Introducing the Caregiver Video Resource Center

Working with families is an integral part of home care agencies do. Unlike most other forms of healthcare, their work is done in their clients’ residences and often alongside the 65,000,000 family members, friends, and neighbors who help care for an elderly or disabled person at home.

To help care providers understand what an agency can do for their loved one, the Alliance has produced a series of short, instructional videos with ElderCareSKILLS.org. The videos feature a variety of home health professionals including nurses, therapists, owners, and home care aides answering the most common questions families ask.

Each Monday, we will feature a new video here on the newsfeed.  In the first, Geoffrey Abraskin, PT, DPT of Amedisys Home Health discusses the basics of choosing a home care agency:

There are currently nine videos available both at www.thinkhomecare.org/videos, and on the Alliance’s YouTube channel, with additional ones planned.  You can also subscribe to  ElderCareSKILLS to access these and hundreds of additional videos designed for family caregivers.

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Congratulations To Our Emerging Leaders

The 2012 graduates of the Emerging Leaders programThe 2012 graduates of the Emerging Leaders program
The 2012 graduates of the Emerging Leaders program

This week was Graduation Day for our 2012/13 Emerging Leaders Class. The Emerging Leaders program is a collaborative effort between the Home Care Alliance of MA and Suffolk University’s Moakley Center for Public Management.  Students in the program attend classes – taught by Suffolk faculty – one full day a month for nine months. Upon completing the program, they receive a Certificate in  Home Care Management, as well as course credits to apply towards a master’s level program at Suffolk.

In a ceremony attended by family, friends and faculty, the graduates heard from class speaker Michelle Landry about how the students bonded over, and overcame,  their fear of writing class papers and about the value of the course information.   Keynote Speaker Meg Doherty, CEO of NVNA and Hospice, congratulated the class on their commitment to learning and leadership despite the sacrifices made and the disruption to their lives and that of their families.  “As leaders,” she told the class, “you will not just do a job, but make a difference.”

Congratulations to this year’s graduation class:  Barbara Belony, Jose DeLaRosa, Janez Hicks, Michelle Landry, Mary O’Malley, Michelle Sweeney, Jenna Tarara, Bernadette Ward and Kathy Wisenski.

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Home Health, Hospice & Durable Medical Equipment Open Door Forum

Save the Date:

The Centers for Medicare & Medicaid Services (CMS) will hold the next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum  on Wednesday, January 9, 2013, from 2:00pm – 3:00pm, ET.

To participate in the call, dial: 1-800-837-1935; Conference ID: 78868196

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Fiscal Cliff Deal Reached with No Home Care Cuts or Copays

In the waning hours of the federal legislative session, the Senate passed an agreement to avoid the fiscal cliff that was then approved by the House with none of the feared elements concerning home health care.

The bill extends tax rates for the vast majority of citizens along with a series of other tax-related extenders and unemployment benefits. It also includes a “doc fix” through New Year’s Eve 2013.

U.S. Capitol BuildingThe agreement was approved with bipartisan support and, according to the National Association for Home Care & Hospice (NAHC), there are no cuts to Medicare home health services or hospice care benefits, payments, or payment rates. No home health copays are in this bill and there are no Medicaid cuts affecting home care. Additionally, NAHC found that protection against the Medicare outpatient therapy cap is continued through December 31, 2013.

The “doc fix” is paid for primarily through cuts to hospitals with nearly $15 billion in a combination of coding adjustments and DSH payment reductions. ESRD payments are also affected by a reduction of $4.9 billion.

The CLASS program established to help finance long term care services through a voluntary insurance approach under the Affordable Care Act is repealed under the Senate bill. The repeal has no financial consequence as CMS earlier indicated that it would not implement the CLASS program due to its inability to assure financial viability.

NAHC also notes that a very important provision in the Senate bill is the establishment of a Long Term Care Commission that will be charged with the responsibility to develop a plan for meeting the needs of the growing population of Americans needing care in the home and in other settings. The Commission will have 15 members appointed by the President and Congressional leaders with representation of consumers, older adults, family caregivers, and care providers.

For more on the fiscal cliff and the health care-related implications, see stories below:

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HCA Offering Intro to MOLST

The Home Care Alliance is part of a state-run committee charged to provide education and outreach on Medical Orders for Life Sustaining Treatment (MOLST) and will be holding a free conference call for members on January 3rd from 1:00-2:00pm.

MOLSTAlliance staff who sit on the MOLST Community Outreach and Education Committee with state officials and other organizations will provide an overview of the standardized form being used to translate a patient’s life-sustaining treatment preferences into a medical order that can be honored across all healthcare settings.

Jeanne Ryan, Alliance Board Member and Executive Director of the VNA & Hospice of Cooley Dickinson, will be on the call to explain how that agency worked with their provider partners to educate their community about MOLST and related issues.

Again, the call is free for HCA members who sign up by contacting James Fuccione at the Alliance.

To download the actual form and to find more information on MOLST, visit www.molst-ma.org.

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Timeline Updated for Dual-Eligible Care Demonstration

MassHealth and CMS have agreed to a new implementation timeline for the statewide demonstration to better integrate and coordinate health care services for dually eligible individuals between the ages of 21 and 64.

Obviously, the deadline for selectionselection of ICO’s, or Integrated Care Organizations, has come and gone, but the “readiness review” for those ICO’s has been extended. Previously, the demo was set to begin enrollment on April 1st, but it now appears that the state and CMS have agreed to have the first self-selected enrollments to become effective on July 1st.

See the updated timeline below and visit the state’s demonstration webpage for more info:

ICO Selection Announcement

November 2, 2012
Readiness Review

Nov. 2012 – March/April 2013
3-Way Contracts

March/April 2013
Learning Collaboratives

March 2013 – Ongoing
Implementation Activities

 
       Stakeholder Workgroups: Quality, Notices, Outreach, Admin. Simplification

Dec. 2012 – Ongoing
     Implementation Council

Feb. 2012 – Ongoing
     Ombudsperson

May 2013 – Ongoing
Public Awareness Campaign

April 2013 – Ongoing
Member Outreach Activities

(Members can begin to select ICOs for effective date July 1, 2013)

May 2013 – Ongoing
Self-Selected Enrollments Begin

July 1, 2013
Auto-assignments Effective

(Members notified at least 60 days prior to the effective date)

Oct. 1, 2013; Jan. 1, 2014

Planned Revisions to Home Health Beneficiary Notice-Open for Public Comment

Presently home health agencies (HHAs) are required to use the Home Health Advance Beneficiary Notice (HHABN), CMS-R-296 to provide beneficiaries with change of care notification consistent with HHA Conditions of Participation (COPs) in addition to its liability notice function. Option Box 1 addresses liability, Option Box 2 addresses change of care for agency reasons, and Option Box 3 addresses change of care due to provider orders.

In CMS’ effort to “streamline, reduce, and simplify notices to Medicare beneficiaries,” HHABN Option Box 1, the liability notice portion, will be replaced by the existing Advanced Beneficiary Notice of Noncoverage (ABN) which is approved by Office of Management and Budget (OMB) for conveying information on beneficiary liability. CMS will introduce the “Home Health Change of Care Notice” (HHCCN) as a separate, distinct document to give change of care notice in compliance with HHA conditions of participation. The HHCCN will replace both Option Box 2 and Option Box 3 formats of the HHABN. The single page format of the HHCCN is designed to specify whether the change of care is due to agency reasons or provider orders. Form Number: CMS–10280 (OCN: 0938–New) To obtain copies of the supporting statement and any related forms for the proposed paperwork collections referenced above, go to CMS’ Web Site address at http://www.cms.hhs.gov/, or Email your request, including your address, phone number, OMB number, and CMS document identifier, to Paperwork@cms.hhs.gov, or call the Reports Clearance Office on (410) 786-1326.

The full notice and details for submitting public comments on the proposed changes can be accessed in the Federal Register.  Comments are due by February 11, 2013

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CMS Updates Policy Requirements for Medical Record Corrections

CMS released Transmittal 442, Change Request (CR) 8105 on December 7th. It provides instructions to Medicare contractors regarding amended, corrected, and delayed entries in medical records. This updates the CMS Medicare Program Integrity Manual, Section 3.3.2.5 effective January 8, 2013.

According to this Change Request, the MACs, CERT, Recovery Auditors, and ZPICs are instructed NOT to consider entries that don’t comply with recordkeeping principles, even if exclusion of an entry will result in a claim denial.

In the manual update, “providers are encouraged to enter all relevant documents and entries into the medical record at the time they are rendering the service.” However, the policy goes on to acknowledge that there may be occasions when documentation was not completed or completed properly and may need to be amended. Medicare contractors are told that they are to consider all submitted entries that comply with the widely accepted Recordkeeping Principles, but NOT consider any entries that do not comply with the principles.

Recordkeeping principles for record amendments apply to both paper and electronic medical records. These principles include:

  • Clearly and permanently identify any amendment, correction or delayed entry as such; 
  • Clearly indicate the date and author of any amendment, correction or delayed entry; 
  • Not delete but instead clearly identify all original content.

When correcting a paper medical record, the “principles are generally accomplished by using a single line strike through so that the original content is still readable. Further, the author of the alteration must sign and date the revision. Similarly, amendments or delayed entries to paper records must be clearly signed and dated upon entry into the record.”

CMS acknowledges that although “record keeping within an EHR deserves special considerations” the same principles apply. EHR corrections or delayed entries must:

  • Distinctly identify any amendment, correction or delayed entry, and;
  • Provide a reliable means to clearly identify the original content, the modified content, and the date and authorship of each modification of the record.

The manual update also states “If the MACs, CERT or Recovery Auditors identify medical documentation with potentially fraudulent entries, the reviewers shall refer the cases to the ZPIC and may consider referring to the RO and State Agency”.

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Encore-Special ODF for Hospice Providers

Did you miss the December 19th Open Door Forum that presented information about the Hospice Quality Reporting Program?

CMS announced that this ODF will have an encore recording available until midnight December 22nd

Agenda Topics included:

  • Updates about the upcoming availability of the data submission website
  • Information about how to access the data submission website and create a user account
  • Details about the data submission process
  • Question and Answer session

ENCORE CALL IN:  1-855-859-2056

CONFERENCE CODE:  81540883

 

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DPH Mandates-Electronic Submission of Plans of Correction

The MA Department of Public Health, Division of Health Care Quality, recently announced in Circular Letter 12-12-577 effective January 1, 2013, certified facilities, agencies and providers will be required to submit Plans of Correction (POC) by email for all statements of deficiencies.

DPH has created three email addresses to ensure that POCs can be submitted to the appropriate surveyors and regions for review:

Detailed instructions for the submission of POCs by email, including the specific email address to which the POC should be sent, will be included in the cover letter to the facility for each Statement of Deficiency.

The following must be observed when submitting POCs by email:

  • Title the email “[Facility/agency name] POC for Survey Ending [date of survey]
  • Scan the POC, signed and dated, separately from any supporting documentation
  • Scan the POC and supporting documentation as separate .pdf files
  • Name the scanned files using the facility name and ending date of the survey
  • Do not send a hard copy of the POC by mail or fax when emailing a POC

When the POC is received at the appropriate email address, the agency/provider will receive an automated response indicating that the POC has been received. Addressing the email with a facility name and date of survey will generate an auto-reply email which will serve as a receipt for the initial submission of a POC, and indicate that the POC has been received by the Department and is being processed for review.

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