Raggsy the hospital trainer illustrating MEMO III-A: P.O.O.P.
From: David R. Stoolworthy, M.H.A., M.B.A. <dstoolworthy@absolutelyreal.org>
Sent: Monday, 7:15 AM
To: All Medical Staff, Nursing Staff
Cc: Revenue Cycle Management
Priority: High Mandatory
MEMO III-A: P.O.O.P. — Patient Output Obligation Protocol

A. P.O.O.P. — Patient Output Obligation Protocol

P.O.O.P.
P — Patient
O — Obligatory
O — Output
P — Protocol

Definition: No patient shall be discharged from any Absolutely Real Hospital System (ARHS) facility without at least one (1) documented fecal event — defined as the physical passage of feces from the body, observed and verified by a licensed clinical staff member.

Documentation Requirements — The Fecal Output Log (FOL) must include:

  • Date and time of fecal event
  • Approximate volume (small, moderate, large, "remarkable")
  • Consistency (Bristol Stool Scale, Type 1–7)
  • Color
  • Whether the patient announced it, denied it, or "blamed the bed"
  • Name of verifying nurse (must have personally confirmed feces — no hearsay, no "I think she went," no "the bathroom smelled like she went")
💰 Billing Note Each documented fecal event supports GEV-1 coding, which contributes to our Medicare Severity-Diagnosis Related Group (MS-DRG) reimbursement tier. A patient discharged with no documented fecal output defaults to a lower reimbursement tier, and frankly, we are not running a charity. We are running a hospital. An excellent hospital. Where people poop. And we get paid for it.

Questions regarding this policy may be directed to:

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

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

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