Malnutrition deep dive: A conversation with ECU Health’s Ashley Strickland

Listeners of Off the Record may recall our episodes on the OIG audit of severe malnutrition directed at North Carolina based Vidant, now ECU Health. Vidant/ECU won a landmark case against the OIG in large part because it had a multidisciplinary clinical and coding team in place to ensure that severe and other forms of malnutrition were appropriately documented in the record and captured. That effort was spearheaded by CDI and coding experts, but also by a great clinical team including my guest today. Ashley Strickland is the adult clinical dietitian supervisor and an surgical/trauma intensive care dietitian at ECU Health. Her primary focus is critical care, complex GI patients, and nutrition support. She's also an independent contractor and educator for the Academy of Nutrition and Dietetics and sits on the American Society for Parenteral and Enteral Nutrition’s Reimbursement Malnutrition Task Force. On this show we cover: • What is a hospital based registered dietitian (RD), and Ashley’s life-saving clinical work supporting critical care/trauma/surgical intensive care patients • How her work impacts documentation/coding/diagnosis of malnutrition and obesity • Strategies for appropriate capture of severe and other forms of malnutrition • The OIG case from Ashley’s perspective, including prepping with mountains of paper records in the war room, courtroom experiences, and lessons learned • Advice for professionals dealing with egregious denials, including flimsy justifications of “not enough care” directed at a condition, or denying conditions clearly reportable per Official Guidelines for Coding and Reporting • Definitions and controversies: AND/ASPEN criteria vs. the Global Leadership Initiative on Malnutrition (GLIM), and compliance concerns with the emergence of “mild” malnutrition • My Dave Matthews gaffe (sorry, heavy metal guy here)