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Quality Assurance data for Performance Improvement

How specific are your clinicians when developing a Patient Fall Program? How do you track and educate clinicians to reduce and or prevent patient injuries related to patients\' falls? The Triangle Pyramid...

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...

Quality Management Role For The Betterment of Your Agency Picture

Quality Management Role For The Betterment of Your Agency

The Quality Manager can be a catalytic agent between departments in your organization. A Quality Manager in a strategic position in an organization can help improve revenues in multiple ways. Identifying processes assigned to staff ....

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.

Tips

CMS Recovery Audits Contractors (RACs)

How many home health agencies failed to respond to Palmetto GBA auto request for copies of the medical record for review in Florida for an specific code probe?

Home Health Value-Based Purchasing Program (HHVBPP) Pilot  Program Picture

Home Health Value-Based Purchasing Program (HHVBPP) Pilot Program

Preliminary and final reports are available at the Value Based Portal site!

CMS Star Report Picture

CMS Star Report

Do you know where to go to get your Medicare Star Report?

Understanding the Benefits of Hiring a Quality Manager Consultant to assist you with your Medicare Home Health organization  QAPI/TQM Program.

Operating a Medicare Certified Home Health Agency does not have to be overwhelming.  Hiring a quality home health care consultant to advise your agency in patient outcomes and corporate compliance can be extremely effective.  At Home Health Care Network Today, Inc. our clinical team can assist your agency to exceed past agency performance and advise your organization in areas that need improvement.  Forward thinking is our motto.

If you need help follow this link, contact us

Medical Director

January 03, 2016

Can we have a Medical Director for each County listed in the home health license?


Does Home Health Care Network Today offer project specific consulting?

Yes, if your home care agency is seeking a specific project, please contact us for a free 10 minute consultation.

For example:

  • Managing request for ADRS
  • Accreditation Survey preparation including mock survey.
  • Performing Quality Assurance Performance Improvement activities
  • Performing chart audits remotely or paper
  • Staff Education on Annual Mandatory Inservice
  • Teach Quality Assurance Activities, Infection Control, Chart Audit, how to manage the QI Program, PAC meeting and Safety Committee.
  • Teach processes related to reviewing clinicians assessment and developing the POC.

What are the State of Florida’s regulation on having a “Director of Nursing QA”?

Florida regulations on Quality Assurance effective 9/2013 state that- "ST - H0224 - Director of Nursing QA 59A-8.0095(2)(e)The director of nursing shall establish and conduct an ongoing quality assurance program. The program shall Include at least quarterly, documentation of the review of the care and services of a sample of both active and closed clinical records by the director of nursing or his or her delegate. The director of nursing assumes overall responsibility for the quality assurance program. The quality assurance program is to assure that:

  1. The home health agency accepts patients whose home health service needs can be met by the home health agency;
  2. Case assignment and management is appropriate, adequate……"

For more information visit Florida AHCA Home Care Unit.

Is a wound with a drain considered a surgical wound?

CMS Quarterly OASIS Q&A January 2015 – Did you know that “M1340 ANSWER 6: Unless associated with an ostomy a wound with a drain is reported as a surgical wound on M1340. …” See OASIS-C1/ICD-10 Guidance Manual, Chapter 3.

 

Where do I find the most recently updated OASIS-C1/ICD-10 Guidance Manual , October 2015?

Follow this link! OASIS-C1/ICD-10 Guidance Manual.

 

Did CMS finalized the proposed changes to the home health regulations that include requirement for Quality Improvement?

No, it is still pending. Learn more about the Proposed Conditions of Participation (CMS-3819-P) "The proposed regulation reflects the most current home health agency practices by focusing on the care provided to patients and the impact of that care on patient outcomes. This proposed regulation focuses on assuring the protection and promotion of patient rights; enhances the process for care planning, delivery, and coordination of services; streamlines regulatory requirements; and builds a foundation for ongoing, data-driven, agency-wide quality improvement", go to CMS Home Health Agency Center.

What organizations can I joint to get more information or get help when I have potential regulatory issues in my company?

The Home Care Association of Florida (HCAF) and the National Association for Home Health and Hospice can provide you with assistance and the latest issues affecting the home health industry? Contact: HCAF and/or NAHC.

What’s an electronic ADR?

A home health organization can received Additional Developmentatl Request (ADRs) notifications by mail or electronically. Electronic ADRs are posted by CMS Intermediary in DDE. Your biller, Administrator and DON must have a process in place to ensure electronic ADRs request are identified timely, fowarded to the right staff member to be completed and mailed on time to the intermediary.

Do you know that Palmetto's Jurisdiction 11 Home Health and Hospice - Florida Medical Review Denials for January -March 2015 for the providers villing 32X, 33X bill types in the state of Florida had a 44.77 denial rate which was equivalent to $90,734? And that 37 claims denies were due to (56900) Auto Denial - Request Records not Submitted. If you need assistance with processing ADRs or need assistance with developing and implementing an ADR Process Home Health Care Network Today, Inc. go to PalmettoGBA for more information.

What marketing tools do you recommend for a Medicare home health care agency?

Your organizations Home Health Compare Report is a great marketing tool. Visit CMS Home Health Compare “Patient Survey” last posted on June 2015? follow to HHCompare.

I am looking for EBP materials for my clinicians, who is a reliable source?

Participating in the Home Health Quality Improvement (HHQI) Campaign can help your organization improve patient outcomes, especially those outcomes that support the acute care facilities. Home Health Quality Improvement Campaign Initiative provides FREE Evidence Base Practice (EBP) educational materials for your clinical staff. Joint them, HHQI.

Where can I find community safety educational materials for my field staff?

“The National Institute for Occupational Safety and Health (NIOSH) has published a Hazard Review Occupational Hazards in Home Healthcare to raise awareness of safety and health risks involved in home healthcare and to suggest prevention strategies to reduce injuries, illnesses, and fatalities that occur among workers in this industry” follow this link for more information, OSHA.

What reliable source that uses EBP do you recommend to write a hand washing policy and procedure?

See CDC guidelines.

Do my new direct care employee need a TST (PPD) upon hire?

See your accrediting body manual, CDC recommendations and State of Florida AHCA Home Care Unit July 24, 2012 presentation by Ann Menard, Manager, Home Care Unit .

My patient live in Palm Beach County and needs information on where to dispose his used sharps. Where can I direct our patient for proper disposal?

For Sharps Disposal sites and Laws in Palm Beach County go to Florida Department of Health (FDH) website.

We have a denial by Palmetto stating that the referral physician is not a PECOS provider, what should I do?

First, when you received the initial order for home health did you checked that the physician was PECOS approved? If yes, did you keep a copy of the verification? If yes, has there been any notifications from the intermediary (PalmettoGBA) stating that they have issued denials in "error" related to physicians not approved in PECOS? If not, you will need to decide if you want to request a Clerical Error Reopening Request Form Appeal, follow the PalmettoGBA website and the denial letter instructions to complete your appeal.

I have a clinician who we have educated multiple times on documentation but still have issues with accuracy, completion and submission of clinical documentation in a timely manner. What steps do you suggest for our home care agency to best follow?

Have you taken the following steps?

  1. Reviewed your organization Administrative Policy and Procedure on this issue?
  2. Address these issues with your HR department?
  3. Have you reviewed the following documents with your clinical staff? Code of Ethics for Nurses and Home Health Nursing: Scope and Standards of Practices, go to American Nurses Association (ANA).

Where do I get information to up-date our agency disaster plan?

You can find this information at Comprehensive Emergency Management Plan (CEMP).

If our Medicare home care agency has implemented a Biomedical Waste Policy, why do I need a Biomedical Waste Operational Plan?

When dealing with biomedical waste disposal, the Florida Department of Health requires that all home health agencies have a Biomedical Waste Permit, a contract with a disposal company, policies & procedures, Annual Staff Education on managing biomedical waste and a Biomedical Waste Operational Plan, all this information can be found on FDH website.

Medical Director

January 03, 2016

Can we have a Medical Director for each County listed in the home health license?

No, only one Medical Director per license!

References: HCAF 12/2015