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Submitting Request for Records to Medicare Picture

Submitting Request for Records to Medicare

More than 47% of denials by PalmettoGBA for the period of 10/2017-12/2018 were related to...... Read More...

CMS Quality Measurements Projects and the Goals

CMS is presently developing outcome core measures that are patient oriented and cross providers setting during the continuum of care.

CMS Proposed Rule of the Home Health QAPI Program

CMS propose regulations needs more work! Make home care organizations assign the QAPI Program responsibilities to a staff member who is free of conflict between the non-clinical and clinical departments in the home care organization.

Does staff cohesiveness impact your organization success?

Leadership tools must include alternative effective forms of communication in order to achieve cohesiveness in an organization, read more...

Tips

Ready for CMS QAPI Program?

According to CMS in 2011 several nursing homes providers begun testing CMS QAPI Program, Quality Assurance (QA) and Performance Improvement (PI), Program which includes Five Elements...

Falls

Patients falls are a marker of frailty, immobility...

Patient-Driven Grouping Model (PDGM)-Effective January 1, 2020 CMS Home Health Payment Methodology. Picture

Patient-Driven Grouping Model (PDGM)-Effective January 1, 2020 CMS Home Health Payment Methodology.

Have you downloaded the CMS PDGM Excel file from the CMS Home Health Agency Center?

OASIS Tip - M1600 Patients discharged with an UTI on discharge and PAEs Report

Are your Potentially Avoidable Events (PAEs) Report showing an increase in patients being discharged while having an UTI?

The Benefits of Accreditation for a Home Health Care Organization

HHCNToday have been there for many home health agencies before, during and after the accreditation and state surveys.

Agency #1 - Cited for incomplete infusion orders and lack of communication among team members. HHCNT assisted the organization to trace the formal processes used by the organization to admit and provide care for a patient on infusion services. Areas identified for improvement were:

1. Educating Community Liaisons on require information and medical orders for patients who require infusion services.
2. Providing education to Team Leaders on nursing standards in clinical practice, state regulations on specific requirements when writing orders and how to apply this requirements when writing infusion orders, communicating and documenting coordination of care with other health care providers in the community and the organization’s Administration policies and procedures.
3. Developed a standard Infusion Therapy Verbal Order form and a flow chart to assist clinicians to be consistent when writing infusion. Orders.
4. Results: Citation lifted.

Agency #2 – Agency placed on 100% Audit by CMS due to overutilization of therapies.
One hundred charts audited by CMS, lost revenue only 2%.

Agency #3 – Agency audited for Face to Face, homebound status, reasonable and necessary services. Won 89% of appeals, how?
Staff education done monthly on documentation, OASIS-C 1 and clinical practice. The organization has never been cited for any deficiency on state survey.

We always educate our home care agencies to conduct best business practice by following the rules, regulations and stay up-to-date on new rulings effecting the agency!

Medicare Accreditation /Non-Medicare Home Care Organizations that provide skills services requires accreditation by an accrediting body such as:

Medicare Accreditation/Non-Medicare Organization that provide nursing skills services requires accreditation by an accreditation bodies as ACHC. Accreditation helps to improves business activities, patient care outcomes and also helps determine if your organization complies with applicable local, state, federal rules and regulations.

There are several standard for accreditation that imposes a higher standard for an organization that’s ACHC Accredited for example in the State of Florida agency licensure (AHCA) does not requires tuberculin skin testing (PPD) or x-ray screening on all  direct care personnel upon hire and annually thereafter. While according to ACHC agencies need to follow Center of Disease Control (CDC) guidelines which recommends that all direct care personnel need to have a PPD upon hire and annually.

7/2016