discharge destinations as follows For each DRG we count the number of discharges to a given destination for the nation and region and divide by the number of discharges to all destinations for the nation and region This gives us the national and regional rates for each discharge destination and DRG These rates are multiplied by the count of discharges from the facility for the same destination and DRG The results of these multiplications are summed over all DRGs and divided by the count of all discharges for the facility giving us the volume adjusted rates for each discharge destination for the nation and the region E OUTCOMES REPORTS MEASURES Administrative Outcomes Measures Admissions in Sa
51. T tab will include a section called Manage I nterrupted Stay Link in which the user is asked whether the patient went to more than one setting since the previous discharge If the user answers No LTRAX will confirm the link between assessments as a single stay for Medicare payment purposes If the user answers Yes then LTRAX will break the link and consider the readmission the beginning of a new stay Linking assessments that belong to the same stay for Medicare payment purposes ensures that your facility s length of stay and related calculations remain accurate in the LTRAX Outcomes Reports For more information about the LTCH PPS and Interrupted Stays please see http www cms gov Outreach and Education Medicare Learning Network MLN MLNProducts downloads ltch intstay pdf V F LTRAX Patient Satisfaction System The LTRAX Patient Satisfaction System integrates the Hospital Consumer Assessment of Health Plans Survey HCAHPS patient satisfaction survey into LTRAX s patient assessments and outcomes reports structure Surveys are available on all admission assessments under the P S I tab Sa a a ae a a a a PATIENT SATISFACTION SYSTEM SURVEYS HCAHPS Discharge Survey The purpose of the discharge survey is to gather information about a patient s total experience in the long term acute care hospital The survey should be distributed to the patient the day before or the day of discharge The patient and or
52. TE In progress assessments must have the relevant discharge or readmission date in order to be included in the report REPORT OUTPUT The report returns two lines for each patient identified with assessments that may indicate a continued stay The report displays with columns that can be clicked to sort the output by a selected column Click a column header once to order the report by that column in ascending alphabetical chronological or numeric order Click the same column header again to reorder the report in descending order Brackets surround the header of the column determining the sort order For example if the report is ordered by discharge date the discharge date column header will be displayed like this Discharged For your selected facility and date range the report displays the following information Last Name The patient s last name recorded as LTCH CARE item AO500A on ID Pay First Name The patient s first name recorded as LTCH CARE item AO500C on ID Pay Birth Date The patient s birth date recorded as LTCH CARE item A0900 on ID Pay Medical Record The patient s Medical Record Number recorded on D Pay Admitted The patient s admission date recorded as LTCH CARE item A0220 on Admit Admit Status The status of the assessment e Incomplete for an assessment that is still in progress and has not passed the LTRAX completion check e Complete for an assessment that has passed the LTRAX completion ch
53. TRANSMISSIONS 44 TRAX HE as Ug amp SYSTEM In order to appear in the Transmittal Report an Admission Assessment must have a recorded admission date and all types of Discharge Assessments must have recorded discharge dates The report s color coding indicates which assessments will soon reach the deadline for submission and which assessments have already passed the deadline for submission Past due assessments also show the number of days late in the Days Late column TRANSMITTAL REPORT FILTERS Use the report filters to determine the parameters of your desired report Click Refresh to display the report with the updated selections Facility Use this drop down menu to generate a transmission report for all facilities in the organization or a single selected facility NOTE This drop down menu shows only for users at multi facility organizations with organization level access to LTRAX reports Time Period The time period fields allow you to choose the assessments included in the report based on admission and or discharge dates Enter start and end dates for the desired date range The date range defaults to the past 30 days NOTE In progress assessments must have an admission date or a discharge date in order to be included in the report Assessments This drop down menu allows you to choose the types of assessments included in the report Admission only Discharge only or both Admission and Discharge Assessment Status M
54. TRAX The answers to these questions will determine what combination of privileges the user needs You can refer to the Privileges Reference Guide in the facility administrator features section for help in determining what privileges to assign each user account We offer Roles you can select from in order to assign a user a pre determined group of privileges or you can customize a user s privileges using the list of available privileges For more information on which privileges are assigned using the Roles selections please refer to the link in the Roles section on the Add User screen The individual privileges are grouped by general tasks as follows Administrator Privileges Organization administrator user can create manage all user accounts for their organization This privilege allows the user to create and manage user accounts for all facilities and sites in their organization and enables the user to grant organization level access to data downloads and reports to any user This level of privileges is only applicable to users belonging to an organization that has more than one subscriber facility on LTRAX NOTE Organization administrator privileges do not give a user full control over each facility in their organization To access facility level settings and functionality such facility settings facility password expiration etc an organization administrator also requires facility administrator accounts at each facility Fa
55. acility administrator privileges or non fac admin users who have been specifically granted permission to perform advanced maintenance functions On discharge assessments the I ncomplete Accept and Decrement ncrement buttons will appear twice on the Advanced screen once under the Admission Advanced Maintenance section and again under the Discharge Advanced Maintenance section Make sure you click the button under the section you intend to edit The advanced functions are as follows Incomplete Accept On assessments that have the status Accepted by CMS click Incomplete to manually change the status back to Incomplete On assessments that have at some point been placed into a CMS transmit file and have the status Incomplete click Accept to manually change the status to Accepted by CMS NOTE The I ncomplete button should only be used if an assessment was marked as Accepted by CMS in error To make corrections to an assessment that has been Accepted by CMS and marked as such in LTRAX use the appropriate Correct button on the MGMT tab instead The Accept button should only be used if an assessment was marked as Rejected by CMS in error If you use the Accept button make sure to visit the CMS I NFO tab and enter the TRAX asg a SYSTEM date that the admission or discharge assessment was accepted by CMS as noted on your CMS Final Validation report Decrement Increment Use the Decrement ncrement buttons to decre
56. ake a selection to view assessments Accepted by CMS only In Progress Assessments only Late In Progress Assessments only or All assessments TRANSMITTAL REPORT OUTPUT The report displays with columns that can be clicked to sort the output by a selected column Click a column header once to order the report by that column in ascending alphabetical chronological or numeric order Click the same column header again to re order the report in descending order Brackets surround the header of the column determining the sort order For example if the report is ordered by discharge date the discharge date column header will be displayed like this Discharged The report returns a line for each admission discharge and corrected assessment so you may see multiple records for a single patient For your selected facility date range assessment type and assessment status the report displays the following information Last Name The patient s last name recorded as LTCH CARE item A0500A on I D PAY First Name The patient s first name recorded as LTCH CARE item AO500C on I D PAY Birth Date The patient s birth date recorded as LTCH CARE item A0900 on I D PAY Medical Record The patient s Medical Record Number recorded on D PAY Assess Type A one or two letter code indicating the assessment type A for Admission D for Planned Discharge DU for Unplanned Discharge or DE for Expired Admitted The patient s admission
57. al time meaning that as pre admissions are admitted or denied this information is immediately reflected in the reports To get to the Referrals Outcomes from your LTRAX home screen click Referrals Outcomes The reports include a set of filters which you can use to view outcomes for your date range by selected referring facility referring physician payer denial reason MDC and or DRG Because none of the fields on a pre admission assessment is required for each measure the reports only include assessments where a value is present For example total denials admissions and referrals may differ across the Referring Physicians Referring Facilities ZIP Codes and Primary Payer tables if there are some assessments missing a value for referring physician referring facility etc Denied assessments are included in a date range based on the date a pre admit was marked as denied while admissions are included based on the admit date entered on an admission assessment that began as a pre admit The reports display the data both numerically and graphically and are available at the facility MDC DRG and denied patient levels The filters and output are detailed below REPORT FILTERS Referring Facility This drop down lets you select from your custom list of referring facilities If your facility has not configured a custom data field drop down called Referring TRAM sitcoms 8 amp 2 Sf amp SYSTEM Facility this filter will not be a
58. an LTRAX facility administrator for your facility If the information in the LTRAX system does not match that on file with CMS you will receive warnings in the transmission report returned by CMS after transmitting your file If you make any changes to your facility information AFTER creating a CMS transmit file you will need to re create the file in order to apply the changes USER FEATURES I D FILE TRANSFER CMS TRANSM SSION DOWNLOADS UPLOADS 7 TR oureowts E user manual 11 USER FEATURES a2 34 amp SYSTEM Preparation of the CMS file can only be performed by users that have the privilege User can download assessments from their facility which is assigned by an LTRAX administrator NOTE This procedure only creates the file you will be sending To actually transmit the files you must use the CMSNet software to connect to the CMS private network and then use a web browser to perform the upload For help with the CMSNet software or for questions about your transmissions please contact QIES Technical Support at 877 201 4721 For instructions please refer to the data submission user s guide available on the CMS Data Transmission page of LTRAX under the Transmission Instructions link on the left side of the screen Creating the file in LTRAX is a multi step process with the first step being the selection of assessments to download and the final step being the actual download of the file containing the assessments
59. and it cannot include the word password LTRAX user passwords are not case sensitive required Confirm Password Type in the password again exactly as you entered it the first time required First Name The user s first name required Last Name The user s last name required MI The user s middle initial Suffix The user s suffix Ph D Esq II etc Email Address The user s email address This is not required but it is recommended especially if the user should receive emails from the LTRAX email list serve List serve ATURES IV B ADD USER ON ADMINISTRATOR F TR Aitana a2 Ag a SYSTEM recipients receive emails at the address listed in LTRAX Users can edit their own email address Phone Number The user s phone number This is not required but it is recommended in case LTRAX support staff needs to contact a user Users can edit their own phone number Extension Any applicable extension to the user s phone number Active This is the on off switch for a user account The default setting is Yes A user with an Active setting of Yes will be able to log on to their account on LTRAX To de activate a user account and prevent that user from logging on select No Privileges When creating a user account consider the user s requirements Will the user need to be able to create other user accounts Will they be creating patient assessments Will they be uploading data to L
60. ary NOTE It is important to process your assessments to accurately reflect their status with CMS i e if a Accepted mark it Accepted if it was Rejected mark it Rejected Corrections can be made to either File CMS_LTRAX_79_120927_154136 zip created by Training User on 09 27 12 03 41 PM EDT Assess Admit Dis Type Date Leave C Rejected C Accepted Transmit CMS 05 05 1955 Admit 09 01 2012 Update Set Transmission date to 09 27 2012 lt lt 09 26 2012 lt lt 09 25 2012 lt lt 09 24 21 Action Name Birth Date For each assessment select the status that CMS assigned Accepted or Rejected If an assessment was accepted and you need to make some changes and re transmit you can mark it as Accepted and then correct and re transmit it Marking an assessment as Rejected automatically reverts that assessment back to an incomplete state so that the necessary corrections can be made Once all assessments from a particular download file have been processed that download file will no longer appear in Step 2 You may select Leave to leave an assessment in Step 3 awaiting processing as Rejected or Accepted CMS Transmission Date When you mark assessments as accepted by CMS you have the opportunity to modify the transmission date using the box to the right of the Update button to reflect when the assessments were transmitted to and accepted by CMS If the day that you mark the assessment as
61. ase or increase an assessment s correction number as necessary Use of these buttons is generally only necessary if an assessment had previously been marked Accepted or Rejected incorrectly Include Exclude On assessments that did not begin as pre admission assessments in LTRAX click I nclude to include them in the Referrals Outcomes reports To exclude individual assessments from the Referrals Outcomes click Exclude Undo Rescreen On a pre admission record that was rescreened by mistake click Undo Rescreen to delete the rescreening Revert On an admission assessment click Revert to delete the admission assessment and move the assessment back into the pre admit assessments table On a discharge assessment click Revert to delete the discharge assessment and move the assessment back into the admission assessments table NOTE When you revert an assessment back into a pre admission assessment all admission assessment information entered will be deleted When you revert a discharge assessment back into an admission assessment all discharge assessment information entered will be deleted Pre Adm Tab On a pre admission assessment the PRE ADM tab allows you to access the pre admission data entry screens When present on a patient assessment the PRE ADM tab allows you to view the information that was entered on the pre admission screening Custom Tab If your LTRAX facility administrator has created any custom data fields to tra
62. assessment that has passed the LTRAX completion check but has not yet been accepted by CMS e Complete xmit Ready for an assessment that has passed the LTRAX completion check and been marked XMIT READY but has not yet been placed into a CMS transmission file e Complete xmit Prepared for an assessment that has passed the LTRAX completion check and been placed into a CMS transmission file but has not yet been marked Accepted by CMS e Complete Accepted by CMS for an assessment that has been marked as Accepted by CMS Facility The name of the facility where the patient was admitted Provider ID The provider ID of the facility where the patient was admitted T LATE TRANSMI TTAL SUMMARY Users with privileges to see reports and or download data for their entire organization can see a snapshot of their organization s transmittal status on the Late Transmittal Summary The Late Transmittal Summary lists all facilities in the user s organization with a tally of late assessments In Progress and late assessments Accepted by CMS Click on any facility in the list to go to the detailed Transmittal Report for that facility EH TRANSMITTAL REPORT The LTRAX Transmittal Report is a live report of LTCH CARE assessment transmissions The report is updated in real time instantly reflecting the addition of new admissions and discharges and the updated status of assessments marked Accepted by CMS USER FEATURES I1 E
63. can Upload NOTE The LTRAX Patient Satisfaction Instrument has been replaced by the HCAHPS Hospital Consumer Assessment of Healthcare Providers and Systems survey as of January 1 2013 This section refers to the superceded LTRAX Patient Satisfaction Instrument and is included in this manual for historic surveys Facilities have two ways to enter completed patient satisfaction survey results into LTRAX by typing results directly into the LTRAX interface or by creating a text file of collected survey results either by hand or with the use of scanning software and uploading the file to LTRAX SSS Es FILE REQUIREMENTS Your PSI Scan Upload file is an ASCII text file with each record contained on a single line and separated from the next by a carriage return line feed Each field in each record is separated by a delimiter of your choosing During the file import the system will automatically identify the first non alphanumeric character found on the first line of the file as the field delimiter for the entire file Your delimiter can be anything except a letter a digit or an underscore dash or space as these characters often appear in actual data We highly recommend the TAB character as the TAB cannot be embedded in any data fields If you do not have data in some of the fields your delimiter must still be used as a placeholder for empty fields where there are gaps in the data If you are uploading partial USER FEATURES I1 D PSI
64. cility administrator user can create manage all user accounts for their facility and configure facility information includes all sites This privilege allows the user to create and manage all user accounts for the facility including multiple sites associated with that facility site administrator privileges inclusive The facility administrator can also create facility custom data fields edit facility settings such as password expirations access assessment tracking information perform advanced functions on individual assessments and sign the facility up for additional services such as the Patient Satisfaction System Facilities can have more than one facility administrator In fact this is recommended as it distributes responsibility in case an administrator is ill on vacation or otherwise unavailable Site administrator user can create manage user accounts only for their site This privilege restricts a user s administrative capacity to their site only This is only applicable if a facility has more than one site and the site administrator should not have access to user accounts at other sites A site administrator creates and manages user accounts for their site only and does not have the ability to grant user privileges associated with a facility for instance a site administrator cannot authorize a user to view reports Site administrators also cannot create custom data fields or manage any other facility level settings TR cure
65. ck information not entered as part of the regular LTRAX assessment your assessments will include a CUSTOM tab which you can click on to complete your custom data fields CMS Info Tab The CMS INFO tab appears on a record once the record has been placed into a file for transmission to CMS This tab lists each CMS file that a patient record has been placed into the type of record admission or specific discharge type the date the file was created the person who created the file the correction number if greater than 0 and the result of the transmission Accepted Rejected as recorded in Step 3 on the CMS Transmit File screen This tab also includes a section labeled CMS Transmission Dates which displays the dates that admission and discharge records were marked as Accepted by CMS and allows you to edit those dates to accurately reflect when records were transmitted to and accepted by CMS Files Tab If you have uploaded any files to an assessment using the Attach Files button on the MGMT tab click the FILES tab to review your uploaded files or upload new files TRAX sexe aa a SYSTEM r 8 MENT FEATURES P S I Tab Click the P S I Patient Satisfaction Instrument tab to access the patient satisfaction survey screens For more information on the Patient Satisfaction System and instructions on entering patient satisfaction survey data please see the LTRAX Patient Satisfaction System section of this manual
66. ct which measure to display The privileges User can view all Administrative level reports for all facilities in their organization includes all facilities and User can view all Clinical reports for all facilities in their organization includes all facilities control access to the Facility Ranking reports In addition to the Facility Region Org and Time Period drop downs available on the other reports screens the Facility Ranking Reports also include a Detail Level drop down which lets you view measures for all of your facilities at the Facility level or at the DRG MDC or DRG level If you select anything other than Facility in the Detail Level drop down a second drop down appears for you to select your detail category For most measures you will see Organization Variance and National Variance percentages Variances are calculated by subtracting the organization or nation measure value from the facility number and then dividing by the organization or nation measure value To change the sort order of the report table click on the column header for the column you want to sort the report by Clicking on the header once will sort the report in ascending order by that value Clicking on the header a second time will sort the report in descending order A lightly shaded background identifies the sort column Facility Report Under the Administrative or Clinical Drill Down reports menu click Faci
67. ctions for your facility missing QRP items listed here T LTACH LAR System User manual V ASSESSMENT FEATURES Check this box to override LTRAX completion checking for incomplete fields that CMS has identified as required to preserve full Medicare reimbursement in the CMS LTCH Quality Reporting Program This may result in Medicare payment reductions for your facility Notes To complete an assessment with missing QRP data check the override box in the warning message and use the Notes field to record the reason the QRP data are missing The notes entered here are available for review on the QRP Override Report In addition to the CMS minimum data set requirements LTRAX requires some fields that are used for outcomes reports and interruptions tracking These fields that LTRAX requires for assessment completion are Complete birth date CMS only requires birth year Payer Admitted From Discharge Location Discharge DRG Optional facility custom data fields custom data field requirements are configured by your LTRAX facility administrator ns M DATA ENTRY TIPS Here are some tips for entering data into the assessment screens on LTRAX eWhile entering data on assessment screens you can use the Tab key on your keyboard to tab to each input field eIn numeric drop down lists such as the Glasgow Coma Scale drop downs you can use the number keypad on your keyboard to select the number
68. d with other special limited privileges such as User can create edit pre admission assessments only Once you have entered all of the user account information and made your privilege selections click Save to create the account and return to the Manage Facility screen PRIVILEGES REFERENCE GUIDE Almost everything a user can do on LTRAX is controlled by a separate user privilege The purpose of this guide is to help you determine which privileges are appropriate for each user account based on the tasks each user has to perform These privileges should be combined as necessary to allow each user only the access they require Administrative Tasks Does the user need to Create other user accounts and manage user privileges Re set passwords for users who have forgotten them Configure a password expiration for all facility passwords Create custom data fields for clinical assessments Revert admission assessments back into pre admissions View assessment tracking and user login history For any combination of the above tasks assign the privilege Facility administrator user can create manage all user accounts for their facility and configure facility information includes all sites Does the user need to Revert an admission assessment back into a pre admit assessment for example on accidentally admitted assessments If the user needs to do these two tasks WITHOUT the administrator tasks listed above they will need
69. dical Record e Patient Name e Payer e SSN e Admit Type e DRG The second Sort drop down controls whether your sort value is listed in ascending or descending order e Ascending Select this to sort your assessments in ascending order For example sorting assessments by Patient Name in ascending order will display them alphabetically with assessments with no last name at the end 82 Sf a SYSTEM si es aisian V ASSESSMENT EATURES e Descending Select this to sort your assessments in descending order For example to view your assessments with the most recent admissions at the top of the lists sort your assessments by Admit Date Descending NOTE It is also possible to sort an assessments list individually by clicking on a column header to sort the list by that column Clicking once on a column header sorts the list by that column in ascending order Clicking a second time on the column header sorts the list by that column in descending order Restrict to Depending upon your selections in this section this option includes three drop downs and up to three input boxes The first Restrict to drop down allows you to filter assessments based on a selected assessment date Assessment date options include e Admitted Select this to apply your date range to assessments admitted during the date range e Discharged Select this to apply your date range to assessments discharged during the date range
70. dmit and admission assessments and edit existing assessments including patient satisfaction surveys User can lock assessments This gives the user the ability to lock assessments against any edits to prevent any changes User can unlock assessments This gives the user the ability to re open locked assessments for further edits Data Download Upload Privileges User can download assessments from their facility This gives the user the ability to download their facility s patient assessment data from the LTRAX system to their local network or computer This privilege is necessary if the user will be creating files to transmit to CMS or if they will be downloading assessment data to keep as a local back up or to import into another software application for custom reporting User can upload files to LTRAX This gives the user the ability to upload patient satisfaction surveys to the LTRAX system without manually keying in information Outcomes Reports Privileges User can view all Administrative level reports for their facility This privilege allows a user to view LTRAX Administrative outcomes reports for their facility including patient satisfaction outcomes reports User can view all Clinical reports for their facility This privilege allows a user to view LTRAX Clinical outcomes reports for their facility including patient satisfaction outcomes reports User can ONLY view Patient Satisfaction outcomes reports for their facility Th
71. dy click the COMPLETE button on the assessment management MGMT screen Once the assessment has passed the LTRAX completion checks and received the status of Complete click the Xmit Ready button to mark the record as Xmit Ready In Step 1 set the Action to Confirm on all assessments that you wish you place into your CMS transmit file Set the action to Leave on any assessments marked as Xmit Ready that you do not wish to include in your file This option leaves assessments marked as Xmit Ready and they will remain in Step 1 USER FEATURES II D CMS TRANSMIT FILE 8 LTACH LITRA A system USeEr manual I1 USER FEATURES Click Confirm to perform any actions you ve marked and proceed to step 2 STEP 2 DOWNLOAD CMS ASSESSMENTS FILE Your CMS file has been created However it is stored on the LTRAX server until you download it The following is similar to what you might see Step 2 Download CMS Assessments file Click the Download link to download the file s to your computer or local network for trans File Name Date Created Created by CMS_LTRAX_79_120927_154136 zip 09 27 12 03 41 PM EDT Training User Click to downloac After downloading your files log in to the CMS network and transmit your downloaded file Then p This shows that one file awaits download By selecting the Click to download link you can save the file to your computer s hard drive The following is similar
72. e Skilled Nursing Facility or Swing Bed SNF 45 days or fewer including the date of discharge If a patient goes to any other location the return to the LTACH is considered a new admission If a patient goes to more than one discharge destination before readmission to the LTACH the readmission is considered the beginning of a separate stay LTRAX detects interruptions in stay for Medicare patients by comparing the Discharge Location A2100 on the most recent discharge with the Admitted From A1800 location on the patient s new admission If LTRAX finds that a patient has been admitted from the same location as the most recent discharge and if the readmission occurs within the number of days that define an interruption LTRAX will automatically link the assessments together as a single Medicare stay LTRAX will also display a message similar to the following with the appropriate discharge location and days of interruption This patient was discharged to a Short stay acute hospital IPPS within 9 days of this Admission Date which indicates that this assessment continues an interrupted stay LTRAX TR LTACH L Es LA vsem User manual V ASSESSMENT FEATURES has linked the assessments See the Interruptions section of the MGMT tab to manage this link The link joins the two sets of assessments together under a single stay The user can confirm or break the link between assessments on the MGMT tab of the second admission record The MGM
73. e measure all questions within the composite must be answered on the survey For that reason the answers from a survey may be included in some composite measures but not others For each measure the Surveys line shows how many surveys were used to compute the averages for each measure Composite Survey Questions The following measures are composites of the survey questions listed for each measure Questions not mentioned below are reported individually Nurse Communication USER FEATURES I I E HCAHPS OUTCOMES 40 TRA ag S amp SYSTEM LTACH OUTCOMES 1 During this hospital stay how often did nurses treat you with courtesy and respect 2 During this hospital stay how often did nurses listen carefully to you 3 During this hospital stay how often did nurse explain things in a way you could understand Doctor Communication 5 During this hospital stay how often did doctors treat you with courtesy and respect 6 During this hospital stay how often did doctors listen carefully to you 7 During this hospital stay how often did doctors explain things in a way you could understand Responsiveness of Hospital Staff 4 During this hospital stay after you pressed the call button how often did you get help as soon as you wanted it 11 How often did you get help in getting to the bathroom or in using a bedpan as soon as you wanted Pain Management 13 During this hospital stay how well was you
74. e Created Select this to apply your date range to assessments created during the date range e Denied Select this to apply your date range to pre admit assessments marked as Denied during the date range The second Restrict to drop down controls the date range applied to your selected assessment date Date ranges include e None blank Select this if you do not want to restrict your assessments lists to any date type e g admit date or range e Custom Select this to enter your own date range If you select this option two additional input boxes will appear for you to enter your start and end dates Enter your start and end dates and then click Enter The remaining options allow you to list assessments that have either been admitted discharged created or denied within a specified time period Those periods include e Last 90 days e Last 365 days e Cal Yr 2012 e Cal Yr 2011 The third Restrict to drop down lets you search for assessments by hand entered values applied to one of four assessment fields and is used in conjunction with the starting with input box to its right Searchable fields include e Last Name Select this to search for records by Patient Last Name e Med Rec Select this to search for records by Medical Record Number e Medicare Select this to search for records by Patient Medicare Number e SSN Select this to search for records by Social Security Number Once you have selected
75. e first time they are marked as accepted by CMS falls on or before the earliest of the following dates Assessment completion date 7 calendar days OR Admission assessment reference date 12 calendar days OR Admission date 14 calendar days Discharge Assessments are considered transmitted on time if the first time they are marked as accepted by CMS falls on or before the earliest of the following dates Assessment completion date 7 calendar days OR Discharge assessment reference date 12 calendar days OR Discharge date 12 calendar days Incomplete QRP Data Admit and Discharge The percent and count of admission and discharge assessments marked as Accepted by CMS for which the LTCH QRP completion requirements override checkbox was checked enabling transmission of assessments to CMS with incomplete QRP data Discharges in Sample The number of discharges during the selected time period based on discharge date Discharged Patient Days The total number of days all discharged patients were present in the facility during the selected time period based on admission date and discharge date This measure is adjusted for qualified interruptions in stay as defined in the CMS LTCH PPS Training Guide as follows An interrupted stay is defined as a case in which an LTCH patient is admitted upon discharge to a short stay acute hospital IPPS inpatient rehabilitation facility or unit IRF or a skilled nursing faci
76. e listed You can complete those fields before selecting a reason for denial and click Deny select a reason for denial and click Deny without filling out the missing information or delete the pre admit by clicking Delete Edit Denial On denied pre admission assessments click Edit Denial to modify the denial date and or reason for denial then click Update to save your changes Undeny To revert a denied pre admission assessment back into an active pre admission assessment first click Edit Denial then click Undeny Delete On an unlocked admission or discharge assessment click Delete to delete the assessment Delete deletes all records associated with an assessment including pre admission screenings and should not be used to try to delete part of a record for example in cases where a pre admission was admitted prematurely or a discharge record was created in error See Revert under Advanced below for more information Tracking Click Tracking to display a list of all of the LTRAX users who have accessed the assessment along with the screens they visited when the screens were visited and whether any data were saved to a screen Tracking is only available to users with facility administrator privileges Advanced The Advanced button gives you access to two specific functions and is generally only used when a mistake was made in processing an assessment using normal workflow channels Advanced is only available to users with either f
77. e pages on this website are dynamic meaning that every time you click on a link a fresh set of data is retrieved from the server to create the page Due to the nature of a database driven website such as LTRAX the data used to create each page may change at any time Each page is set to expire as soon as you move on to the next page This also enhances security as expired pages and therefore sensitive data are not cached saved on your computer If you use your browser s Back button to revisit a page you may see a warning message telling you that the last page you visited has expired To avoid encountering this message always use the navigation provided on the left side of each page to move around the website You can always return to your homepage by clicking HOME below the LTRAX logo Always log out when you are through For security reasons it is important to log out of LTRAX when you are finished working on the system or if you are taking a break If you don t log out of the system it is still possible to return to the site from your computer and bypass the login screen for up to 2 hours after the last time you accessed an LTRAX screen This applies even if you browse to another website This means that if you leave the site without logging out and then leave your computer unattended anyone with access to your computer can potentially access LTRAX using your account Closing your web browser does not log you out of the system If yo
78. e values for denials and admissions are calculated against the total number of denials and admissions while the referrals conversion percentages are based on the number of admissions from each zip code The accompanying pie chart shows referrals by zip code percentages calculated against the total number of referrals You can click on a column header in the table to sort the list by the selected column in ascending order Click the column header again to sort the list in descending order Referrals by Payer This table displays counts and percentages of denials admissions and referrals by primary payer Percentage values for denials and admissions are calculated against the total number of denials and admissions while the referrals conversion percentages are based on the number of referrals from each payer The accompanying pie chart shows referrals by payer percentages calculated against the total number of referrals You can click on a column header in the table to sort the list by the selected column in ascending order Click the column header again to sort the list in descending order MDC REPORT Admission assessments with an MDC are included in the MDC Report Click on MDC Report to view a list of all MDCs To collapse the list to display only MDCs with admissions at your facility check the box labeled Hide codes with zero admission assessments Clicking on an individual MDC will give you a report structured like the Facility Report
79. eck but has not yet been accepted by CMS e Complete xmit Ready for an assessment that has passed the LTRAX completion check and been marked XMIT READY but has not yet been placed into a CMS transmission file LTACH ITR KE scons user manual E E EZ Wg a SYSTEM Il USER FEATURES e Complete xmit Prepared for an assessment that has passed the LTRAX completion check and been placed into a CMS transmission file but has not yet been marked Accepted by CMS e Complete Accepted by CMS for an assessment that has been marked as Accepted by CMS Discharged The patient s discharge date recorded as LTCH CARE item A0270 on Dischg An Admission Assessment with no associated Discharge Assessment may show a blank in this column Discharge Location The patients discharge location recorded as LTCH CARE item A2100 on Dischg An Admission Assessment with no associated Discharge Assessment may show a blank in this column Discharge Type The LTCH CARE discharge assessment type An Admission Assessment with no associated Discharge Assessment may show a blank in this column e D Planned Discharge e DU Unplanned Discharge e DE Expired Discharge Status The status of the assessment An Admission Assessment with no associated Discharge Assessment may show a blank in this column Incomplete for an assessment that is still in progress and has not passed the LTRAX completion check e Complete for an
80. ed interruptions in stay as defined in the Centers for Medicare amp Medicaid Services LTCH PPS Training Guide as follows An interrupted stay is defined as a case in which an LTCH patient is admitted upon discharge to a short stay acute hospital IPPS inpatient rehabilitation facility or unit IRF or a skilled nursing facility SNF and returns to the same LTCH within a specified period of time eAny discharge destination 3 days or less Short stay acute hospital IPPS 9 days or less eInpatient rehabilitation facility or unit IRF 27 days or less Skilled nursing facility SNF 45 days or less For qualified interruptions the interruption days are subtracted from the patient s length of stay and thus are not counted as patient days Bed Days The number of facility beds multiplied by the number of days in the selected time period Facility bed count is configured for each facility by any user with the Facility Administrator privilege Occupancy Rate Calculated as bed days divided by patient days see above for definitions of bed and patient days TRAM sitcoms Gea amp ES Sf amp SYSTEM On Time Transmissions Admit and Discharge The percent and count of admission and discharge assessments marked as Accepted by CMS that were transmitted to CMS on time On time is defined in the LTCH Quality Reporting Program QRP manual as follows Admission Assessments are considered transmitted on time if th
81. eir facility To load a template select the radio button next to the template name and click Load Additionally users can delete templates they have created by selecting the radio button next to the template name and clicking Delete Select Facility Data to Download This option allows you to download data for an individual facility or multiple facilities in your organization or for all facilities in your organization combined However if you select more than one facility or the All Facilities in Organization option your file will not contain facility custom fields NOTE The Select Facility Data to Download option is only available to users belonging to an organization that has more than one subscriber facility on LTRAX N USER FEATURES II1 D DATA DOWNLOAD CUSTOM TEMPLATE TRAXE user a2 Ag amp SYSTEM and the privilege to download data from multiple facilities can only be assigned by an LTRAX organization administrator Select Available Fields This box displays all fields available for download grouped by section You can select individual fields or entire sections for download To select an individual field click on it To select multiple fields hold down the Ctrl key while you click on each field name To select an entire section click the section name For example to grab all of the patient demographic fields select the section header labeled Demographic Information all fields Use the gt gt
82. eport menu screen is a list of all available measures Click on a measure to view facility national and regional data for that measure for each DRG containing facility data for the selected time period and payer Check the Show all DRGs checkbox at the top of the screen to view the facility national and regional data for the selected measure for each DRG containing national data for the selected time period and payer From this screen you can click on a DRG to jump directly to the report of all measures for that DRG ae OUTCOMES REPORTS REGIONS Regions are defined as the nine U S Census Regions as follows Outcomes Reports Regions Region State New England Connecticut Maine New Hampshire Rhode Island Vermont Middle Atlantic New Jersey New York Pennsylvania South Atlantic Delaware Florida Georgia Maryland North Carolina South Carolina Virginia Washington DC West Virginia East North Central Illinois Indiana Michigan Ohio Wisconsin East South Central Alabama Kentucky Mississippi Tennessee USER FEATURES I1 E OUTCOMES 23 LTACH TRA ourcomts user Manual Gm a amp EZ Sf amp SYSTEM Il USER FEATURES Outcomes Reports Regions Continued Region State West North Central lowa Kansas Minnesota Missouri Nebraska North Dakota South Dakota West South Central Arkansas Louisiana Oklahoma Texas Mountain Arizona Colorado Idaho Montana Nevada New Mexico Utah Wyoming
83. eports menu click HCAHPS on your LTRAX homepage This user manual contains the following information about the HCAHPS Outcomes Reports 1 HCAHPS Outcomes Reports General Information 2 HCAHPS Outcomes Reports Drill Down Levels 3 A Facility Ranking Report B Facility Report 4 HCAHPS Outcomes Reports Regions HCAHPS Outcomes Reports Measures E SSS HCAHPS OUTCOMES REPORTS GENERAL I NFORMATION The LTRAX HCAHPS Outcomes Reports show your facility s aggregated patient responses to the HCAHPS Standard Survey also known as the Hospital Consumer Assessment of Health Plans Survey an instrument developed by the Agency for Healthcare Research and Quality a division of the Department of Health and Human Services Your facility or the facilities in your organization are included in HCAHPS reporting when one or more HCAHPS surveys are returned in the month or when you have Discharge Assessments marked accepted by CMS in any month and had returned one or more HCAHPS surveys in the prior month The LTRAX HCAHPS Outcomes Reports are delivered in a tiered hierarchy under Facility Drill Down If your facility belongs to a larger organization your menu may start with the Facility Ranking Report If not your menu will start with the Facility Report You can jump to any drill down level from any other HCAHPS report by using the links under Facility Drill Down The reports are upda
84. er goes to the CUSTOM tab on that assessment Dr Xavier will appear as a temporary value in the drop down and a message displayed on screen will alert the user to the fact that the value no longer exists as a valid option If the user doesn t then select a different option from the drop down then the data will not be updated to reflect one of the available values It is important to recognize that a selection made in the drop down is identified in the database by the Value not the Description Here is another example Patient Smith s assessment had its Attending Physician value set to Other The next day the administrator edited the facility custom element and changed that option from Other to Other Other Attending If Smith s assessment is loaded and the user clicks on the TR A ourcones user manua i FAC T b T E A amp SYSTEM CI LI ADMI NI STRATOR FEATURES CUSTOM tab it will appear as if the choice was changed from Other to Other Attending In this case because only the Description changed the database entry stays the same Other However if instead the line were changed to Other Attending no colon then both the Value and Description would change If the assessment were then loaded and the CUSTOM tab clicked the drop down would display a temporary value of Other because the value of Other is no longer a valid drop down option and the assessment is in edit mode
85. es section of this manual If all else fails Call LTRAX support staff at 301 357 8110 UJUS Gm EE EZ SSUSYSTEM y TR een We Il USER FEATURES II USER FEATURES II A Logging In To log in to LTRAX you must use a computer that is connected to the Internet After confirming that you have an Internet connection open a web browser Internet Explorer version 8 0 or higher Firefox version 3 or higher or something similar and point it to www ltrax com Your browser will be directed to a secure website and the login screen will appear Enter your facility s Medicare provider number and the username and password that were created for you by your facility s LTRAX administrator If you have forgotten your username and or password type in your facility s Medicare provider number and then click Forgot your password The contact information for your facility s LTRAX administrator s will appear and you can contact your facility administrator for assistance with logging in II B My Account The My Account screen allows you to manage your personal contact information on your user account as well as customize certain aspects of LTRAX to suit your preference The My Account screen is available when you log onto LTRAX and click the My Account link that appears on the left side of your screen Change Password Your password must be at least 8 characters long and must include letters and at least 2 numbers Additionally
86. essment Reference Date 5 Transmission Date no later than Completion Date 7 ITR YE rones user manual 2 Se S S SYSTEM II USER FEATURES In addition CMS issues quarterly deadlines for the submission of all missing and corrected LTCH CARE assessments Assessments submitted past the final deadlines will not count toward your facility s participation in the LTCH QRP For more information on assessment scheduling and submission deadlines please see the CMS LTCH ORP Manual and CMS s LTCH PPS rules and regulations QRP OVERRIDE SUMMARY Users with privileges to see reports and or download data for their entire organization can see a snapshot of their organization s QRP compliance on the QRP Override Summary The QRP Override Summary lists all facilities in the user s organization with a tally of assessments In Progress and Accepted by CMS that have the override checkbox checked Click on any facility in the list to go to the detailed QRP Override Report for that facility u QRP OVERRI DE REPORT The LTRAX QRP Override Report is a live report of LTCH CARE assessments that have the LTCH QRP completion requirements override checkbox checked enabling transmission of assessments to CMS with incomplete QRP data The QRP Override Report can be viewed by users with privileges to download assessments and or view outcomes reports on LTRAX The report is updated in real time instantly incorporating new assessments
87. ettings To access the administration screen log in to LTRAX and click My Facility under the Manage header on the left side of your homepage You will see a table displaying the names of all LTRAX users for your facility including your own If your facility has more than one site you can toggle between the sites to display the users for each site by selecting the site name from the Sites box at the bottom of the screen and clicking Switch Site eee EDITING USER ACCOUNTS You can edit an existing user account from the Manage Facility screen by clicking on a username The screen will refresh with the selected user s account information displayed at the top Click Edit User to make any changes to the user s account See the Add User instructions below for an explanation of user account requirements and privileges You will also see the option Delete User If the user has ever logged on to LTRAX even once you will not be able to delete them from the system This option is included only to allow you to correct mistakes in account assignments If you need to deactivate a user s account you can remove all of their privileges and then select No under Active on the edit screen See the Add User instructions below for more information a MANAGE FACILITY SCREEN OPTIONS On the left side of your Manage Facility screen you will see the following links grouped under the headers Facility Admin Recent Activity and Systems
88. facility site administrator privileges inclusive The facility administrator can also create facility custom data fields edit facility settings such as password expirations access assessment tracking information and perform advanced functions on individual assessments Facilities can have more than one facility administrator In fact it is recommended that each facility have more than one administrator as it distributes responsibility in case an administrator is ill on vacation or otherwise unavailable Site administrator user can create manage user accounts only for their site This privilege restricts a user s administrative capacity to their site only This is only applicable if a facility has more than one site and the site administrator should not have access to user accounts at other sites A site administrator creates and manages user accounts for their site only and does not have the ability to grant user privileges associated with a facility for instance a site administrator cannot authorize a user to view reports Site administrators also cannot create custom data fields or manage any other facility level settings NOTE If you are designating the user as a facility administrator this privilege is unnecessary and redundant Sub Administrator Privileges Non admin user can perform Clinical Assessment advanced maintenance functions This privilege allows a user who is not an LTRAX facility administrator to perform certain functi
89. g the most severe wound status and 9 representing a healed wound Average Discharge BWAT Score The sum of BWAT scores on the last assessment for included wounds divided by the total number of wounds with BWAT scores Average Change in BWAT Score The difference between the Initial BWAT score and Discharge BWAT score calculated for each wound and then averaged for the sample Average Change in BWAT Score Per Day The difference between the Initial BWAT score and Discharge BWAT score divided by the number of days elapsed between initial and discharge LTACH TRA wrons user Manual z 2 amp 2 32 a SYSTEM lI USER FEATURES BWAT assessments calculated for each wound and then averaged for the sample Healed Rate The percentage and count of wounds where the discharge BWAT score 9 Total Wounds w Volume The count of wounds that have at least 2 wound assessments with complete volume data and with distinct assessment dates Wounds with all three measurements length width and depth recorded as zero are included but wounds with one or two measurements recorded as zero are excluded NOTE Only wounds that meet these criteria are included in the wound Healed Rate and Volume measures Average Initial Volume The average wound volume of all wounds in the sample calculated from the wound assessment fields Length Width and Depth on the first earliest wound assessment Average Discharge Volume The average wou
90. gin must be Pressure Wounds of other types or no recorded type will not copy 2 The Wound Assessment Date s must fall within the appropriate assessment reference period For admission assessments the assessment reference period is the admission date plus two calendar days For discharge assessments planned and unplanned the assessment reference period is the date of discharge and the two calendar days prior to discharge 3 In addition to Wound Type and Wound Assessment Date each wound assessment must have the following required fields completed e Date Identified or Unknown e Present on Admission e Stage at Time Identified e Stage at This Assessment e Wound Dimensions e Complete BWAT or PUSH score In addition to the above requirements for wound assessments the patient s record must also have the following dates completed eAdmission Date and Admission Assessment Reference Date for an admission assessment Discharge Date and Discharge Assessment Reference Date for a discharge assessment TURES V A LTRAX CLINICAL ASSESSMENT GENERAL I NFORMATION SPRL system V ASSESSMENT FEATURES See the documentation available under the HELP icon on the WOUNDS tab for more information on assessing and copying wounds LTCH QRP Manual LTRAX assessment screens that include LTCH CARE Tool data items offer links to the respective sections of the LTCH QRP Manual for those items These links are found at the bottom of the data
91. hare Template f you are saving your download options as a template and would like other users at your facility to be able to use your template select Yes If you want exclusive use of your template select No NOTE For organization level downloaders If your template includes facility custom data fields from one facility and you select to use that template to download assessment data at a different facility the facility custom data fields will be removed from the list of available fields and replaced by any facility custom fields exist for the facility whose data you are downloading Save Template f you wish to save your download options as a template enter a name for the template into the Name and Save Template box and click Save You can overwrite an existing template that you have created by saving a template with the same name You cannot overwrite a template created by a different user You do not need to save a template in order to download a file with the download options you have selected Download your file Make your selections and click Download You will see a list of the parameters you chose and below that links that say Change Parameters and Create File If your file parameters look correct click Create File to create the file and a link to your file s will appear below If you are downloading data that comes in separate files you ll see links to each individual file plus a link to a ZIP file that will contain
92. hat is described If you believe you do not have the privileges you require in order to perform your assessment duties contact one of your LTRAX facility administrators and ask them to adjust your user permissions CREATING NEW ASSESSMENTS Pre Admission Screening You can create a new pre admission assessment by clicking Pre Admit on your LTRAX home page or by uploading an Offline PAS Tool record For more information on pre admissions please see the Pre Admission Screening PAS Tool Assessments section of this user manual Admission Assessmenis You can create an admission assessment in one of two ways by clicking the Admit button on the MGMT screen of a pre admit assessment or by clicking New Admission on your LTRAX home page Discharge Assessments You can create a discharge assessment by clicking the Discharge button on the MGMT screen of an admission assessment then selecting the type of discharge assessment Planned Unplanned or Expired and clicking CONFIRM EDITING EXISTING ASSESSMENTS To view or edit existing assessments click on the patient name from your assessments lists on your LTRAX home screen For more information on searching for and displaying assessments on your home screen please see the Displaying Patient Assessments on the LTRAX Home Screen section of this manual WORKING IN MULTIPLE BROWSER WINDOWS OR TABS Your web browser can only track one patient record at a time If you attempt t
93. he bottom of your LTRAX home screen On the left side of the Launch Screen Options screen is a table listing all available display columns The right side of the Launch Screen Options screen offers several options that control how your assessments tables appear and how the home screen refreshes when a change is made to any of the display options DISPLAY COLUMNS CONFI GURATI ON The display columns section includes two controls for each column you want to display in your assessments lists The first is a simple checkbox that determines whether or not the column will appear on your LTRAX homage If the box next to a column is not checked that column will not appear on your home page The second is a text box to the right of the column name which allows you to specify the order of display If a column is added but no order number is entered it will be appended to the list when you click Save e If a column is changed to the same order number as another column the changed column will be inserted before the unchanged column of the same number If more than one column is added without specifying an order the new columns will be added at the end of the list in alphabetical order NOTE Depending on the type of assessment some selected display columns will not appear in some assessment tables For example Admit Date Discharge Date and LOS will not appear in the Pre Admit table Individual column information Line Number If you
94. if you need 2C or 3C For more information on configuring your discharge surveys please see the Organization Administrator Features section of this manual Ranges of valid values are indicated in the Value column below The survey file formats are as follows Service Recovery Survey File Format Name or Survey Question Number Value Notes SurveyVersion S S Service Recovery Survey as printed in bar code lower left corner of survey page 1 Facilityl D 6 digits Facility s Medicare provider number as printed in bar code upper left corner of survey page 1 SurveyI D 6 7 digits Survey ID as printed in bar code upper right corner of survey DatePrinted MMDDYYYY As printed in bar code lower right corner of survey page 1 Q1 0 4 Q2 0 4 Q3 0 4 Q4 0 4 Q5 0 4 Q6 0 4 Q7 0 4 Q8 0 3 Q9 0 3 Q10 0 3 Q11 0 3 Q12 0 3 SurveylD 6 7 digits Survey ID as printed in bar code upper right corner of survey USER FEATURES II D PSI SCAN UPLOAD 17 LTACH l TRA wroes user Manual a2 34 a SYSTEM Il USER FEATURES Service Recovery Survey File Format Continued Name or Survey Question Number Value Notes Q1 memo ComfortableStayComments Q14 memo BetterAccomodateComments Q15 GeneralComments memo Q16 1 3 Discharge Survey File Format Name or Survey Question
95. imary payer admission date discharge date and admit or discharge DRG For more information about the Skin Wounds and Vent portions of the LTRAX patient assessment please see the documentation located under the HELP icon on the SKIN WOUNDS and VENT tabs within a patient record For more information about the screens and functions on admission assessments please see the Assessment Tabs Navigation section of this user manual ITRAX ES ag D SYSTEM V E Interruptions in Stay Leave of Absence LOA Under CMS policies there are two different definitions of an interruption in a patient s stay One is specific to the guidelines for completing LTCH CARE Tool records and the other is specific to Medicare reimbursement for Medicare patients LTRAX accommodates both of these definitions in the following ways Interruptions Lasting Three Days or Fewer LTCH CARE Data Set If a patient leaves your hospital and returns within three days no new admission record is required upon the patient s return An interruption of three days or fewer is considered a continuation of the patient s initial admission so a discharge record and a new admission record should not be created in LTRAX The three day period counts the day the patient leaves as day 1 so for example if a patient leaves August 1 and returns August 3 they have returned on day 3 and their original admission is continued If they return on August 4 that
96. in read only mode unless it is unmarked xmit Ready using the XMIT REMOVE button xmit Prepared The assessment has been included in a file for submission to CMS in Step 2 on the CMS Transmit File page It is in read only mode and no changes can be made until it is marked Accepted or Rejected on the CMS Transmit File page Accepted by CMS The assessment has been marked Accepted by CMS in Step 3 on the CMS Transmit File page Locked The record has been locked It is in read only mode and no changes can be made unless it is first unlocked using the Unlock button Filed The record has been locked and filed It is in read only mode and no changes can be made unless it is first unfiled and then unlocked using the Unfile and Unlock buttons Denied The pre admission screening has been denied It is in read only mode and no changes can be made unless the Edit Denial button is clicked Completion Date This column displays the date entered in LTCH CARE Item Z0500 for the relevant assessment type Discharge Type In the discharge assessments list this displays the type of LTCH CARE Tool discharge record following this abbreviation key D Planned Discharge DU Unplanned Discharge DE Expired Length of Stay If Length of Stay is specified as a display column but there is no discharge date for an assessment the running LOS will be displayed in italics in the LOS column This means that the value displayed shows how many days have pas
97. ion and discharge records have been sent to and accepted by CMS e In Progress and Accepted Filed prior to 10 1 2012 it was possible to file completed records In Progress or Filed Denied Pre Admission The second Show drop down controls the assessments displayed by owner These options include e Only assessments have created Select this to display only the assessments that you created All assessments for my site Select this to display assessments created by any LTRAX user at your site This is only applicable if your facility has more than one site sharing the same Medicare provider number Site assignment at this level is controlled by user account association with a site not any custom data fields All assessments for my facility Select this to display assessments created by any LTRAX user at your facility This option is only available to users who have the privilege User can view all assessments for their facility includes all sites and is the recommended default setting Sort by This option also includes two drop downs which are used together The first Sort drop down controls by which value the assessments lists are ordered Sort options include e Date Admitted e Date Created sorts the assessments by the date the record was first created in LTRAX Date Denied sorts the assessments by the date a pre admission was marked Denied e Date Discharged e Medicare Number e Me
98. is day 4 in which case a discharge record and a new admission record are required This rule applies for all patients regardless of payer If a new admission record is created for an interruption lasting fewer than three days the following warning message will be displayed at the top of the second admission record An assessment exists that matches this patient s Last Name and Birth Date and has a Discharge Date within three days of this patient s Admission Date Patients who return within three calendar days of discharge should be treated as a continued stay and do not need a new admission assessment The warning will include a link to the previous record for your reference If the patient noted in the link is not the same person as the previously discharged patient with the same Last Name and Birth Date you may disregard the message and continue to complete the assessment Interruptions Lasting More than Three Days Medicare Long Term Care Hospital Prospective Payment System LTCH PPS Under the payment policy for long term acute care hospitals Medicare considers a patient to have had a single stay in an LTACH if they experienced an interruption in stay of the following lengths according to discharge destination Any discharge destination three days or fewer Inpatient Acute Care Hospital IPPS nine days or fewer including the date of discharge Inpatient Rehabilitation Facility IRF 27 days or fewer including the date of discharg
99. is privilege allows users without clinical or administrative outcomes reports privileges to view their facility s patient satisfaction survey outcomes NOTE This privilege is not necessary if the user has any of the Outcomes Reports privileges above Special Limited Privileges User can create edit pre admission assessments only This allows users who do not have the privilege User can create edit Clinical assessments to create pre admission assessments NOTE This privilege is not necessary if the user has the privilege User can create edit Clinical assessments and it cannot be combined with other special limited privileges such as User can create edit patient satisfaction surveys only TRAX i a2 Ag a SYSTEM User can create edit patient satisfaction surveys only This allows users who do not have the privilege User can create edit Clinical assessments to enter patient satisfaction survey results Such users will be able to view assessment data only for the surveys they are entering but they will not be able to change any assessment data other than the patient satisfaction survey responses If the user needs to print surveys for distribution to patients they will also need the privilege User can view all assessments for their facility includes all sites NOTE This privilege is not necessary if the user has the privilege User can create edit Clinical assessments and it cannot be combine
100. ist of all of the referring facilities with counts and percentages of denials admissions and referrals for each facility with an accompanying graph showing total referrals by facility Percentage values for denials and admissions TRAM wee user E EF Wf amp SYSTEM nana nana II USER FEATURES are calculated against the total number of denials and admissions while the referrals conversion percentages are based on the total number of referrals from each source You can click on a column header in the table to sort the list and graph by the selected column in ascending order Click the column header again to sort the list and graph in descending order You can click on a referral source to filter the report by the selected source along with your other filters Distribution by Denial Reason This table displays counts and percentages by denial reason for your facility your region and the nation Percentages are calculated against the total number of denials for each geographic category The accompanying pie chart shows facility denials You can click on a column header in the table to sort the list by the selected column in ascending order Click the column header again to sort the list in descending order You can click on a denial reason to filter the report by the selected reason along with your other filters Referrals by Zip Code This table displays counts and percentages of denials admissions and referrals by zip code Percentag
101. it cannot include any part of your name or your facility s name and it cannot contain the word password To change your password click Change Password type your new password into both the password and password confirmation boxes and click Update Password If your password doesn t match the password confirmation or the password is not in the required format you will receive an error message in red at the top of the screen If you have entered everything correctly you will be automatically redirected to a page confirming that your password has been updated Contact Data You can edit the contact information on your account to ensure that you can receive LTRAX emails and be contacted by phone if necessary To update your contact information click Contact Data enter or edit your email address and or your phone number with extension if applicable and click Save Font Settings Due to variances in the way different web browsers web browser versions and computer hardware monitors video cards etc display font types and sizes and in consideration of user preference we ve added some display options to allow users to customize the look of their LTRAX homepage and other screens You can control the type and size of the font in which LTRAX appears using the display options settings From the My Account menu click Font Settings Changing The Font Setting the font is done via drop down lists Using the font samples displayed on the screen
102. ities From your Manage Facility screen click Recently Modified Assessments to view a list of your facility s assessments that have been modified within the last specified number of days Click on a patient name to list all the users who have accessed that patient s assessment and when the record was accessed Click on a Session ID Username link to list all of the screens that user visited during that particular session and when the screens were visited FACILITY ADMINISTRATOR FEATURES I11 B RECENTLY MODIFIED ASSESSMENTS 62 TR LTACH iT PEPRA vse user manual iy ORGANIZATION ADMINISTRATOR FEATURES IV ORGANIZATION ADMINISTRATOR FEATURES IV A Organization Administrator General Information Users with LTRAX organization administrator privileges are responsible for managing user accounts for all LTRAX subscribed facilities belonging to their organization This type of account is only necessary if an organization has more than one facility facility being defined by a unique Medicare provider number This level of access has been included for convenience to allow one user to manage user accounts for different facilities without needing to log out and log back in under each provider number An organization administrator has access to assign the organization level privileges for data downloading or outcomes reports viewing to any user under their organization All other access to data on LTRAX is done at the facility level For example a
103. ity to copy a PAS Tool assessment from one facility to another Note that in these cases the original PAS Tool assessment will need to be manually deleted from the originating facility Forward The Forward button allows you to forward the assessment in a message to another LTRAX user at your facility through the secure LTRAX internal messaging system This is a HIPAA compliant means by which you can communicate with other users about a record as opposed to regular email which is not secure and could potentially be intercepted in transit For more information on the LTRAX messaging system please see the LTRAX Messaging System Send Message section of this manual TRA ag S amp SYSTEM LTACH OUTCOMES car i ae Attach Files Click Attach Files to access a screen that will allow you to upload files to LTRAX for storage with an assessment record The LTRAX document repository allows you to store files such as Word documents pdfs scanned images of other documents or any other file or document in electronic format that you want to store with the assessment record on LTRAX Attached files are not subject to any processing or importing like the other LTRAX uploads Deny On pre admit assessments click Deny to access the reason for denial screen This screen checks the pre admit assessment for values present in the fields included in the LTRAX referrals outcomes reports Any missing or incorrectly configured fields will b
104. l Interrupted Stay Rate The percentage of patients discharged within the selected time period who had a qualified interruption during their stay LTRAX uses the CMS definition for an interrupted stay as described under Patient Days above Unplanned Interruption Rate For Discharges Patients discharged within the selected time period who had an unplanned interruption in their stay as a percentage of total discharges Unplanned Interruption Rate For Interrupted Stays Patients discharged within the selected time period who had an unplanned interruption in their stay as a percentage of interrupted stays Short Stays Number of stays that qualify as a short stay under CMS regulations based on discharge date CMS defines a short stay as a length of stay up to and including five sixths the average length of stay for the patient s MS LTC DRG Short Stay Rate Percentage of stays that qualify as a short stay under CMS regulations based on discharge date CMS defines a short stay as a length of stay up to and including five sixths the average length of stay for the patient s MS LTC DRG Wound Patient Rate Patients Percentage and count of patients with wounds discharged during the selected time period calculated as the number of patients with at least one wound assessment Discharges in Sample Wound Patient Rate Days Percentage and count of patient days for discharged patients with wounds calculated as the sum of wound
105. l HOME button on the left side of the screen below the LTRAX logo and a teal toolbar in the upper right corner of your screen This toolbar contains the following buttons USER MANUAL CONTACT and LOG OUT HOME takes you to the LTRAX homepage also known as the launch screen USER MANUAL takes you to this user manual online CONTACT displays contact information for the LTRAX offices LOG OUT will log you out of the LTRAX system and end your user session The left side of your screen displays a set of links that change depending on what part of the site you are on When you are working on an assessment the links will appear as tabs with names representing individual sections of the assessment In other areas of the site the links are grouped under descriptive headers If you have the ability to view patient assessments you will see tables of assessments on your LTRAX home screen Below those tables you will see a List Options link which takes you to the Launch Screen Options screen Use the Launch Screen Options screen to configure the information displayed in your assessments tables on your homepage and the order of the information For more information on configuring the assessments display options please refer to Configuring List Options under the Assessment Features section of this manual INTRODUCTION I INTROL T LTACH OUTCOMES E EZ Vg a SYSTEM Do not use your web browser s Back button Most of th
106. l also see the option Delete User If the user has ever logged on to LTRAX even once you will not be able to delete them from the system This option is included only to allow you to correct mistakes in account assignments If you need to deactivate a user s account you can remove all of their privileges and then select No under Active on the edit screen See the Add User instructions below for more information Cl MANAGE FACILITY SCREEN OPTIONS On the left side of your Manage Facility screen you will see the following links 1 Add User 2 Custom Data Fields ORGANI ZATION ADMINISTRATOR FEATURES IV ORGANI ZATION ADMINISTRATOR FEATURES 63 TR baresi Gea amp ES Sf amp SYSTEM Ti IV ORGANI ZATI ON ADMI NI STRATOR FEATURES If you see links for Bed Count Facility Settings Recently Modified Assessments and Patient Satisfaction Instrument you are either solely a facility administrator or a facility administrator in addition to an organization administrator Please refer to the Facility Administrator Features section for how to manage the facility level information If you are an organization administrator with facility administrator privileges you will be able to manage facility information for only the one facility at a time corresponding to the Medicare provider number you log on with To edit facility information for other facilities in your organization you will need to create a facilit
107. lity Report Your Facility Report displays all available measures for all patients in your facility for your selected time period against national and regional benchmarks MDC Report Under the Administrative or Clinical Drill Down reports menu click MDC Report to view the Major Diagnostic Category Report menu On the left side of the screen is a list of the MDCs with counts of facility admissions and discharges for the selected time period and payer Click on an MDC to view facility national and regional comparisons of all available measures for the selected MDC USER FEATURES II E OUTCOMES NJ N TR beled L MAA ysm User Manual 11 USER FEATURES On the right side of the MDC Report menu screen is a list of all available measures Click on a measure to view facility national and regional data for that measure for each MDC From this screen you can click on an MDC to jump directly to the report of all measures for that MDC DRG Report Under the Administrative or Clinical Drill Down reports menu click DRG Report to view the Diagnosis Related Group Report menu On the left side of the screen is a list of DRGs with counts of facility admissions and discharges for the selected time period and payer This list only includes DRGs for which there were facility admissions and or discharges Click on a DRG to view facility national and regional comparisons of all available measures for the selected DRG On the right side of the DRG R
108. lity SNF and returns to the same LTCH within a specified period of time eAny discharge destination 3 days or less Short stay acute hospital IPPS 9 days or less eInpatient rehabilitation facility or unit IRF 27 days or less Skilled nursing facility SNF 45 days or less For qualified interruptions the interruption days are subtracted from the patient s length of stay and thus are not counted as patient days NOTE In any given time period it is possible for a facility to have Discharged Patient Days and no Discharges in Sample if the patients were discharged during a subsequent time period LTACH OUTCOMES ag S amp SYSTEM Average Length of Patient Stay The average length of stay during the selected time period based on discharge date For qualified interruptions in stay interruption days are subtracted from length of stay and thus are not included in the average Average Age The average patient age at admission during the selected time period based on discharge date Gender Split The counts and percentages of male and female patients during the selected time period based on discharge date Case Mix Index CMI The average DRG payment weight for the selected time period based on discharge date Higher numbers indicate increased average acuity Payment weights for each DRG are available from the CMS website here https www cms gov Medicare Medicare Fee for Service Payment PCPricer index htm
109. load Privileges User can download assessments from all facilities in their organization This gives the user the ability to download patient assessment data for any facility in their organization from the LTRAX system to their local network or computer This privilege is only applicable to users belonging to an organization that has more than one subscriber facility on LTRAX and can only be assigned by an LTRAX organization administrator User can download assessments from their facility This gives the user the ability to download their facility s patient assessment data from the LTRAX system to their local network or computer This privilege is necessary if the user will be creating files to transmit to CMS or if they will be downloading assessment data to keep as a local back up or to import into another software application for custom reporting User can upload files to LTRAX This gives the user the ability to upload patient satisfaction surveys to the LTRAX system without manually keying in information Outcomes Reports Privileges User can view all Administrative level reports for all facilities in their organization includes all facilities This privilege allows a user to view LTRAX Administrative outcomes reports for all facilities in their organization including patient satisfaction outcomes reports This privilege is only applicable to users belonging to an organization that has more than one subscriber facility on LTRAX and can
110. ludes the measures displayed above Discharges in Sample in the Administrative drill down reports In order to be included in these measures a record must have a Admission Date or for the Referrals measure a Denial N 1 H USER FEATURES I1 E OUTCOMES TRAX 2 user man Bea amp ES Sf amp SYSTEM Il USER FEATURES Date if the record is a denied pre admission assessment Records are included in the admission based measures after a referral has been resolved either by admitting and entering an admission date or by denying and entering a denial date Discharge based measures this includes all measures starting with Discharges in Sample In order to be included in these measures a record must have a Discharge Date a Discharge Disposition and a valid DRG either Discharge DRG or where none is present a valid Admit DRG The record must also have the status FILED See the Outcomes Reports Measures section below for more information on individual measure requirements e a a a uuu OUTCOMES REPORTS DRILL DOWN LEVELS Facility Rankin Under the Administrative or Clinical Drill Down reports menu click Facility Ranking For users belonging to organizations with more than one facility in LTRAX the Facility Ranking Report allows you to display any individual outcomes measure for comparison with all facilities in your organization A measures drop down at the top of the report table lets you sele
111. ly no Bottom HCAHPS Box Counts and Average Box Counts At the bottom of the Facility Report you may check a box to display two additional tables related to HCAHPS box style reporting both with national and regional comparisons The Total Box Counts table displays the total count of all answers in each box used in computing the Average Box Percentages table above The Average Box Counts table displays the average number of answers per survey that fall within each box You can uncheck the box to hide the tables 4 Transmissions LTRAX Transmissions Reports are available to LTRAX users with the privilege to view outcomes reports or download data for their facility or organization To get to the Transmissions Reports menu click Transmissions on your LTRAX homepage The Transmissions menu page offers links to these reports 1 Continued Stay Warnings 2 Late Transmittal Summary 3 Transmittal Report 4 QRP Override Summary 5 QRP Override Report SaaS CONTINUED STAY WARNINGS The Continued Stay Warnings Report is a live list of patients who have separate assessments reflecting a discharge and readmission within 3 calendar days This report is designed to help facilities identify assessments that may have been created and or transmitted to CMS in error Under the rules of the LTCH CARE Data Set a patient who leaves an LTCH and returns within 3 calendar days including the da
112. m Upper Arm Elbow Lower Arm Wrist Wrist Hand Hand Pelvis includes Hip Ilium Buttocks Ischial Tuberosity Greater Trochanter Leg Upper Leg Lower Leg Knee Knee Medial Knee Lateral Knee Ankle Ankle Medial Ankle Lateral Ankle Foot Foot Heel Heel Unspecified Not answered VENTILATORS TABLE Ventilator Patient Rate Patients The percentage and count of patients on mechanical ventilation discharged during the selected time period calculated as the number of patients with an admit vent assessment Discharges in Sample Ventilator Patient Rate Days The percentage and count of patient days for discharged patients who were on mechanical ventilation calculated as the sum of patient days during the time period for discharged patients with an admit vent assessment Discharged Patient Days NOTE In any given time period it is possible for a facility to have Vent Patient Days and no Vent Patients if the patients were discharged during a subsequent time period Ventilator Patients Liberated The percentage and count of vent patients whose vent end date was at least 2 days prior to discharge and whose Ventilator Weaning Outcome was Patient liberated This measure excludes terminal weans Ventilator Patients Returned To Vent After Liberation The percentage and count of vent patients who returned to vent after liberation as identified by the Patient resumed vent dependency after USER FEATURES I1 E OUTCOMES 34 TRA
113. m data fields management screen by an LTRAX facility administrator See the specification for other column names While the individual records themselves generally appear in the order in which they were initially created this is not guaranteed so no assumptions should be made regarding order Null values are not specified by any particular sequence of characters other than having no characters between two delimiters All downloaded files contain the seven fields listed in the file specification in red text The first value in each record is the Medicare Provider ID CCN of the facility to which the record belongs The second value in each record is the unique ID assigned to the assessment by LTRAX This value is numeric and can be used by a facility to uniquely identify each record If the system that imports these data instead assigns its own ID this value should nonetheless be kept so that after future downloads duplicate or updated records can be easily identified The third value in each record indicates the current state of the assessment P for Pre Admit A for Admit D for Planned Discharge DU for Unplanned Discharge DE for Expired and XP XA XD XDU XDE for Deleted The complete file specification including a list of field names with their data types grouped by section of the assessment record can be found in the documentation available under the HELP icon at the top of the Data Download Custom Template screen 3 PSI S
114. me screen by checking the box next to the message s you wish to delete and clicking DELETE SELECTED Send Message To send a message to another user in your organization click Send Message on your LTRAX homepage A box labeled Recipients containing the names of all LTRAX users at your facility will appear Select the name of the person to whom you are sending the message To select more than one person hold down the Ctrl key while clicking on the names Enter the message subject in the Subject box and the text of the message in the Message box The text you type into the subject box will appear as the message subject on the recipient s homepage when they log in to the system To send the message to the selected recipients click Send Message at the bottom of the screen To cancel click HOME You can also send a message to LTRAX tech support by clicking Send Message on your LTRAX home screen and selecting LTRAX Tech Support as the recipient These messages are checked regularly by the LTRAX staff II D File Transfer CMS Transmission Downloads Uploads If you have been granted permission to transfer files from your facility to LTRAX and or vice versa you can download your assessment data from and or upload assessment data to the LTRAX system To access the file transfer screens log in to LTRAX You will see a header on the left side of your home page labeled File Transfer Below that depending upon your user privileges you may see li
115. mplate Depending on your user permissions you may see some or all of the following options for setting your download parameters Display Facility Templates Load Saved Template Select Facility Data to Download Select and Arrange Data Fields Choose Search Settings Choose Settings for Download File and Save Template for Future Downloads Saved templates include all download parameters selected when the template was saved except for start and end dates if your date range selection is Custom Date Range NOTE If you do not see the Downloads or Data Download Custom Template options you will need to contact your facility s LTRAX administrator and ask them to grant you the privilege User can download assessments from their facility SS ee OOO a DOWNLOAD PARAMETERS Display Facility Templates This option allows users to view a list of all shared templates at each facility in their organization Select a facility to display the list of shared templates for that facility NOTE The Display Facility Templates option is only available to users belonging to an organization that has more than one subscriber facility on LTRAX and the privilege to download data from multiple facilities can only be assigned by an LTRAX organization administrator Load Saved Template This option allows you to load a previously saved template Users can see templates they have created plus all templates that have been shared by other users at th
116. mple The number of admissions during the selected time period based on admission date USER FEATURES I1 E OUTCOMES 24 LTACH OUTCOMES asg S amp SYSTEM Referrals The total number of pre admission assessments during the selected time period based on either admission date for successful conversions or denial date for denied referrals Referral Conversions The total number of pre admission assessments that were converted into admission records during the selected time period based on admission date Referral Conversion Rate The percentage of referrals that were converted into admission records calculated by dividing the number of referral conversions by the total number of referrals during the selected time period based on either admission date for successful conversions or denial date for denied referrals Highest Referral Percentage The highest percentage of admissions referred from a single facility during the selected time period based on admission date Top Referring Facility The name of the referring facility with the highest number of admissions during the selected time period based on admission date Patient Days The total number of days all patients were present in the facility during the selected time period based on admission date and discharge date where present or where discharge date is not present today s date or the last day of the time period This measure is adjusted for qualifi
117. n include instructions to the user examples of acceptable values etc DataType of element This is used to error check data entry TEXT allows any characters to be entered while DATE INTEGER and DECIMAL NUMBER all require that values entered conform to a specific definition INTEGER refers to whole numbers with no decimal points and DECIMAL NUMBER means real or floating point values for example 98 6 If you specify a datatype other than TEXT LTRAX will apply the appropriate validation check to that element For example if you specify a DATE data type and a user tries to enter anything other than a proper date value a warning will be displayed and the invalid value will not be saved Entry method This refers to the means by which the user will enter the data into this field on the CUSTOM tab Two methods are available Text Box hand entry and Drop Down select list Text Box allows the user to type in values Drop Down allows the element to be configured with a list of values from which the user can choose The latter method is useful for preventing data entry errors due to typos and for enforcing the standardization of data It is required for any fields used as a basis for outcomes analysis and is also required for your Referring Physician and Referring Hospital fields in order for them to appear on the REFERRAL PAYER tab of pre admission screenings See Configuring Drop Downs below for more i
118. n off switch for a user account The default setting is Yes A user with an Active setting of Yes will be able to log on to their account on LTRAX To de activate a user account and prevent that user from logging on select No Y ADMINISTRATOR FEATURES I11 B ADD USER 53 TR Th a2 34 amp SYSTEM Privileges When creating a user account consider the user s requirements Will the user need to be able to create other user accounts Will they be creating patient assessments Will they be uploading data to LTRAX The answers to these questions will determine what combination of privileges the user needs You can refer to the Privileges Reference Guide below for help in determining which privileges to assign each user account We offer Roles you can select in order to assign a user a pre determined group of privileges or you can customize a user s privileges using the list of available privileges For more information on which privileges are assigned using the Roles selections please refer to the link in the Roles section on the Add User screen The individual privileges are grouped by general tasks as follows Administrator Privileges Facility administrator user can create manage all user accounts for their facility and configure facility information includes all sites This privilege allows the user to create and manage all user accounts for the facility including multiple sites associated with that
119. n optional Internet connection monitor which checks the status of your Internet connection at regular intervals and pops up an alert message if your connection is disrupted offering you an opportunity to avoid data loss by re establishing a good connection before trying to save or leave the screen To enable the monitor check the Use the Internet Connection Monitor checkbox and click Save Show SSN in Patient Report The LTRAX Outcomes Patient Report coming soon displays a patient identification number for each patient By default the Patient ID is shown but if you prefer to see each patient s Social Security number instead check the Show SSN in Patient Report checkbox and click Save Pre Admission Screening PAS Tool Offline Form The LTRAX Pre Admission Screening Tool Offline Form is intended for use ONLY by LTRAX users who are not able to work on PAS Tool assessments online due to limited Internet connectivity This form stores patient pre admission screenings which may contain protected health information on the user s computer in the Safari browser database until the user is able to establish a connection to the Internet and upload their screenings to LTRAX Follow the instructions in this section of the Functional Settings screen to download and install the Safari web browser and the offline PAS Tool form NOTE The LTRAX Pre Admission Screening Tool Offline Form can only be used with Apple s Safari web browser and only
120. n organization administrator with the privilege to view patient assessments can only see assessments belonging to the provider number the organization admin logged in with There is no limit to the number of organization and facility administrator accounts an organization can have IV B Manage Facility Screen The administration screen is the starting point for all administrator functions including managing user accounts To access the administration screen log in to LTRAX and click My Facility under the Manage header on the left side of your home page You will see a table displaying the names of all LTRAX users for your facility You can toggle between the facilities under your organization to display the users for each facility by selecting the facility name from the Facilities box at the bottom of the screen and clicking Switch Fac If you do not see the Facilities box you do not have organization administrator privileges Likewise if a facility has more than one site you can toggle between sites by selecting the site name and clicking Switch Site n eS EDITING USER ACCOUNTS You can edit an existing user account from the Manage Facility screen by clicking on a username The screen will refresh with the selected user s account information displayed at the top Click Edit User to make any changes to the user s account See the Add User instructions below for an explanation of user account requirements and privileges You wil
121. nd volume of all wounds in the sample calculated from the wound assessment fields Length Width and Depth on the last wound assessment Average Change in Volume The difference between the initial wound volume and the discharge wound volume calculated for each wound and then averaged for the sample Average Change in Volume Per Day The difference between the initial wound volume and the discharge wound volume divided by the number of days elapsed between the initial and discharge wound volume assessments calculated for each wound and then averaged for the sample Wound Type The percentage and count of total wounds that fall into each category as identified on the initial wound assessment for each wound Wound Location The percentage and count of total wounds that fall into each location group as identified in the Site of Wound drop down on the initial wound assessment for each wound Locations on the wound assessment screen are mapped to location groups in the outcomes reports as follows Outcomes Reports Wound Location Wound Assessment Site of Wound Head Head USER FEATURES I1 E OUTCOMES 33 LTACH TRA wrons user Manual z 5 22 32 a SYSTEM Outcomes Reports Wound Location Wound Assessment Site of Wound lI USER FEATURES Neck Neck Chest Chest Abdomen Thoracic Cage Abdomen Back Back Scapula Spine Spine Sacrum Shoulder Shoulder Ar
122. ndex if you have selected a thread or your LTRAX home screen USER FEATURES I1 G LTRAX USER FORUMS 51 LTACH I TR svat user manual asg a SYSTEM II FACILITY ADMINISTRATOR FEATURES III FACILITY ADMINISTRATOR FEATURES II A Facility Administrator General Information Users with LTRAX facility administrator privileges are responsible for managing their facility s information settings and user accounts on LTRAX This includes creating and updating user account profiles and privileges setting password expiration requirements for all LTRAX user accounts at the facility creating and updating optional custom data fields and configuring facility bed count data for outcomes reporting purposes Once a facility has at least one facility administrator account configured on LTRAX that user is encouraged to set up any other required user accounts and manage them directly This includes resetting user passwords when lost or forgotten In order to avoid conflicts in case an LTRAX facility administrator is unavailable to adjust user account or other information we recommend that each facility have at least two users with LTRAX facility administrator privileges There is no limit to the number of facility administrator accounts a facility can have II B Manage Facility Screen The Manage Facility screen is the starting point for all administrator functions including managing user accounts facility custom data and other facility s
123. nformation on drop down fields The next set of options refers to the list of checkboxes that control when during the assessment process the element can or must be filled out You can select more than one of the following options Required Check this box to require that the field be filled out before an assessment can be marked Complete As with the other tabs the Custom tab uses the green yellow red color coding to indicate completion state Pre Admit Assessments Use these checkboxes to specify during which stages of the assessment process the field can be edited Items not allowed before a given stage will not appear on the CUSTOM tab until that stage is reached For example a field configured for entry only at discharge will not appear during pre admit or admit but will appear on discharge assessments Once you have completed the form click Save to create your new custom data field EDITING CUSTOM FIELDS To edit a custom data field click on My Facility gt Custom Data Fields From your list of existing facility custom data elements select the radio button to the left of the element you wish to edit and then click Edit Element Make your changes on the edit screen and click Save Changes REORDERING CUSTOM FIELDS By default your facility custom fields appear on the CUSTOM tab in the order in which they are created You can reorder the fields using the Order input boxes on your Custom Data Fields admin screen To cha
124. nge the order of your facility custom elements click on My Facility gt Custom Data Fields Use the input boxes in the Order column next to your TRAXES user E 8 2 Sf amp SYSTEM existing elements to type in numbers representing the order you want those fields to appear in Then click Reorder Elements and review the new order CONFIGURING CUSTOM DROP DOWNS Drop downs are intended as a means to help avoid data entry errors make facility custom data entry faster and easier and also standardize data values for accuracy Custom data fields configured as drop downs will appear on your LTRAX home screen as drop downs that you can filter your assessments lists by in addition to the other filters available To configure a drop down field first set the Entry Method to Drop down select list as specified above An input box labeled Allowable Values will appear You will use this box to specify both the values that will appear in the drop down itself and the corresponding values that are saved to the database when a selection is made using the drop down Enter the valid values in the edit box by typing only one item per line in the form Value Description where Value is what is stored in the database and Description is what is displayed in the drop down on the CUSTOM tab during assessment data entry with the two separated by a colon If a line only contains only a value then that will also be used in the descripti
125. nical and acute hospital data and extracts patient centered outcomes in real time The LTRAX system incorporates pre admission screening clinical assessments and a Suite of patient satisfaction instruments along with specific data collection tools for wound and ventilator patients LTRAX delivers these tools to long term acute care hospitals using secure maintenance free Internet technology To subscribe contact LTRAX representatives at Fleming AOD at 202 872 1033 I A About This User Manual The LTRAX User Manual is a comprehensive but not wholly inclusive document In some sections of this manual you will be directed to help documents available on the LTRAX website under the HELP icons for content not included here This manual may also include information not found in the help documents available under the HELP icons on the system Wherever you see colored text referencing a link or button the colors indicate the following Teal text refers to text links on the screen such as the site navigation links on the left side of the home screen BRIGHT BLUE text in all caps refers to buttons on the screen that are images such as the HOME and LOG OUT buttons Dark yellow text refers to submit buttons such as the Enter buttons that appear in the display options below the assessments tables on the home screen I B General Guidelines to Follow when Navigating the LTRAX Website After you have logged in to LTRAX you ll see a tea
126. nks for CMS Transmit File Downloads and or Uploads NOTE If you do not see the File Transfer header you will need to contact your facility s LTRAX administrator and ask them to adjust your user permissions You can determine who your LTRAX facility administrator is on the LTRAX login screen by entering your facility s Medicare provider number into the Provider ID box and then clicking on the Forgot your password link Click CMS Transmit File to prepare a file of assessments for transmission to CMS Click Downloads to access the Data Download Custom Template for use in extracting data from LTRAX Click Uploads to access the uploads for use in importing data into LTRAX Currently the only available upload format is the PSI Scan Upload A brief description of each file is displayed on the Downloads and Uploads screens along with a HELP icon You can click the HELP icon next to each file description for online instructions These instructions are also included here for your reference 1 CMS Transmit File Transmitting assessments to CMS for Medicare reimbursement requires that they be uploaded in a specific format to the CMS system These guidelines cover how to use LTRAX to create one of these CMS Files Before creating any files for transmit to CMS you must first confirm that the Facility ID information on file with LTRAX matches the facility information on file with CMS This is a one time only process that must be performed by
127. no later than Assessment Reference Date 5 Transmission Date no later than Completion Date 7 Discharge Assessment Timing Assessment Reference Date is equal to Discharge Date OR equal to date of death if patient dies within 3 days of discharge Completion Date no later than Assessment Reference Date 5 Transmission Date no later than Completion Date 7 V C Pre Admission Screening PAS Tool Assessments The LTRAX Pre Admission Screening PAS Tool provides long term acute care hospitals a means to gather a comprehensive uniform set of data on potential patients The tool s multipurpose mission is to streamline data collection introduce uniformity in admission justifications and feed information on referrals admissions and denials to the Referrals Outcomes Reports For more information about the PAS Tool please see the documentation located under the HELP icon on the PAS Tool screens An offline version of the PAS Tool is available for users with chronic Internet connectivity problems For more information about the offline PAS Tool please see Functional Settings under the User Features section of this user manual NOTE Use of the LTRAX PAS Tool Offline Form requires the Safari web browser To create a pre admission assessment on the left side of your LTRAX home screen click Pre Admit or upload an offline PAS Tool record You can use the tabs at
128. nts lists select the first radio button To display just the numeric or letter code select the second radio button This is useful for minimizing the width of your home screen especially if you are displaying a large number of columns Line Separator To display a distinct line in between each column to visually separate one column from the next in each row select the first radio button To display the rows with no lines demarcating the columns select the second radio button When you have made all of your selections on the List Options screen click Save to save your settings The screen will refresh with a Changes saved message at the top Then click HOME to return to your home page and review your settings NOTE The options you select will not be permanently saved for future LTRAX logins until you log out If you allow your session to expire without logging out by clicking the LOG OUT button your changes will be lost ty ASSESSMENT COLOR CODING Patient admission and discharge dates shown in the In Progress assessments lists on the LTRAX home screen are displayed against color coded backgrounds to guide you through the timeline for completing and transmitting LTCH CARE Tool records The background color identifies a record s place in the workflow from entry of the admission or discharge date through assessment reference date completion date and transmission date Based on the admit discharge and assessment reference dates en
129. nweighted Numbers section above NOTE Some discharge destinations are grouped into more than one category The categories are defined as follows Inpatient I nstitutional Discharges patients discharged to either 2 Long term care facility LTC 3 Skilled nursing facility SNF 5 Short stay acute hospital IPPS 6 Long term care hospital LTCH 7 Inpatient rehabilitation facility or unit IRF 8 Psychiatric hospital or unit 9 ID DD facility or 98 Other Community Discharges patients discharged to either 1 Community residential setting 2 Long term care facility LTC only if Pre Hospital Living Setting was Long Term Care 10 Hospice or 12 Discharged against medical advice SNF Subacute Discharges patients discharged to either 2 Long term care facility LTC 3 Skilled nursing facility SNF or 9 ID DD facility Lower Level of Care Discharges patients discharged to either 1 Community residential setting 2 Long term care facility LTC 3 Skilled nursing facility SNF 7 Inpatient rehabilitation facility IRF or 9 1D DD facility Home Settings Discharges patients discharged to either 1 Community residential setting or 10 Hospice Discharge Destination TRAM scons E 8 82 Sf amp SYSTEM The percentage and count of patients discharged to each discharge setting during the selected time period with weighted case mix adjusted and unweighted national and regi
130. o open multiple patient records in separate browser windows or tabs you will see a Multiple Windows Warning message that will prevent you from opening more than one record simultaneously or visiting the CMS Transmit File screen while you have a record open in another tab or window If you get a Multiple Windows Warning message you should locate all windows or tabs open to LTRAX click the HOME button on each of those and then close all but one If that does not clear the Multiple Windows Warning message you will need to click the LOG OUT button in the top navigation bar and then login again To avoid these problems only work in one browser window or tab at a time AN IMPORTANT NOTE ABOUT SAVING ASSESSMENT DATA The data you enter into your assessment screens are saved only when you go to another screen or refresh the current screen by clicking the tab corresponding to the screen you are on For example if you are on the Medical screen entering Medical codes you can save your entries and remain on the MEDI CAL screen by clicking the MEDI CAL tab to refresh that screen or you ASSESSMENT FEATURES V A LTRAX CLINICAL ASSESSMENT GENERAL INFORMATION 7 T A LTACH LA sem User manual V ASSESSMENT FEATURES can save your data while navigating to another screen by clicking any other tab the NEXT button at the bottom of the screen HOME or even LOG OUT to leave the screen NOTE It is important to remember that the information isn t
131. on Values and Descriptions may not contain the characters double quotes lt or gt If there are multiple colons on one line the first colon is treated as the Value Description separator and the rest are kept as part of the Description The values are also type checked against the DataType specified so for example if an element is configured as a Date then each choice configured must be a valid date For example An element called Attending Physician is configured as a text drop down with the following allowable values X Dr Xavier N Dr Nelson Other Line 1 Dr Xavier is what the user selects in the drop down on the CUSTOM tab and X is what is actually stored to the database and downloaded in your facility custom data files Line 2 Dr Nelson appears in the drop down N is stored in the database Line 3 Other is displayed in the drop down and stored in the database Values automatically appear in the drop downs in the order in which you enter them in the Allowable Values box EDITING CUSTOM DROP DOWNS Editing the list of options available for a drop down will not automatically alter any data in existing assessments For instance in the above example if Dr Xavier is removed from the list any assessments that already have that value will retain that value HOWEVER in this example if an assessment containing Dr Xavier is selected from the LTRAX home screen and the us
132. on Facility hierarchy to those facilities This allows you to manage user accounts download data and view outcomes reports for all facilities from one or more Organization Administrator accounts and or perform the same functions from Facility Administrator accounts assigned to each facility If your facility includes different sites that share the same Medicare provider number you can apply the Facility Site hierarchy to those sites and manage user accounts for all sites from one or more Facility Administrator accounts and or manage them from Site Administrator accounts assigned to each individual site If your facility belongs to a larger organization that includes other facilities under its umbrella and your facility includes different sites you can apply the full Organization Facility Site hierarchy to those facilities and sites This allows you to view reports download data and manage user accounts for all facilities and sites from one Organization Administrator account from Facility Administrator accounts for each facility and or from Site Administrator accounts for each site If your facility does not belong to a larger organization with other facilities or your facility should not be managed from its parent organization and your facility has only one site you do not need to consider the hierarchy at all ITRA ourconts user manual 2 22 Sf a SYSTEM I INTRODUCTION The structure of your facility s account with LTRAX is
133. on checks cannot be transmitted to CMS until the required fields have been completed to CMS s specifications e EEE E EE es ASSESSMENT TABS NAVIGATION The patient assessment screens on LTRAX have a unique navigation scheme as compared to the rest of the LTRAX site While in a patient record you ll see a list of tabs on the left side of the screen displayed next to colored flags Most tabs are specific to different sections of the patient assessment with the exception of the Mgmt Pre Adm Custom Files Notes and P S I tabs The tabs that are not specific to the patient assessment are as follows Mgmt Management Tab The assessment management screen is the starting point for all functions you can perform on an assessment Clicking on an existing assessment from your LTRAX home screen brings up the management screen for that assessment or you can use the MGMT tab from within an assessment to get to the management screen The top of the management screen displays some general information about the record you are viewing including Medicare and Birth Date Below that is a list of buttons you can use to do such things as print the assessment The list of function buttons changes depending on the kind of assessment the assessment status and your user permissions The complete list of all possible buttons on the management
134. onal comparisons For more information on the weighted calculations please see the Weighted vs Unweighted Numbers section above Clinical Outcomes Measures Discharges in Sample The number of discharges during the selected time period based on discharge date Discharged Patient Days The total number of days all discharged patients were present in the facility during the selected time period based on admission date and discharge date This measure is adjusted for qualified interruptions in stay as defined in the CMS LTCH PPS Training Guide as follows An interrupted stay is defined as a case in which an LTCH patient is admitted upon discharge to a short stay acute hospital IPPS inpatient rehabilitation facility or unit IRF or a skilled nursing facility SNF and returns to the same LTCH within a specified period of time eAny discharge destination 3 days or less Short stay acute hospital IPPS 9 days or less eInpatient rehabilitation facility or unit IRF 27 days or less Skilled nursing facility SNF 45 days or less For qualified interruptions the interruption days are subtracted from the patient s length of stay and thus are not counted as patient days NOTE In any given time period it is possible for a facility to have Discharged Patient Days and no Discharges in Sample if the patients were discharged during a subsequent time period Average Length of Patient Stay The average length of stay during
135. only be assigned by an LTRAX organization administrator User can view all Administrative level reports for their facility This privilege allows a user to view LTRAX Administrative outcomes reports for their facility including patient satisfaction outcomes reports User can view all Clinical reports for all facilities in their organization includes all facilities This privilege allows a user to view LTRAX Clinical outcomes reports for all facilities in their organization including patient satisfaction outcomes reports This privilege is only applicable to users belonging to an organization that has more than one subscriber facility on LTRAX and can only be assigned by an LTRAX organization administrator User can view all Clinical reports for their facility This privilege allows a user to view LTRAX Clinical outcomes reports for their facility including patient satisfaction outcomes reports User can ONLY view Patient Satisfaction outcomes reports for their facility This privilege allows users without clinical or administrative outcomes reports privileges to view their facility s patient satisfaction survey outcomes NOTE This privilege is not necessary if the user has any of the Outcomes Reports privileges above Special Limited Privileges User can create edit pre admission assessments only This allows users who do not have the privilege User can create edit Clinical assessments to create pre admission assessments N
136. ons such as reverting an admission assessment back into a pre admit assessment on accidentally admitted assessments for example NOTE This privilege is not necessary if the user has facility administrator privileges Non admin user can copy assessments from their facility to other facilities in their organization This privilege allows a user who is not an LTRAX facility administrator to duplicate a pre admission screening into a facility other than the one in which the original pre admission screening was created NOTE This privilege is not necessary if the user has facility administrator privileges Assessment Privileges User can view all assessments for their facility includes all sites This privilege gives the user the ability to see all patient assessments at their facility TR seen Gea amp ES Sf amp SYSTEM including assessments from multiple sites if your facility has more than one site This does not include the ability to create or edit assessments User can view only assessments for their site This limits the user to seeing only assessments at their site This does not include the ability to create or edit assessments NOTE This privilege is not necessary if the user has the privilege User can view all assessments for their facility includes all sites It is also unnecessary if your facility has only one site User can create edit Clinical assessments This gives a user the ability to create pre a
137. or use the up and down arrows to scroll up and down through the drop down list When you arrive at your desired selection hit Tab to move on to the next field Similarly in alphabetical drop down lists you can use your keyboard to select the first characters of the selection you wish to make When you arrive at your desired selection hit Tab to move on to the next field elf you tab to radio buttons or check boxes you can use the Space bar on your keyboard to check the checkbox and the arrow keys on your keyboard to move to different radio button choices eWhen you tab to a submit button for example the Next button at the bottom of an assessment screen you can hit Enter on your keyboard to effectively click the button sae Sse a SSS a Sa ee ASSESSMENT TOOLS The assessment screens on LTRAX have a variety of built in tools to assist you with data entry These tools include 1CD9 Search Below items Primary Diagnosis on the ADMIT tab LTACH Principal Diagnosis and Secondaries on the MEDICAL tab and Diagnosis for Interruption Diagnosis for Death ASSESSMENT FEATURES V A LTRAX CLINICAL ASSESSMENT GENERAL I NFORMATION 77 TRAM wee user Bs Gf A SYSTEM Se nanda V ASSESSMENT FEATURES Procedures During Stay and Secondaries on the DISCHG tab is the ICD9 Search link which when clicked pops up a window that allows you to search for ICD 9 codes by either part of the code or by description A HELP icon on the search windo
138. ord expiration interval that will require all users at your facility to update their passwords at your specified interval To verify or update your facility settings click My Facility gt Facility Settings FACILITY INFORMATION Your Medicare Provider is a six digit number assigned to your facility by CMS It is unique to your facility All users at your facility will use this number as part of their login when logging in to LTRAX BILLING CONTACT I NFORMATION The billing contact information section of the Facility Settings screen is used to indicate where any communication regarding LTRAX invoices should be directed PASSWORD EXPIRATION SETTINGS Facility administrators can specify how often all users at their facility will need to change their LTRAX user passwords Enter a value between 0 and 365 to represent how long the facility s passwords remain valid If you enter 0 your facility s passwords will never expire however this is not recommended for reasons of security and HIPAA compliance You LTACH rR vous user Manual 11 FACILITY ADMINISTRATOR FEATURES Gm a E EZ Sf amp SYSTEM should check with the person in charge of HIPAA compliance at your facility before setting your password expiration to 0 After you have entered your values click Save at the bottom of the screen 5 Recently Modified Assessments Recently Modified Assessments allows LTRAX facility administrators to track assessment activity for their facil
139. ports ORYX reports time series graphs dashboard reports or Patient Satisfaction Instrument outcomes reports If yes the user will need the privilege User can view all outcomes reports for their facility Does the user need to View only Patient Satisfaction Instrument outcomes reports without seeing any other outcomes reports If yes the user will need the privilege User can ONLY view Patient Satisfaction outcomes reports for their facility 2 Bed Count Your facility bed count is used to calculate occupancy data in LTRAX If your facility maintains the same number of patient beds over time you only need to configure one bed count value If your facility gains or loses patient beds you will need to configure multiple bed counts to reflect those changes and ensure accurate occupancy rate calculations over time CONFIGURING YOUR BED COUNT To set your bed count value click on My Facility gt Bed Count then click Add New You will see the following input boxes Description of effective date range e g FY2011 Enter a description of the time period covered for instance Current or 2008 2011 TRAN ter user n yl Sees n U at a II FACI LIT F Ema amp EF Aasa SYSTEM Y ADMINIST FEATURES Effective Date Start Enter the date when your facility acquired this number of beds MM DD YYYY If your bed count has remained the same since you started using LTRAX you can use 01 01 2011
140. ports only User can ONLY view Patient Satisfaction outcomes reports for their facility 1 Outcomes To get to the outcomes report menu from your LTRAX home screen click Outcomes The core LTRAX outcomes reports are separated into Administrative and Clinical report groupings which are delivered in a four tiered hierarchy under the Administrative Drill Down reports and Clinical Drill Down headers starting at the top with the overall Facility Report and then drilling down into the MDC DRG and Patient levels patient report coming soon Users with organization level reports access will also see links to the Facility Ranking Reports Below is a table of contents for the Outcomes section of this user manual with links to the respective subsections This section is structured as follows 1 2 Outcomes Reports General Information Outcomes Reports Inclusion Requirements Outcomes Reports Drill Down Levels A Facility Ranking B Facility Report C MDC Report D DRG Report Outcomes Reports Regions Weighted vs Unweighted Numbers Outcomes Reports Measures A Administrative Outcomes Measures B Clinical Outcomes Measures TR LTACH orcos user Manual Bea amp ES SS a SYSTEM Il USER FEATURES OUTCOMES REPORTS GENERAL I NFORMATI ON The LTRAX drill down outcomes reports show you performance measures
141. r pain controlled 14 During this hospital stay how often did the hospital staff do everything they could to help you with your pain Communication About Medicines 16 Before giving you any new medicine how often did hospital staff tell you what the medicine was for 17 Before giving you any new medicine how often did hospital staff describe possible side effects in a way you could understand Discharge Information 19 During this hospital stay did doctors nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital 20 During this hospital stay did you get information in writing about what symptoms or health problems to look out for after you left the hospital How Answers Are Sorted into HCAHPS Box Methodology Outcomes results are reported using the HCAHPS box methodology wherein each category displays the average number of survey responses that fall into top box TRAX sc as Ag amp SYSTEM Il USER FEATURES middle box or bottom box answers for each question or composite Survey answers are assigned a box as follows Answer Categories Box Assignment Questions 1 17 Always Top Usually Middle Sometimes Bottom Never Bottom Questions 19 amp 20 Yes Top No Bottom Question 21 9 10 Top 7 8 Middle 0 6 Bottom Question 22 Definitely yes Top Probably yes Middle Probably no Bottom Definite
142. refer to the data submission user s guide available on the LTRAX CMS Data Transmission page under the Transmission I nstructions link on the left side of the screen You can also reach QIES Technical Support at 877 201 4721 At this point each assessment that has been included in your download file displays the status Locked xmit Prepared on the home screen This status identifies those assessments that have been downloaded from LTRAX and should be in transmission to CMS These assessments are locked and cannot be modified until they have been marked as either Accepted by CMS or Rejected by CMS in Step 3 STEP 3 ACCEPT REJ ECT ASSESSMENTS After you have transmitted your assessments file to CMS you should receive a final validation report detailing which assessments were accepted and which ones were rejected and why Use the CMS validation report to manually mark each assessment from the file you transmitted as Accepted or Rejected At the top of the CMS Transmit File page click Skip to Step 3 The following is similar to what you might see USER FEATURES I1 D CMS TRANSMIT FILE 10 TR er user manual Il USER FEATURES mm s amp EZ Sf a SYSTEM Step 3 ESSJJ Ors eos Mark each assessment placed in a download file and sent to CMS as Accepted or Rejected Rejected assessments will be automatically set back to an incomplete state for editing and re transr Accepted assessments can be corrected and re transmitted if necess
143. ressure Ulcers The percent and count of planned and unplanned discharge records transmitted to CMS where pressure ulcers were present total and broken down by stage Because this is a count of records with pressure ulcers and not a sum of pressure ulcer counts at each stage the sum of the TRA LTACH OUTCOMES SYSTEM individual stage breakdowns may exceed the total displayed under Any because some records may contain multiple pressure ulcers at different stages Only records where the count for at least one type of pressure ulcer is greater than zero are included in the Any group New or Worsened Pressure Ulcers The percent and count of planned and unplanned discharge records transmitted to CMS with new or worsened pressure ulcers as identified on the Skin CMS tab in questions M0800 A B and C Because this is a count of records with pressure ulcers and not a sum of pressure ulcer counts at each stage the sum of the individual stage breakdowns may exceed the total displayed under Any Stages 2 3 or 4 because some records may contain multiple new or worsened pressure ulcers at different stages SKIN TABLE Hospital Acquired Pressure Ulcers The percentage and count of patients who developed pressure ulcers after being admitted to the facility A patient must meet the following criteria in order to be included in this measure 1 The earliest post admission skin assessment in the patient s record mu
144. rwrite the existing survey If an identical survey is found the new survey record will not be imported If the facility ID in the survey record does not match the facility to which the assessment belongs the record will not be imported DE UPLOADI NG YOUR FILE To upload your PSI Scan Upload file to LTRAX log in to LTRAX and click Uploads gt PSI Scan Upload NOTE If you do not see the Uploads or PSI Scan Upload options you will need to contact your facility s LTRAX administrator and ask them to grant you the privilege User can upload assessments to LTRAX From the PSI Scan Upload screen use the Browse button to browse to the location of the file you created for upload In your browse window make sure that under Files of Type you have selected All files or you may not see your upload file Double click on the file name and then click Upload You should see the following message appear on the screen File Upload successful The file lt filename gt was successfully uploaded It has been assigned ID lt number gt It now awaits processing in the upload queue Once it has been processed the results will be sent to you via the LTRAX messaging system accessible from the Launch Screen Uploaded files are processed at regular intervals Once the surveys in your upload file have been processed you will receive a message via the LTRAX messaging system confirming your survey import The message will list
145. s assessments User can view all assessments for their facility includes all sites This privilege gives the user the ability to see all patient assessments at their facility including assessments from multiple sites if your facility has more than one site This does not include the ability to create or edit assessments User can view only assessments for their site This limits the user to seeing only assessments at their site This does not include the ability to create or edit assessments NOTE This privilege is not necessary if the user has the privilege User can view all assessments for their facility includes all sites It is also unnecessary if your facility has only one site User can edit Clinical assessments belonging to ANY facility in their organization This gives a user belonging to an organization with multiple hospitals in LTRAX the ability to edit existing assessments at any of those hospitals within their organization User can create edit Clinical assessments This gives a user the ability to create pre admit and admission assessments and edit existing assessments including patient satisfaction surveys where enabled User can lock assessments This gives the user the ability to lock assessments against any edits to prevent any changes User can unlock assessments This gives the user the ability to re open locked assessments for further edits TR Th Gea amp ES Sf amp SYSTEM Data Download Up
146. saved as you type into each field but only after you click a tab or button on LTRAX To illustrate let s say you are entering Medical information onto the Medical screen and you are called away from your desk You leave without logging out of LTRAX You are gone long enough about two hours that the system assumes you are no longer active and automatically logs you out ending your user session In this case if before you left your desk you had clicked the MEDI CAL tab to save your data to the Medical screen your data will be saved even though your user session timed out If you didn t click the MEDI CAL tab or another tab or button to save your data when you return you will still see the information you entered displayed on the Medical screen but because your session timed out when you next click your mouse you will be redirected to the login screen and the information you entered will be lost ee CLINICAL ASSESSMENT SECTION COLOR CODING The colored flags next to the tabs for each section indicate the completion status of each section with green indicating that nothing more is required for that section and yellow indicating that some required information is missing Red flags are displayed after you click the Complete button on the MGMT screen to highlight sections that still need attention Completion requirements for each record are based on the LTCH CARE Tool data specifications published by CMS Records that do not pass all completi
147. sed since the patient was admitted not the final LOS MS LTC DRG This column displays the Diagnosis Related Group as recorded on the MEDICAL tab The Discharge MS LTC DRG is displayed unless it has not been entered in which case the the Admission MS LTC DRG is displayed Payer This column displays abbreviations for all payers selected on the record The abbreviations key is as follows TRAX 2 Gea amp ES Sf amp SYSTEM SMENT FEATURES M Medicare traditional fee for service MC Medicare managed care Part C Medicare Advantage D Medicaid traditional fee for service DC Medicaid managed care W Workers compensation TP Title programs e g Title III V or XX OG Other government e g TRICARE VA etc P Private insurance Medigap PC Private managed care SP Self pay NO No payor source UN Unknown O Other Site If your facility has configured a custom data field called SITE this column displays the value in that custom field for each assessment ASSESSMENT LISTS SETTINGS Screen Refresh Select the first button to require the click of a Refresh button to refresh the home screen after you ve made changes to the display options To have the screen automatically refresh each time you change a drop down selection select the second radio button Codes To display the numeric code with a text description of the code for Admission Type and Discharge Setting in your assessme
148. sessment is not late a zero will appear in the Days Late column e If an assessment is one or two days from the submission deadline the column will show a zero with a yellow background e If an assessment is due for submission that day the column will show a zero with a red background e If an assessment is late the Days Late column will display the number of days past due with a red background Correction If a correction was made to an assessment you may see more than one record for the same assessment type This column displays the correction number for corrected assessments If an inactivation record was transmitted Inactivation is displayed Inactivation records may be sent to correct key LTCH CARE fields or to retract an assessment transmitted to CMS SUBMISSION SCHEDULING CMS has issued the following guidelines for completing and submitting LTCH CARE assessments See also Table 2 1 amp 2 2 in Chapter 2 of the CMS LTCH Quality Reporting Program Manual Admission Assessment Timing Assessment Reference Date no later than Admission Date 2 OR equal to Discharge date whichever is sooner Completion Date no later than Assessment Reference Date 5 Transmission Date no later than Completion Date 7 Discharge Assessment Timing Assessment Reference Date is equal to Discharge Date OR equal to date of death if patient dies within 3 days of discharge Completion Date no later than Ass
149. site this user will be associated with from the drop down list User Name This is the name the user will log in with A standard format username is first initial of the first name followed by the entire last name with no spaces for example jdoe for John Doe but you may choose whatever format you wish The username is not case sensitive required Password An LTRAX password must be at least 8 characters long and must include letters and at least 2 numbers Additionally it cannot include any part of your name or your facility s name and it cannot include the word password LTRAX user passwords are not case sensitive required Confirm Password Type in the password again exactly as you entered it the first time required First Name The user s first name required Last Name The user s last name required MI The user s middle initial Suffix The user s suffix Ph D Esq II etc Email Address The user s email address This is not required but it is highly recommended especially if the user should receive emails from the LTRAX email listserv Listserv recipients receive emails at the address listed in LTRAX Users can edit their own email addresses Phone Number The user s phone number This is not required but it is recommended in case LTRAX support staff needs to contact a user Users can edit their own phone numbers Extension Any applicable extension to the user s phone number Active This is the o
150. spond shortly If you have a question while using the website Li See if your question is answered in the User Manual You can search for keywords in the manual by holding down the Ctrl key while pressing the F key on your keyboard and typing your search word into the box that pops up Then click Find Next You can find all instances of your search word in the manual by continuing to click Find Next If there is a help icon HELP on the page you are having trouble with click the icon and a pop up window will appear The pop up window contains some basic information about the screen you are on and your question may be answered there Search the LTRAX Email Archive After you log in click I nfo Links gt Email Archive on the left side of your screen This archive is a compilation of all of the emails sent to the LTRAX email list organized by date If your question isn t answered in any of the above forums you can use the LTRAX messaging system to send a message to LTRAX Tech Support To send a message please see the instructions for the LTRAX messaging system in the User Features section of this manual If you have a suggestion or request or you have encountered an error on the site 1 You can log your suggestion request or a description of the error you encountered in the Enhancement Requests section of the website To post new items please see the instructions concerning Enhancement Requests in the User Featur
151. ssment Tabs Navigation section of this user manual To create an admission assessment from a pre admission assessment from the MGMT tab on the pre admission assessment click the Admit button V D Admission And Discharge Assessments To create an admission assessment click the Admit button on the MGMT tab of a pre admit assessment or click New Admission on your LTRAX home page To create a discharge assessment click the Discharge button not the DISCHG tab on the MGMT tab of an admission assessment then select the type of discharge Planned Unplanned or Expired and click CONFIRM LTRAX patient assessments incorporate the LTCH CARE Tool data set into the LTRAX patient record which captures patient demographic and clinical information and enables you to record skin and wound assessments and ventilator weaning information The LTCH CARE Tool data set fields are identified by the LTCH CARE Tool number preceding the field name or section For example on the I D PAY tab the patient name section is labeled A0500 Legal Name of Patient Using the tabs on the left side of the assessment screen or the Next buttons at the bottom of each screen you can navigate to the different sections of the assessment The patient assessments feed into the nightly outcomes reports which offer clinical and administrative outcomes measures with national and regional comparisons In order to be included in outcomes a patient record must contain a pr
152. st have a calculated Braden score This score is used to group each patient into a risk category as defined in the attack rate measure below Subsequent skin assessments are ignored 2 The patient must have a wound assessment with a Wound Type of Pressure a wound Present on Admission value of No Unknown Clinically Undetermined or blank not answered and a wound Stage at Time Identified OR wound Stage at This Assessment value of 2 3 or 4 Pressure Ulcers Attack Rate The percentage and count of patients with hospital acquired pressure ulcers as defined above grouped by Braden scale pressure sore risk score Severe Risk Calculated Braden score is 1 9 High Risk Calculated Braden score is 10 12 Moderate Risk Calculated Braden score is 13 14 Mild Risk Calculated Braden score is 15 18 None Calculated Braden score is 19 23 WOUND TABLE Wound Patient Rate Patients Percentage and count of patients with wounds discharged during the selected time period calculated as the number of patients with at least one wound assessment Discharges in Sample Wound Patient Rate Days TRAM irons Gea amp ES Sf amp SYSTEM Percentage and count of patient days for discharged patients with wounds calculated as the sum of wound patient days during the selected time period for discharged patients with at least one wound assessment Discharged Patient Days Wound patient days are counted s
153. tarting from the first wound assessment date through the discharge date NOTE In any given time period it is possible for a facility to have Wound Patient Days and no Wound Patients if the patients were discharged during a subsequent time period Total Wounds The total number of wounds for patients discharged during the selected time period Average Wounds per Patient The total number of wounds for patients discharged during the selected time period divided by the number of discharged patients with wounds Total Wounds w BWAT The total number of wounds for patients discharged during the selected time period that have at least two wound assessments with complete Bates ensen Wound Assessment Tool BWAT scores and distinct wound assessment dates NOTE All of the BWAT measures include only wounds that have at least two assessments with BWAT scores and distinct assessment dates Average Initial BWAT Score The sum of BWAT scores on the initial assessment for included wounds divided by the total number of wounds with BWAT scores If a wound has a post debridement assessment that assessment is used for the initial BWAT score If a wound has no post debridement assessment the first wound assessment is used for the initial BWAT score NOTE The BWAT score for an individual wound is the sum of the 13 items on the Bates J ensen Wound Assessment Tool The scale ranges from 65 to 9 in decreasing severity with 65 representin
154. te of transfer may not USER FEATURES I1 E TRANSMISSIONS 42 TRAX i as Ug amp SYSTEM need assessments transmitted for the discharge and readmission Please see the Interruptions in Stay Leave of Absence LOA section of this manual for more information The report returns two rows for each patient identified as having been readmitted within 3 calendar days of discharge The first row shows data for the record containing the discharge date and the second row shows data for the record containing a readmission within 3 days of the discharge date in the row above The report is updated in real time instantly reflecting the addition of new admissions and discharges Users with privileges to see reports and or download data can see the Continued Stay Warnings REPORT FILTERS Use the report filters to determine the parameters of your desired report Click Refresh to display the report with the updated selections Facility Use this drop down menu to generate a Continued Stay Warnings Report for all facilities in the organization or a single selected facility NOTE This drop down menu shows only for users at multi facility organizations with organization level access to LTRAX reports Time Period The time period fields allow you to choose the assessments included in the report based on the patient s readmission date Enter start and end dates for the desired date range The date range defaults to the past 30 days NO
155. ted Rejected or All REPORT OUTPUT The report displays with columns that can be clicked to sort the output by a selected column Click a column header once to order the report by that column in ascending alphabetical chronological or numeric order Click the same column header again to reorder the report in descending order Brackets surround the header of the column that controls the sort order For example if the report is ordered by discharge date the discharge date column header will be displayed like this Discharged The report returns a line for each message so you may see multiple messages for a single patient For your selected facility date range message type and message status the report may display the following information Last Name the patient s last name First Name the patient s first name Account the patient s account number Admitted the patient s admission date Discharged the patient s discharge date Message Type An alphabetic code indicating the message type P for Pre Admission A for Admission XA for Cancel Admission D for Discharge XD for Cancel Discharge LOA for Leave of Absence RLOA for Return from Leave of Absence or U for Update Process Date The date and time LTRAX processed the message Result The outcome of message processing A for Accepted or R for Rejected SER FEATURES TR gurcons user manual Gea amp ES Sf amp SYSTEM Notes This column
156. ted Last Modified Admitted Discharged Denied On for denied pre admits Transmitted for assessments that have been marked as Accepted by CMS Referred or Screened NOTE Make sure that when use a date range filter you filter on a date that will be present in the records you are downloading For example if filtering by Discharge TRAX src Gea amp ES Sf amp SYSTEM Il USER FEATURES Date you should not expect to download any pre admit or admission assessments because those records do not contain discharge dates The second drop down allows you to specify a date range that will be applied to the search date type you selected in the first drop down Ranges include All Records Current Day Last Days includes today Previous Days excludes today and a specified date range Select your date range and a box or two boxes will appear to the right of the drop down where you can enter either your number of days or your start and end dates If you do not wish to apply a date filter select All Records Include column header in download file This option controls whether your download file will contain a header record with all of the column names If you want column names in your file select Yes Select Field Delimiter This option allows you to specify what character will separate each individual data element in each record with the recommended TAB character being the default S
157. ted nightly A time stamp at the top of the report indicates the last time the reports were generated HCAHPS Outcomes include all patient satisfaction surveys in which at least one survey question was answered and the associated discharge assessment has been marked Accepted by CMS Because some survey questions may be unanswered the number of surveys included in any individual measure may not match the total number of surveys returned in the time period Drop down menus at the top of the reports allow you to select different time periods and payers The reports automatically refresh each time you change your selection in one of the drop down menus The HCAHPS reports show aggregated patient satisfaction survey results starting from January 2013 when the survey was incorporated into LTRAX SER FEATURES I1 E HCAHPS OUTCOMES cee TRAX Il USER FEATURES aa a SYSTEM displayed by the following time periods calendar month and quarter year to date calendar years and fiscal years Surveys are included in a time period based on the patient s discharge date In the payer drop down menu the Medicare payer selection includes assessments where one of the selected payers is Medicare traditional fee for service or Medicare managed care Part C Medicare Advantage Non Medicare excludes assessments that have either of the Medicare payers selected HCAHPS reports can be printed as PDF documents using the PRINT PDF button near the
158. tered into a record two days before an imminent deadline for either assessment completion or transmission the background color changes to a shade of yellow orange light blue or medium blue depending on the current state of the assessment and the action required On the actual deadline day the background turns red and stays red until the required action is taken ES V B DISPLAYING PATIENT ASSESSMENTS ON THE LTRAX HOME SCREEN 84 LTACH il OUTCOMES Gea amp ES Sf a SYSTEM The LTRAX launch screen cues you to the next action needed for each assessment as follows Status Status Complete or Xmit Incomplete Ready Prepared Admission Date present Assess Patient and Enter Data Assessment Reference Date present Completion Date Pending Completion Date present Transmission Date Pending Transmission Date present after Transmission Date due Completion Due Completion Past Due Completion Past Due Completion Past Due Ready for Transmission Transmission Due Transmission Past Due The color coding is based on the assessment completion and transmission guidelines summarized below which can be found in Tables 2 1 and 2 2 in Chapter 2 of the LTCH QRP Manual Admission Assessment Timing Assessment Reference Date no later than Admission Date 2 OR equal to Discharge Date whichever is sooner Completion Date
159. that qualify for inclusion To be included in the report an Admission Assessment must have a recorded admission date A Planned or Unplanned Discharge Assessment must have a recorded discharge date Additionally the assessments shown on the report have had the override box checked on the MGMT tab acknowledging incomplete CMS LTCH QRP data More information about the field requirements for each type of LTCH CARE assessment can be found in the LTCH QRP Manual Appendix E REPORT FILTERS Use the report filters to determine the parameters of your desired report Click Refresh to display the report with the updated selections Facility Use this drop down menu to generate a QRP Override Report for all facilities in the organization or a single selected facility NOTE This drop down menu shows only for users at multi facility organizations with organization level access to LTRAX reports Time Period The time period fields allow you to choose the assessments included in the report based on admission and or discharge dates Enter start and end dates for the desired date range The date range defaults to the past 30 days NOTE in progress assessments must have an admission date or a discharge date in order to be included in the report Assessments This drop down menu allows you to choose the types of assessments included in the report Admission only Discharge only or both Admission and Discharge Assessment Status Make a selection to vie
160. the Forums home page You ll then see a list of all threads posted under that forum organized in chronological order with the thread containing the latest posted message appearing at the top You can choose to start a new thread by clicking Start New Thread on the left side of the screen or at the bottom of the threads index page To browse the messages posted under a thread click on the name of the thread You can reply to a message in a thread by clicking Reply on the left side of the screen or Reply to this thread at the bottom of the messages page You can send a private message to a user who has posted a message on the forums by clicking on that user s username You can also edit or delete messages you have posted by selecting the thread the message is posted under and clicking the Edit or Delete link in your message Above the threads list you ll see what are called breadcrumbs These links represent your location in the forums For instance if from the forums index you clicked on the General forum the breadcrumbs at the top of the screen would look like this LTRAX Forums gt General Each time you click to a deeper level in the forums the breadcrumbs will expand to illustrate where you are and offer you links to climb back up the hierarchy so you re never more than a click or two away from any of the other forums or threads You can also use the links on the left side of the screen to jump to the forums index the threads i
161. the field you wish to search by type your search string into the starting with input box and click Enter TRAX 222 user manual SEM Bea amp ES Sf amp SYSTEM Facility Specific f your facility has any facility specific custom fields that have been configured as drop downs you can filter assessments based on the facility custom values Using the Facility Specific drop down select your facility custom field Another drop down containing all of the possible values for that field will appear and you can use that to filter by your custom data field Display Use this option to control the maximum number of assessments displayed in each assessment list at any one time Enter a large number to display a lot of information or a smaller number to shrink the vertical size of your home screen This doesn t limit the number of assessments returned by your search filters and if the total number of records returned exceeds the number you enter in this box your assessments lists will display links that you can use to page through the records The default value is 50 To change that type in your desired maximum number and click Enter SSS ESS CONFIGURING LIST OPTIONS The List Options feature allows you to specify the information or values to be displayed in the assessments tables on your LTRAX home page and to customize three additional home page display settings To access the list options settings click List Options on t
162. the privilege Non admin user can perform Clinical Assessment advanced maintenance functions Assessment Tasks Does the user need to eEnter patient assessments including pre admit admission and patient satisfaction surveys If yes they will need the privileges 1 User can view all assessments for their facility includes all sites 2 User can create edit Clinical assessments 3 User can to lock assessments AND TRAM wee user m E E EY Wf SYSTEM sea Nanua III FACILITY ADMINISTRATOR FEATURES 4 User can unlock assessments Does the user need to Enter pre admission assessments only If the user only enters pre admission assessments without entering any clinical assessments they will only need the special limited privilege User can create edit pre admission assessments only Patient Satisfaction Surveys Does the user need to Print and or enter Patient Satisfaction Instrument surveys only If the user only enters pre admission assessments without entering any clinical assessments they will only need the Special Limited Privilege User can create edit patient satisfaction surveys only Data Uploading Does the user need to Upload files to LTRAX for import into the LTRAX system such as patient satisfaction surveys If yes the user will need the privilege User can upload files to LTRAX Outcomes Reports Does the user need to View facility reports patient re
163. the top of the screen or the Next buttons at the bottom of each screen to navigate to the different sections of the assessment TRAXES user mm a amp ES Sf amp SYSTEM Saving PAS Tool Data Data Entry Tips Saving data to the PAS Tool screens works the same as it does for the admission and discharge records For more information on how to save data and for some data entry tips please see Working In Multiple Browser Windows Or Tabs and Assessment Warnings Errors And Completion Checking in the LTRAX Clinical Assessment General Information section above Patient Referrals Denials Tracking The pre admission assessments also include a patient referrals denials tracking feature which is intended for use generating Referrals Outcomes This feature is voluntary but will allow you to run reports on admission referrals and denials at your facility This feature incorporates two facility custom fields you can configure Referring Facility and Referring Physician In order for these custom fields to be incorporated into the referrals outcomes they must be configured for drop down data entry and must be named exactly as stated For more information on configuring facility custom fields please see the Custom Data Fields section of this user manual under Facility Administrator Features For more information about the screens and functions on pre admission assessments please see the Asse
164. time you logged out and apply those selections the next time you log in NOTE The options you select will not be permanently saved for future LTRAX sessions until you log out so if your session expires before you click LOG OUT you will need to repeat your selections the next time you login If you have trouble finding the assessments you expect to see on the home screen review your display options to make sure the selections are correct for what you intend to display The options are as follows enn eee DISPLAY OPTIONS Show The Show option includes two drop downs which are used together The first Show drop down controls which assessments are displayed based on the current state of the assessments The options you have depend on your user privileges Assessment status options include In Progress e Admit Incomplete the admission record has not been completed e Admit Complete the admission record has been completed e Admit Accepted the admission record has been sent to and accepted by CMS e Discharge Incomplete the discharge record has not been completed Discharge Complete the discharge record has been completed SESSMENT FEATURES V B DISPLAYING PATIENT ASSESSMENTS ON THE LTRAX HOME SCREEN 79 TRAYS user manus Oe a2 SS amp SYSTEM denen bate Ea V ASSESSMENT Discharge Accepted the discharge record has been sent to and accepted by CMS e Accepted Admit and Discharge both admiss
165. to what you might see File Download Do you want to open or save this file x Name CMS_LTRAX_79_120927_154136 zip Type WinZip File 916 bytes From ltraxcaret aod cx Open Save IV Always ask before opening this type of file harm your computer If you do not trust the source do not open or 0 While files from the Internet can be useful some files can potentially save this file What s the risk Choose Save File and click OK Next select a destination on your computer s hard drive using the Save in drop down change the suggested filename if you wish and click Save After CMS_LTRAX the default file name includes your facility s Medicare provider number followed by the file creation date yymmdd then the file creation time hhmmss so if you do not change the filename when you save the file you won t accidentally overwrite your other downloaded CMS files USER FEATURES II D CMS TRANSMIT FILE 9 LTRAX S ER system USer manual II USER FEATURES Save As 21x Save in fo CMS Transmit Files gt E gt e My Recent Documents Desktop My Documents om g My Computer ie e My Network File name em S_LTRAX_79_120927_154136 zip gt Save Places Save as type WinZip File Cancel Once you have saved the file you must access the CMS website using the CMSNet connection to perform the actual transmission For help with CMSNet and the CMS website
166. tom Template allows you to select individual fields or groups of fields to include in a file you can download to your computer and allows you to control the order in which those fields appear in your file Data fields are grouped by sections based on the LTCH CARE Tool and the LTRAX patient assessment screens and additional sections allow you to include facility custom data PAS Tool data vent wound and skin Braden assessments and patient satisfaction survey fields in your download file giving you total control over the structure of your file File download parameters can be saved as templates for future downloads and these templates can be shared among users at a facility or organization The files you create are delimited text files that use the delimiter you specify Each line in a file contains one record and each record is separated by a carriage return ASCII 10 with each element in the record separated by your selected delimiter Depending on the fields you select to download your data could be delivered in single file or across multiple files which can be downloaded either individually or in a single ZIP file Please see the Separate DAT Files column in the File Structure table in the documentation available under the z HELP icon on the download screen for the list of fields that will download in separate files To download your custom template data file log into LTRAX and click Downloads then click Data Download Custom Te
167. u log out first there is no way for anyone else to access the system using your account unless they know your username and password For security make sure you click the LOG OUT button in the top navigation bar at the conclusion of every visit or if you step away from your computer Only work in one browser window or tab at a time Your web browser can only track one patient record at a time If you attempt to open multiple patient records in separate browser windows or tabs you will see a Multiple Windows Warning message that will prevent you from opening more than one record simultaneously or visiting the CMS Transmit File screen while you have a record open in another tab or window If you get a Multiple Windows Warning message you should locate all windows or tabs open to LTRAX click the HOME button on each of those and then close all but one If that does not clear the Multiple Windows Warning message you will need to click the LOG OUT button in the top navigation bar and then login again I C Explanation of the Organization Facility Site Hierarchy The LTRAX system was designed to accommodate different kinds of hospital organizations through a three tiered hierarchy of Organization Facility Site A facility is defined by a unique Medicare provider number One organization can own or manage several facilities If your facility belongs to a larger organization that includes other facilities under its umbrella you can apply the Organizati
168. vailable on your reports Custom data fields are configured by an LTRAX facility administrator for your facility NOTE In order for this filter to be available on the reports the custom data field must be called Referring Facility must be spelled correctly and must be configured as a drop down Referring Physician This drop down lets you select from your custom list of referring physicians If your facility has not configured a custom data field drop down called Referring Physician this filter will not be available on your reports Custom data fields are configured by an LTRAX facility administrator for your facility NOTE In order for this filter to be available on the reports the custom data field must be called Referring Physician must be spelled correctly and must be configured as a drop down Denial Reason This drop down lets you filter the report by the denial reason indicated on the pre admit assessment at the time of denial Payer This drop down lets you filter the report based on the primary payer categories of either All Medicare including B Medicare B CM Coinsurance Medicare M Medicare or MR Medicare Replacement or Non Medicare all other payers Between These boxes let you enter a date range to view your referrals based on denial date and admission date MDC The MDC drop down shows you admissions by selected MDC Because MDC is not collected on the pre admission screening
169. w assessments Accepted by CMS only In Progress Assessments only or Both REPORT OUTPUT The report displays with columns that can be clicked to sort the output by a selected column Click a column header once to order the report by that column in ascending alphabetical chronological or numerical order Click the same column header again to USER FEATURES II E TRANSMISSIONS 47 TRAY a2 32 a SYSTEM reorder the report in descending order Brackets surround the header of the column determining the sort order For example if the report is ordered by discharge date the discharge date column header will be displayed like this Discharged The report returns a line for each Admission or Discharge record with the QRP override acknowledgment checked so you may see multiple records for a single patient For your selected facility date range assessment type and assessment status the report displays the following information Last Name The patient s last name recorded as LTCH CARE item A0500A on I D PAY First Name The patient s first name recorded as LTCH CARE item AO500C on I D PAY Birth Date The patient s birth date recorded as LTCH CARE item A0900 on I D PAY Medical Record The patient s medical record number recorded on D PAY Assess Type A one or two letter code indicating the assessment type A for Admission D for Planned Discharge or DU for Unplanned Discharge Admitted The
170. w includes some instructions for various ways you can search for codes or descriptions If your search returns a code you wish to use click on the down arrow next to the code to pop it into the code box DRG MDC Crosswalk Below Major Diagnostic Category on the MEDI CAL and DI SCHG tabs is a link to the DRG MDC Crosswalk a PDF displaying DRG codes and descriptions and the MDCs they belong to This file is also accessible from the Valid Codes links on the same tabs Disable I CD Checking Below Secondaries on the MEDI CAL and DISCHG tabs is the Disable ICD Checking checkbox The list of ICD 9 codes that LTRAX refers to when checking for valid codes may not be a fully comprehensive list If you believe a code you have entered is valid but the LTRAX system disagrees with you you can disable the ICD 9 code validation for the duration of your login by checking the Disable ICD Checking checkbox This will allow you to enter codes that LTRAX does not recognize Copy Wounds If you record wound assessments using the LTRAX WOUNDS tab click the COPY button on the SKIN CMS tab to automatically fill out the LTCH CARE Tool Skin Conditions questions This is useful for ensuring accurate and consistent data entry for the section M questions especially the present on admission logic In order for wound assessment information to copy to the SKIN CMS tab the wound assessments must meet the following qualifications 1 The recorded Wound Type or Ori
171. xactly match the case mix in your facility For this reason the weighted numbers give you a more accurate picture of how your facility compares to other facilities in the nation and your region The drill down reports are updated nightly A time stamp at the top of the report screens indicates the last time the reports were generated Some reports are available as PDF documents On reports where this is available near the top of the report screen is a El PRINT PDF button that you can click to open a new window displaying a PDF version of the report You can then click the print icon in the new window to print your report NOTE This requires Adobe Reader software If you don t already have Reader installed on your computer you can get the latest version from the Adobe website here http get adobe com reader Some reports are also available as an Excel spreadsheet On reports where this is available near the top of the report screen is an GJ OPEN EXCEL button that you can click to either open the comma separated csv file as an Excel spreadsheet or save the csv file to your computer We suggest that national and regional benchmarks not be heavily relied upon for periods of less than 90 days regardless of the time period you select SST OUTCOMES REPORTS INCLUSION REQUIREMENTS In order to be included in the LTRAX outcomes reports all records must meet the following minimum standards Admission based measures this inc
172. y administrator user account for yourself under each of those facilities L Add User Organization administrators are responsible for managing all user accounts for all facilities under their organization Each user should be given their own user account with a unique username and password and each user from a particular facility will use their facility s Medicare provider number as part of their login Each user should also be given a set of user privileges that corresponds to their duties on the LTRAX system Privileges can be combined to ensure that each user has the unique combination of user privileges they require in order to perform their job There is no limit to the number of user accounts a facility or organization can have To add a new user from your Manage Facility screen click Add User You will see the following fields Facility Site Select the facility site this user will be associated with from the drop down list User Name This is the name the user will login with A standard format username is first initial of the first name followed by the entire last name with no spaces for example jdoe for John Doe but you may choose whatever format you wish The username is not case sensitive required Password An LTRAX password must be at least 8 characters long and must include at least 2 numbers along with letters it must be alphanumeric Additionally it cannot include any part of your name or your facility s name

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