Raggsy the hospital trainer illustrating MEMO III-G: C.R.A.P.
From: David R. Stoolworthy, M.H.A., M.B.A. <dstoolworthy@absolutelyreal.org>
Sent: Monday, 7:15 AM
To: Dietary, Pharmacy, GI Service, Nursing
Cc: Revenue Cycle Management
Priority: High Protocol
MEMO III-G: C.R.A.P. — Constipation Recovery & Active Preparation

G. C.R.A.P. — Constipation Recovery & Active Preparation

C.R.A.P.
C — Constipation
R — Recovery &
A — Active
P — Preparation

For patients with prolonged absence of fecal output (defined as 48+ hours with no documented fecal event), the following C.R.A.P. protocol shall be initiated:

  • Step 1: Dietary consult — high-fiber meal plan with a dietary technician who will say "We're going to get things moving. Your insurance covers this."
  • Step 2: Pharmacist-initiated bowel regimen — Polyethylene glycol, bisacodyl, and one (1) smoothie that tastes like friendship but works like a plunger
  • Step 3: Daily physician rounds conversation: "How are we doing with the poop? And I say 'we' because your bowel movements are now a team effort."
  • Step 4: If no fecal output by Day 3 — Gastroenterology consult, abdominal X-ray (billable), and a radiologist's written impression that includes the phrase "moderate fecal loading" (billable and deeply satisfying to type)
💰 Billing Note The C.R.A.P. protocol generates an average of $3,400–$6,200 in additional billable services per patient, including the dietary consult, pharmacy regimen, imaging, and GI consultation. This is not an exaggeration. This is revenue. This is why we're here. To provide excellent care. And to bill for it. Appropriately. And aggressively. And with pride.

Questions regarding this policy may be directed to:

David R. Stoolworthy, M.H.A., M.B.A.
Chief Operating Officer — Absolutely Real Hospital System (ARHS)
Email: dstoolworthy@absolutelyreal.org
Phone: Ext. 2800
Compliance Oath — MEMO III-G

You have read MEMO III-G. Federal regulations (invented) require you to swear to comply.

Absolutely Real Hospital System (ARHS)
"Trust Us, We're a Hospital"
WCAG 2.2 Compliant Fully Wheelchair Accessible Braille Ready Hearing Loops Installed Large-Print Forms Available

* Accessibility claims certified by the ARHS Department of Honestly Trying. The large-print forms exist but nobody knows where Ward Four keeps them.