Background: Hospital reimbursement for medical necessity is based on the level of care a patient is receiving. In the electronic medical record (EMR), the level of care, inpatient or observation, is determined by a practitioner order or physician certification. The timeliness of this order is of utmost importance, as medical necessity is a dynamic status. [...]

Background: Since 2020, UNC Hospitals has increasing numbers of patients who no longer require acute level of care. A portion of these patients have longer length of stay exceeding 30 days while awaiting disposition. This is noticeable in our percentage of long length of stay patients hospitalized 31-60 days (6.8% in 2022 vs 6.0% in [...]

Background: With increasing subspecialization in the field of Internal Medicine, the role of the hospitalist has metamorphosed, and the expectation for certification in specialized procedures, such as paracentesis, has diminished. Many hospitalist groups have traditionally relied on procedure services to manage specialized procedures. As a result, the majority of hospitalist faculty, and to a greater [...]