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To determine the charges for the physician services, we selected five-digit procedural codes from me American Medical Associations (AMA) physician''s Current Procedural Terminology (CPT) Fourth Edition 2001 (17). The selection methods for the codes were based upon the AMA CPT 2001 coding guidelines. The AMA CPT 2001 is separated by categories such as evaluation and management, anesthesia, surgery, radiology, pathology, and medicine. We used codes from the evaluation and management and surgery sections (Table 3). For simplicity, we chose to use only the Arkansas Medicare non-facility fee schedule for the CPT codes; however, we realize that these costs may vary in other locations. The non-facility fee, which is used for private practice clinics, differs from facility (academic center) fees.

Under this model, retainer-based search firms had everything to gain and nothing to lose by taking any search that came their way. Protected by contractual obligation, the best news a retained search firm could get would be to have a frustrated hospital CEO cancel an engagement. Anything billed to that point was free money. By the time the flaws of the retained model were realized, enough hospitals were burned and the reputation of the medical recruiting industry suffered.Happy EndingA new generation of retained recruiting firms emerged out of the hard-earned lessons learned, putting reputation before profit by adopting the money-back model. Simply stated, if the search firm fails to deliver a qualified candidate, the client doesn''t pay. Terms are clear and the ground rules put the responsibility on the search firm to deliver.

In addition to using the federal Medicare comparison information, Janelle Carter of the Associated Press offers other suggestions for choosing a nursing home. Consumers should ask nursing home residents and families, community advocacy groups, personal physicians, and clergy about area facilities. She also recommends that consumers visit several nursing homes at varying times of day and on weekends, when staff and services may be less. Each state is also supposed to have a long-term care ombudsman''s office, which acts as an advocate for those in assisted living or nursing homes. The ombudsman may have information about problems with individual facilities. The National Citizen''s Coalition for Nursing Home Reform (www.nursinghomeaction.com or 202-332-2275) tells how to contact the state ombudsman and provides guidance on choosing a facility as well as how to ensure quality care.

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