Raggsy the hospital trainer illustrating MEMO III-B: F.A.R.T.
From: David R. Stoolworthy, M.H.A., M.B.A. <dstoolworthy@absolutelyreal.org>
Sent: Monday, 7:15 AM
To: All Medical Staff, G.A.S. Team
Cc: Revenue Cycle Management
Priority: High Mandatory
MEMO III-B: F.A.R.T. — Flatulence Assessment & Release Tracking

B. F.A.R.T. — Flatulence Assessment & Release Tracking

F.A.R.T.
F — Flatulence
A — Assessment &
R — Release
T — Tracking

Definition: A fart is defined for clinical, billing, and legal purposes as:

"An anal release of wind — the passage of intestinal gas through the rectum and anus, producing either an audible sound, a detectable odor, or both."

Mandatory Discharge Requirement: Every patient must produce at least one (1) verified anal release of wind before discharge paperwork may be initiated.

Acceptable Verification Methods:

  1. Auditory confirmation — heard by a licensed staff member (nurse, CNA, respiratory therapist who happened to be walking by, or physician)
  2. Olfactory confirmation — smelled by a licensed staff member who can attest in writing that the odor was consistent with intestinal gas and not "lunch in the breakroom"
  3. Patient self-report — only accepted if accompanied by one of the above OR confirmed by a family member who states on the record: "That was definitely a fart. I know that face. He's been making that face since 1987."
  4. Bed sensor alert — our new smart-bed technology includes a vibration sensor that can detect an anal release of wind and auto-log it to the EHR. (Yes, this is real. We spent $400,000 on these beds. Use them.)

Unacceptable Verification Methods:

  • "I think he went" (went what? where? be specific)
  • "The room smelled like something" (this is not clinical documentation)
  • "Patient denies passing gas but is smiling" (while suspicious, this alone does not meet criteria)
  • "I didn't hear it but the patient's gown moved" (we are not billing based on gown movement)
💰 Billing Note A documented anal release of wind supports GEV-2 coding, which contributes to our Post-Operative Gastrointestinal Recovery Quality Score — a metric CMS now uses to calculate our annual quality incentive payment adjustment. Last year, we missed $890,000 in quality bonuses because 61% of our patients were discharged with no documented flatulence event. Sixty-one percent. That means more than half of our patients walked out of this hospital without passing gas on the record, and we lost nearly a million dollars because nobody wrote it down. This is unacceptable. This ends today.

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-B

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

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