Accreditation/State Survey/Citations

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Up-date to ICD-10!

Changes to ICD-10 for 2018-2019 from the CDC!

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.

Understanding Medicare Secondary Payer (MSP)

Understanding the role that Medicare Secondary Payer plays to patient care and your agency is critical.

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...

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?

Falls

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

Assisting Medicare Home Health Care Agencies Before, During and After the Accreditation and State Surveys

HHCNT 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 60% 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 agencies to conduct business every day following the rules and regulations!