Time for a few comments on how the bureaucrats and their
special language are driving us all crazy. I hate acronyms. Everyone pretends
they know what they stand for but most of the time we just move on from them
without a clue, because we don’t want to have to ask the “stupid” question.
Fortunately, I have always been very good at asking “stupid” questions, and I have
a history of driving bureaucrats crazy by insisting they tell me what each of
these things actually stands for. Here’s a little secret. They often don’t know
either. By the way, did you ever wonder if acronym is actually an acronym for
something, and if so what. Next time you’re in a big meeting with someone
spinning off all these gobbledygook words, ask them what acronym stands for.
The bottom line is that I am tired of the government
screwing up my life. It’s not enough that they write 100,000 page tax codes or 2000
page health plans, but then they load these things up with non-word words that mean
nothing to the average reader. Then when you ask them what the hell a HIPPA is
they get to look down on you with that special bureaucratic “smirk” that says
you’re an idiot.
I wrote the following piece (Granite Grumblings, 2011) when I was in a VNA meeting. Oh,
you don’t know that the VNA is the Visiting Nurse Association? What are you,
some kind of idiot? Anyway I wrote this piece in one of those meetings, because
the government seemed to be swamping us by the minute with new acronyms.
I hope it brings a little comic relief from a world that
seems increasingly to have no sense of humor. I can only hope that no
bureaucrat is reading this or I will probably be audited, again.
Glenn K. Currie
Comments From The HHA (Home Health Agency) Frontlines
I sat in what I hoped looked like a state of contemplative
evaluation. Actually, however, it was dazed incomprehension.
They were talking about Groupers, HIPPS, No-RAP LUPA’s and
OASIS.
I hate acronyms. They are never what they seem, and they
make my head ache. In fact, lately, the whole health care system is starting to
make me crazy.
A few years ago, I agreed to serve on the Board of Trustees
of the Concord Regional Visiting Nurse Association (aka the CRVNA or VNA).
I figured this might be fun. You know, get to meet a lot of
nice nurses, eat some cookies at the meetings, maybe learn something about the
caregivers who are going to be dealing with me in a few years. (Maybe sooner if
there are many more meetings like this one).
The CFO is now discussing HHRG’s. “An HHRG of C2FZS1 would
have a care mix weight of 1.0758 and a labor quotient of 1.3303, if the patient
lives in Barnstable…”
The room begins to swim. A bunch of old Navy acronyms
suddenly appear on the inside of my eyeballs. (MEGO/SOS/ASAP). I have a page
and a half of these VNA acronyms and their meanings in front of me, but they
aren’t helping.
I look up Grouper, which I always thought was a large
bottom-feeding fish. But no, according to my sheet, its “a software module…and
for HH PPS data from the OASIS assessment tool is grouped to form HHRG’s and
output HIPPS codes”.
It goes downhill from there. Trust me when I tell you that
HIPPS and OASIS are not body parts or a green spot in the desert. And the
No-RAP LUPAs are not a Latin American singing group.
The amazing thing to me is that the nurses and
administrators actually understand all this stuff. (They don’t necessarily like
it but they understand it).
The health care system is getting so complicated now, that
only geniuses should apply to become nurses. Which is probably why we have a
current shortage of nurses.
Who would have thought thirty years ago that nurses would
all be using laptops on their visits, and focusing on POC’s, PEP’s and PPS to
keep HCFA happy.
The good news is that they haven’t forgotten about the basic
mission of providing quality care to those in need. And despite all the
bureaucracy, the level of services that these wonderful people provide is
better than ever.
That doesn’t, however, prevent me from increasingly feeling
like an anachronism in this era of acronyms and anomalies.
I think they just keep me around because I’m so good
looking, and I make everyone else feel smart.
(By the way, I am actually writing this in the meeting.
Hopefully, all the other Trustees and staff think I am paying attention to my
DMERC’s and SCICs and am just taking copious notes.)
Glenn K. Currie