A New Version of OASIS is Coming!

Is your staff just getting used to completing OASIS-D?  Surprise,   CMS recently announced there will be a new version for 2020!

It was a surprise to many when CMS declared during the April 3rd, Open Door Forum, that effective January 1, 2020 there would be a new version of OASIS. I know I was thinking at first that the presenter misread the effective date, but apparently this update is needed to support the Patient Driven Grouping Model (PDGM).  One more thing for HHA to deal with. But, HCA of MA will be here for you.  (See link at end to out Fall 2019 OASIS training.)  

Thankfully though, after reviewing the  CMS Memorandum,   I realize that there are only a few minor changes.

Quick synopsis:   Two items will be added to the Follow-Up assessment:  M1033-Risk for Hospitalization and M1800-Grooming. These items should pose no problem since staff is familiar with answering these items at SOC/ROC. Surprisingly, the other change involves the “option” to no longer answer 23 items!  Rather than leaving the items blank,  the clinician will be required, however,  to respond by using the equal sign (=).

Here are the “optional” items for your convenience.

Start of Care/Resumption of Care (SOC/ROC)

• M1910 Fall risk Assessment

Transfer (TRN) and Discharge (DC)

• M2401a Intervention Synopsis: Diabetic Foot Care

• M1051 Pneumococcal Vaccine

• M1056 Reason Pneumococcal Vaccine not received

Follow-Up (FU)

• M1021 Primary Diagnosis

• M1023 Other Diagnoses

• M1030 Therapies

• M1200 Vision

• M1242 Frequency of Pain Interfering with Activity

• M1311 Current Number of Unhealed Pressure Ulcers at Each Stage

• M1322 Current Number of Stage 1 Pressure Injuries

• M1324 Stage of Most Problematic Unhealed Pressure Ulcer that is Stageable

• M1330 Does this patient have a Stasis Ulcer

• M1332 Current Number of Stasis Ulcers that are Observable

• M1334 Status of Most Problematic Stasis Ulcer that is Observable

• M1340 Does this patient have a Surgical Wound

• M1342 Status of the Most Problematic Surgical Wound that is Observable

• M1400 Short of Breath

• M1610 Urinary Incontinence or Urinary Catheter Presence

• M1620 Bowel Incontinence Frequency

• M1630 Ostomy for Bowel Elimination

• M2030 Management of Injectable Medications

• M2200 Therapy Need

HCA of MA next Blueprint for OASIS Accuracy will be held on November 4th and 5th. Option to take the certification exam will be on the 6th.

You can register for the course here.

Blog post by:  Colleen Bayard.

Home Health, EHRs and Data Interoperability

In 2011, the Centers for Medicare and Medicaid Services launched the “Meaningful Use (MU) initiative to incentivize certain sectors in the US health care system to move toward electronic health records (EHR) that would be used in a meaningful manner that allows for the electronic exchange of information to improve continuity and quality of care. Significant financial incentives were provided to “eligible providers” – essentially defined as hospitals and physician practices. More than $20 billion was spent and more that 600,000 eligible providers were enrolled. Home health, behavioral health and skilled nursing facilities were not eligible.

Now, it seems there is some limited acknowledgement that it may be time to rethink that. In a proposed rule relative to interoperability just published in the Federal Register, CMS is including – as a Request for Information – an ask for any feedback as to how to improve data interoperability for providers that have as yet received any incentives for using electronic health records.

“Transitions across care settings have been characterized as common, complicated, costly, and potentially hazardous for individuals with complex health needs. Yet despite the need for functionality to support better care coordination, discharge planning, and timely transfer of essential health information, interoperability by certain health care providers such as long term and PAC, behavioral health, and home and community-based services continues to lag behind acute care providers,” the proposed rule says.

CMS acknowledges that a contributing factor to the lag in Interoperability among post-acute care providers was that they were not eligible for incentives under the program formally known as meaningful use. CMS asks for input on specific ways it could financially help these sectors adopt and use technology.

CMS also asks for feedback on measurement concepts and quality improvement steps that could feasibly be applied to post-acute care, behavioral health and home and community based-services providers. Given that mandate in the IMPACT ACT that certain patient assessment data should be standardized and CMS is interested in feedback as to what parts of that data set — or the whole IMPACT Act data set — would be appropriate to include.

Adding some fuel to what may be an obvious fire (no incentive = limited movement) is a just published study in the Journal of the American Medical Directors Association that examined gaps in communication between hospital and home health care staff, concluding that some could have serious medical consequences.

The authors surveyed nurses and staff at 56 home health agencies throughout Colorado. Participants were sent a 48-question survey covering communication between hospitals and agencies, patient safety, pending tests, medication schedules, clinician contact and other areas. Although almost all (96 percent) respondents indicated that Internet-based access to a patient’s hospital record would be at least somewhat useful, fewer than half reported having access to EHRs for referring hospitals or clinics. No surprise: getting medication doses right due to conflicting information was identified as a major problem.

Their conclusion: Future interventions to improve communication between the hospital and HHC should aim to improve preparation of patients and caregivers to ensure they know what to expect from HHC and to provide access to EHR information for HHC agencies.

Comments to CMS will be due in April. Date not yet announced.

Return to www.thinkhomecare.org.

Advocacy Alert: Email Senators Urging Support for HCA Budget Priorities

Last week, the Massachusetts Senate Ways and Means committee released its fiscal year 2019 state budget totaling $41.4 billion dollars. Senators had a deadline of Monday to file amendments to the bill, and it will be debated next week. Three Alliance priorities have been filed as amendments. Below are brief descriptions of each, with a link to send a pre-drafted email to your state legislator. The Alliance encourages you to send an email for all three amendments.

Amendment #589: EMAC Assessment Hardship Waiver:

  • This amendment would authorize the Department of Unemployment Assistance to establish a hardship waiver for employers that provide services to EOHHS/EOEA clients, or services in the public interest, who have a financial burden as a result of their EMAC tax liability. Take Action.

Amendment #560: Enough Pay to Stay Amendment:

  • This amendment would provide $28.8 million in increased funding for the State’s home care system front-line workforce. Take Action.

Amendment #620: Continuous Skilled Nursing Funding

  • This amendment would provide a $16 million increase for the Commonwealth’s Continuous Skilled Nursing program to address the workforce shortage resulting in unfilled service hours. Take Action.

Celebrate Nurses Week

Next week is National Nurses week. It is a time to celebrate the dedication, caring and overall contributions of those who choose nursing as their profession.

The Home Care Alliance would like to share your nursing human interest stories next week across our various social media platforms, whether it’s a shout out to a team or a staff member.

Email Megan Fournier at mfournier@thinkhomecare.org to tell us why you love home care & hospice nurses – OR – share our post below and comment why!

Celebrate Nurses Week 2

Full Quality & Compliance Conference Agenda Now Available!

Join us for our first annual Quality & Compliance Conference being held on Thursday, March 29th in Worcester, MA. This conference has been created due to the overwhelming new regulations that agencies need to understand to remain compliant.

After surveying members, HCA determined some of the most important topics that will be discussed during this full day conference.

Members are able to register for the LOW price of $50/person.
5 Nursing CEUs will be awarded!

The agenda is as follows:

 

 

  • ADRs, Pre-Payment Reviews, Post-Payment Audits and Suspensions – Navigating Medicare’s Administrative Appeal Process.
    Robert W. Liles, J.D., M.B.A., M.S., Managing Member, Liles Parker Attorneys & Counselors at Law
    Pre-payment reviews are now being conducted by both UPICs and ZPICs. While the government has placed some restrictions on their use, contractors continue to exercise great latitude in their scope and the length that they are imposed. Similarly, contractors remain in control of post-pay-ments conducted and suspension actions recommended to CMS. In this presentation, Robert W. Liles, J.D., will discuss these enforcement actions and outline the adverse impact each action can have on your agency and discuss your rights under the Administrative Appeal Process.
  • The COPs are Here, is Your Agency Complying?
    Susan M. Filshie, RN, Director of Clinical Consulting, QIRT
    The Conditions of Participation have been here since January, here is what we are seeing that is wrong! Quality in Real Time consults their clients regulary on the new home health standards. Filshie will take a deep dive into what what they have seen regarding the COPs and will give you the steps needed to ensure you are complying with the new regulations. A major focus will be spent on Patient Rights, which has been pinpointed as one of the more “heavy hitters” for the industry.
  • Developing a QAPI Project and the Fundamentals to Make it Successful
    Cheryl Pacella DNP, HHCNS-BC, CPHQ, COS-C, HCS-D, CAP Consulting
    We all celebrated the fact that quarterly record reviews and an annual agency evaluation are no longer required under the new Conditions of Participation. HOWEVER, agencies do need to comply with a robust Quality Assessment and Performance Improvement (QAPI) program. We need to utilize data from record reviews and various reports to prioritize Performance Improve-ment Projects (PIPs). Agencies need to identify at least one QAPI project by July 2018. So where do you start? The goal of this program is to help you identify target areas and provide you with the tools to implement a successful Plan of Action.
  • Panel Discussion: Real Examples of Successful Performance Improvement Projects
    Suzanne Clark, PT, DPT, GCS Direction of PI & Education, NVNA and Hospice
    Melinda Monteverde, RN, MSN, WCCN, Executive Director of Nursing Operations, Steward Home Care
    Kate Mercier, Vice President of Operational Excellence, Brockton VNA
    Three Home Health Agenices in Massachusetts have been put together to show real example of successful Performace Improvement Projects. Panelists will explain how they implemented their projects, what worked, and what didn’t. Q&A time will be available!

DOWNLOAD THE FULL AGENDA HERE!

Something for Everyone at 2018 NEHCC!

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There is something for everyone at the 2018 New England Home Care & Hospice Conference and Trade Show. See below just some of the topics that may be suited for you!

Clinical Directors

  • Stop Sepsis at Home: Learn from the Home Care Association of NY on how to equip your clinicians with educational/preventative, screening and follow-up tools to combat sepsis.
  • CoP Compliance: Discuss which key performance indicators have the most impact on quality and client outcomes.
  • Developing and Maintaining a Wound Care Program: Learn about the operational and clinical aspects of creating and/or maintaining your wound care program. Hear real agency examples of using best practices and guidelines and much more!
  • Emergency Preparedness Table Top: Join your peers to take part in a realistic table top simulation.

Quality

  • Communicating with CMS: Get a primer into the new patient-centered language of CMS
  • Metrics for CoP Compliance: Discuss which key performance indicators have the most impact on quality and client outcomes
  • Optimizing Operations Through Data Collection and Dissemination: Examine the changing healthcare landscape and focus on making operational decisions based on data. 

Private Duty

  • How the Age-Friendly Communities Movement Builds Partnerships: Hear local examples of how home care agencies can be involved in the movement to create “Age-Friendly Communities”
  • The Patient Experience: Learn strategies, action items, and tools to enable your agency to achieve improved patient experience while managing all other operational demands.
  • Problem Solving for Clients with Dementia: Learn how to engage direct care staff in active observation of the client, gather information, investigate and examine behaviors, and strategic problem solving. 

CEO

We have carved out an entire CEO track for you to enhance your skills and knowledge as well as engage with panelists, and peers.

  • Employee Recruitment and Retention: Hear successful and unsuccessful strategies to attract and retain top-tier talent.
  • Population Health: Gain the knowledge base you need to make decisions for the population you serve.
  • Home Health Groupings Model (HHGM): Learn from experts on how the final prospective payment system promises to offer the industry direction what what it means for agency strategy and capability heading into 2019.

Therapy

  • Embracing Our Physical Therapy and Occupational Scope of Practice in Home Care: This session will explore how therapy in the home has evolved and expanded and how this impacts you, your patients and your agency. 

Human Resources

  • Employment Law: Examine how various employment laws apply to the home care workforce and understand how to make sure your agency follows these laws and integrates in practice and your employee handbook.
  • Employee Retention: Learn specific approaches on how an agency can better engage the highest performers while still holding the lowest performers accountable and analyze the changing staff dynamics.
  • Engaging the Millennial Workforce: Hear how engaging the growing millennial workforce and understanding their mindset and motivation will be key for your agency in defining duties, assessing skill sets and identifying team leaders.

Finance

  • CFO Panel: Address management concerns, discuss operating efficiencies and internal financial controls and performance indicators.
  • How Population Health and Telemedicine Affect the Bottom Line: Learn how telehealth will show advancement in terms of improved patient satisfaction, increased patient census, reduced cost of care, and decreased nursing visits. 

Hospice & Palliative Care

  • Creating a Pediatric Palliative Care Program: Learn about the interface and collaboration between home care and hospital programs as well as the use of the National Consensus Project to guide current and future program development.
  • The Patient Experience: Learn strategies, action items, and tools to enable your agency to achieve improved patient experience while managing all other operational demands.
  • Ethics of Patient Choice and Aid-In Dying: Discuss how death with dignity/ aid-in-dying laws present new and evolving ethical and legal challenges for agencies in the states where it is legal, or where legislation is pending. 

There are even more break-out sessions to learn from and 5 keynotes not even mentioned! Be sure to take a look at the full brochure to learn about ALL sessions being offered at this years conference!

Go to http://www.NEHCC.com for more information and to register today!

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HCA Partners with Other State Associations to Offer Valuable Webinars

HCA prides itself in providing the most current, important, and in demand educational topics for our members. To do this, we sometimes partner with sister state associations who are willing to offer their programs at member rates. Below you will find some upcoming webinars that are being made available to all HCA of MA members!

Operational Lessons Learned from a Disaster Plan That Didn’t Work
March 7: 1:00-2:30PM

This case study will help your agency better prepare for the unthinkable. Hear the experience of an agency that worked with local and regional groups to develop a comprehensive disaster plan only to discover IT DIDN’T WORK!! Emergency preparedness will be a top priority in upcoming surveys. Failure to comply can result in serious financial penalties, or even loss of your agency’s license. Take the steps necessary to create a plan that works.

Learn More and Register

The Aide’s Role in Confidentiality and HIPAA
March 8: 3:00-4:00PM
This workshop will focus on assisting your In-Home Aides in understanding HIPAA and confidentiality guidelines. This workshop will offer practical tips to ensure that the para-professional adheres to the required privacy standards. Also included: the impact of social media such as Facebook, My Space, YouTube and cell phones, text messages, etc.

Learn More and Register

Re-Imagining the Plan of Care: A Pyramid Model
March 22: 1:00-2:30PM
There are many ways to build a plan of care – but how do you know that the one you are using is effective, comprehensive and will support strong clinical care in the home?

The “Pyramid of Care” uses the comprehensive OASIS assessment you already have as the foundation. Explore the process of identifying critical areas that become the goals of the plan of care, and transform these into skilled interventions. This process will be easy for your clinicians to grasp and implement, will enable them to clearly support skill in each visit, and achieve measurable improvement in the outcome goals attached to each plan.

Learn More and Register

Understand PT & OT Functional Tests: Selecting & Interpreting the Best Assessment Tools
April 5: 1:00-2:30PM
There are so many assessment tool options available to home care, but so little time to research them all! Home care physical therapist and educator Ernest Roy has taken the deep dive to provide webinar participants with an evidenced-based review of tests suitable for field use by Physical and Occupational Therapists. Roy will focus on data norms for specific populations, as well as highlight minimal clinically important differences as well as specificity and sensitivity. Utilize the data you collect from intake to discharge, and improve your functional testing efficacy.

Learn More and Register

The Aide’s Role in Assisting a Patient with Chronic Pain
April 12: 3:00-4:00PM
Our world is aging. The elder population may falsely believe that because they are aging that pain is a normal part of living and is therefore not reported or managed. Since the majority of our patients seen in the home are elderly, this webinar will provide an overview of symptoms the aide may observe and the aide’s role in providing care to those patients experiencing pain.

Learn More and Register