Guest Blog Post: Reducing Winter Loneliness in the Elderly

By: Wendy Drastal, RN
Vice President, HomeCare, Inc., a home care provider in the Merrimack Valley, Northeastern Massachusetts and Southern New Hampshire. To learn more visit their web site at

The cold and snowy winter months can be challenging for many people.  A trip outside, even for a brief errand, can be both difficult and dangerous.  The winter can be especially treacherous for the elderly, who are at risk for broken bones from falls on ice, breathing problems caused by cold air, hypothermia and frost bite.  Many hold less body heat due to a slower metabolism and reduced physical activity, so they feel the cold more severely.  And, as people age, the ability to feel changes in temperature decreases, making it important for elders to monitor the house temperature and to dress in layers.

For the elderly, the winter months can also be long and lonely.  With the holidays over and family members back to work and family responsibilities, January and February can be especially lonely months for the elderly who find themselves homebound with fewer social activities and outside contact.

So what can you do to help an elderly family member, friend or neighbor reduce the isolation and loneliness of winter?

  • Make it a New Year’s resolution to visit once a week for a meal, cup of coffee or just to socialize for an hour or two.
  • Encourage other family members to visit, call or e-mail on a regular basis.
  • Contact your local senior center or community center to check for opportunities for group meals, social programs and outings, or even friendly visitor programs.
  • Buy, fill and hang a bird feeder in a backyard or attach it directly on a window.  Birding activity can be very entertaining and a great topic for conversation.
  • Check the local library for a mobile book loaning program, or offer to pick up and drop off books and magazines.
  • Send a letter.  An old-fashioned letter in today’s age of electronic communication can mean a lot to the elderly and bring a sense of anticipation while awaiting a mail delivery.  Enclose a couple of pictures for added enjoyment.
  • Plan an occasional outing for lunch, a trip to the barber or hairdresser, or for some shopping.

Finally watch for signs of depression.  The elderly are at increased risk for depression due to life changes, medication and illness.

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NHIC- Ask the Contractor January 17th

The Medicare Administrative Contractor, NHIC. Corp., will hold the Hospice & Home Health Ask the Contractor Teleconference (ACT) on January 17th at 10:00 a.m.

Ask-the-Contractor Teleconference is an opportunity to speak directly with the contractor. NHIC staff representing a variety of functions will be available to answer questions. NHIC usually will provide some updates to the home health and hospice community but the majority of this call is dedicated to providers as a question and answer open forum.

Registration is required on NHIC’s website- Education Programs.

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Home Health and Hospice Education Webinars for 1st Quarter 2013.

The Medicare Administrative Contractor for Massachusetts, NHIC, Corp. has posted upcoming Home Health and Hospice Education Webinars for January-March 2013.  Providers are encouraged to participate in these educational sessions.

More information on registration, materials, and training assessments are provided on the Education Programs Information section for NHIC website. Note: Registration is required for all programs.

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Reminder- “Home Health and Hospice ODF” – Wednesday, January 9th

The next Home Health, Hospice & DME Open Door Forum is scheduled for Wednesday, January 9, 2013 at 2:00 PM Eastern Time (ET).

Proposed Agenda

1. Proposal to discontinue the Home Health Advance Beneficiary Notice (HHABN), Form CMS-R-296, and replace the HHABN with a new Home Health Change of Care Notice (HHCCN), Form CMS-10280, and the existing Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131.


3. Home Health Study regarding Access to Care

4. Home Health & Hospice Quality Reporting Update

5. Retroactive Grouper Change for Basel Cell, Squamous Cell, and Unspecified Malignant Cancers for Home Health Services Rendered October 1, 2011 through December 31, 2012

6. Update to OASIS Web-Based Training at: , Addition of Module, OASIS C Online Training: Patient Tracking Domain

7. Flu Vaccination Announcement

8.  Open Q&A


Dial: 1-800-837-1935 & Reference Conference ID: 78868196.

The audio recording of this call that can be accessed by dialing 1-855-859-2056 and entering the Conference ID beginning 2 hours after the call has ended. The recording expires after 2 business days

Encore: 1-855-859-2056; Conference ID: 78868196

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Hospice Quality Reporting WebEx Now Available –Posted 12/5/2012

CMS’ Hospice Quality Reporting Program (QRP) on data entry and submission WebEx training  is now available online.  Hospice providers can view the WebEx at their convenience; no registration is required. It will remain available until April 2013. The training will help hospices prepare for web-based data entry and submission of quality data affecting the FY 2014 reimbursement rates.

The Hospice QRP Data Entry and Submission WebEx addresses how to:

  • Access the Hospice Quality Reporting Program Data Entry and Submission link
  • Register your Hospice Provider and User Account
  • Navigate the Structural Measure data entry, attestation and submission
  • Navigate the NQF #0209 Pain Measure data entry, attestation and submission
  • Access Clinical and Technical Help Desk Support

To meet the hospice quality reporting requirements in order to qualify for full payment of Medicare rates in FY 2014, hospices must submit two measures: the Structural/QAPI measure and the NQF #0209 measure. Reporting of the structural measure may begin Jan. 1, 2013, and must be completed by Jan. 31, 2013, while reporting of data on the pain measure (NQF 0209) must be completed by April 1, 2013.

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CMS Releases New MLN Article

On November 26th, CMS released the Medicare Learning Network  Article- (SE1237) Importance of Preparing/Maintaining Legible Medical Records. This article highlights the importance of legible documentation in avoiding claim denials. The key points highlighted:

  1. General Principles of Medical Record Documentation
  2. Medicare Signature requirements
  3. Amendments, Corrections and Delayed Entries

If you are looking for more facts on amendments, corrections and delayed entries see the Medicare Program Integrity Manual Section The MLN article, Complying with Medicare Signature Requirements, provides a question and answer format for information on signature regulations

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Hospice WebEx Training on Data Submission — Taken Offline

CMS put out notification last week that the WebEx training related to the Hospice Quality Reporting Program (HQRP) was available online.  It was available for a BRIEF time on Wednesday night and Thursday; the WebEx training is temporarily unavailable due to technical issues.  Only the Technical User Guide is available on the website. The contractor is working to correct the issues and will get the training and manual back up as quickly as possible.  The HCA will keep you updated.

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November is National Home Care Month – Help Us Celebrate!

Join the Home Care Alliance in celebrating National Home Care Month throughout November by visiting our new webpage

On that site, the Alliance has posted materials to help home care agencies and advocates celebrate and raise awareness. There are templates for a press release, op-ed’s, and letters to the editor that can be sent to local media as well as downloadable posters that can be posted in your office and community.

Be sure to follow us on Facebook and Twitter where the Alliance will be posting a “Home Care Fact of the Day” each day in November, along with other important news and updates. We have 142 “Likes” and are aiming to get to 150 and beyond!

HCA has plenty of educational and training events in November so please be sure to check our busy calendar of events this month.

Finally, our radio campaign in partnership with WGBH is still ongoing so stay tuned to 89.7 FM or Classical New England (99.5 FM) to hear great sponsorships from HCA members.

For more info on how to celebrate and raise awareness, or if you would like assistance with the press materials, please contact James Fuccione at the Alliance.

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Guest Post: Utilization of Post-Acute Services by ALF Residents

The following is a guest blog post on the utilization of post-acute services by residents of an assisted living facility written by Elizabeth Hogue, Esq. The author plans future articles on this subject so be sure to check back for updates!

As the number of years in which they have been in business increases, ALF’s are more eager to help their residents to “age in place.”  ALF’s often view availability of services from post-acute providers; including Medicare home care, private duty home care, hospice, and home medical equipment (HME); as essential to allow them to achieve this goal.  While ALF’s want to encourage utilization of these types of services by residents, ALF’s cannot lose sight of the fact that the healthcare industry is highly regulated.  With ever-increasing emphasis on fraud and abuse compliance, ALF’s and post-acute providers cannot afford to violate the law.

How can ALF’s encourage the use of services available from post-acute providers by residents?  What are the potential legal pitfalls that ALF’s and post-acute providers must avoid?  The most effective way to maximize utilization of these services may be to take a multi-pronged approach that includes:

1. Assignment of liaisons/coordinators from post-acute providers to ALF’s

Use of coordinators/liaisons at ALF’s raises issues related to violation of the federal anti-kickback statute.  This statute generally prohibits providers from either offering to give or actually giving anything to referral sources in order to induce referrals.  Consequently, liaisons and coordinators must be scrupulous about avoiding the provision of free services to ALF’s and/or their residents.  Possible violations include “staffing” an office with an RN who responds to requests from residents in their apartments or has “office hours” to address health conditions of residents.

Continue reading “Guest Post: Utilization of Post-Acute Services by ALF Residents”

Skin and Wound Handoff Tool – for All Providers

The Massachusetts Pressure Ulcer Collaborative (PUC) recently developed a Skin and Wound Handoff Tool that can be used across the continuum of care.  The PUC was formed in 2010 by the Massachusetts Hospital Association (MHA), Massachusetts Senior Care Association, and the Home Care Alliance of Massachusetts to implement a statewide quality initiative to prevent pressure ulcers across the continuum of care through the promotion of best practice, education and improved communication.

The committee encourages all health care providers to pilot the form and to provide feedback to the committee. If you have any questions or comments please email Colleen Bayard.

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