Home Health & Hospice Articles by Topic: Administration and Management

Top 10 consumer marketing sources in 2018

• Homecare Direction, Issue 10, October 11, 2019

  Search engine optimization (SEO) was the top consumer marketing source for private duty agencies in...

Leverage Google business listing, reviews to earn prime slot in search

• Homecare Direction, Issue 10, October 11, 2019

  Online searches for in-home care are growing, but if you’re not making smart decisions around...

Long-awaited rule on overtime exemption slated to take effect January 1

• Homecare Direction, Issue 10, October 11, 2019

  The U.S. Department of Labor (DOL) has announced its new regulation outlining who is eligible to...

As PDGM approaches, it's increasingly important to fight for hospital referrals

• Homecare Direction, Issue 9, September 4, 2019

  With the Patient-Driven Groupings Model (PDGM) launching on Jan. 1, 2020, agencies are recognizing...

Make sure to use CMS' tool to examine how your agency will fare under PDGM

• Homecare Direction, Issue 7, July 8, 2019

  When preparing for the Patient-Driven Groupings Model (PDGM), one crucial step agencies should...

Educate marketers about PDGM, and use data to formulate a strategy

• Homecare Direction, Issue 7, July 8, 2019

  It’s not too early to alert your agency’s marketing representatives that an entirely...

Should we stop using non-clinicians at intake under PDGM?

• Homecare Q&A, Issue 6, June 28, 2019

  No. I recommend you continue with utilizing non-clinicians in intake.

Take these crucial actions to ensure success during CMS' Review Choice Demo

• Homecare Direction, Issue 6, June 6, 2019

  Agencies seeking to pass CMS’ Review Choice Demonstration (RCD) with flying colors should...

Why aren’t patient rights citations common and will they become a bigger issue?

• Homecare Q&A, Issue 5, May 31, 2019

  There were some things in the patient rights requirements that were new, that were different.

Can you answer my question about the scope of orders?

• Homecare Q&A, Issue 5, May 31, 2019

  You have a specific question about the scope of physician orders and co-signatures.

In your mind, should my agency's long-term PIP goal be to reduce hospitalizations to the national average?

• Homecare Q&A, Issue 5, May 31, 2019

  I personally don’t like national averages.

In advance of PDGM, now is a good time to set up or reexamine lines of credit

• Homecare Direction, Issue 5, May 8, 2019

  Set up a financial cushion for your agency so it can withstand financial rough patches that may...

Agencies' cash flow plans under PDGM

• Homecare Direction, Issue 5, May 8, 2019

  Many agencies don’t yet have a plan for how to withstand potential cash flow disruptions...

Should we use a risk assessment form for hospitalizations?

• Homecare Q&A, Issue 4, April 18, 2019

  I don’t like adding extra forms and paperwork for staff.  

Is it legal for the outpatient therapy agency to provide services in the assisted living?

• Homecare Q&A, Issue 3, March 22, 2019

  Therapy can provide Part B billing if patients are outpatient or even in their homes.

Private duty office staff turnover overall and by revenue range

• Homecare Direction, Issue 3, March 6, 2019

  The overall median turnover rate for office staff in private duty agencies in 2017 was 30...

I have a question about therapists submitting a list of patient medications for the nurse to review.

• Homecare Q&A, Issue 2, February 25, 2019

  You say that your agency just learned that according to the revised CoPs, in rehabilitation...

We have an issue with M2003 (Medication follow-up).

• Homecare Q&A, Issue 2, February 25, 2019

  The quality measure “drug regimen review conducted with follow-up for identified...

For PDGM, agencies will need to change how they handle case conferencing

• Homecare Direction, Issue 2, February 5, 2019

  Case conferences will take on increased importance when the Patient-Driven Groupings Model (PDGM...

Reduced rural add-on payments cause agencies to create efficiencies

• Homecare Direction, Issue 2, February 5, 2019

  Rural add-on payments have changed significantly for many agencies this year, with some providers...

Is the patient in the following scenario considered to be incontinent of stool for the M1620 question?

• Homecare Q&A, Issue 1, January 16, 2019

  This scenario is not specifically addressed in the OASIS Q&As.

What is G1024 (Authentication) and how can agencies avoid getting cited for it?

• Homecare Q&A, Issue 1, January 16, 2019

   G1024 (Authentication) is one of the more common standard-level deficiencies in 2018.

Do agencies have a responsibility to train staff to identify whether patients are addicted to opioids?

• Homecare Q&A, Issue 1, January 16, 2019

  You asked whether agencies have a responsibility to train staff to identify whether patients are...

Active year for mergers & acquisitions; small agencies continue to struggle

• Homecare Direction, Issue 1, January 4, 2019

  Merger-and-acquisition activity in the home health market remained hot in 2018, with some of the...

Will community-based agencies survive in PDGM?

• Homecare Q&A, Issue 17, December 17, 2018

  Although the new payment model does not value community-based referrals as well, I believe that...

My agency appears to be losing a significant amount of money under PDGM. What strategies would you recommend I take?

• Homecare Q&A, Issue 16, November 20, 2018

  PDGM is designed to be budget neutral, but the impact on payment depends on type of provider and...

Do per-day sanctions begin when a surveyor finds a deficiency or do they begin on the date in the medical record when the deficiency occurred?

• Homecare Q&A, Issue 16, November 20, 2018

  I’ve seen it go both ways.

What recommendations would you have when it comes to caring for patients who have lice or scabies?

• Homecare Q&A, Issue 15, October 19, 2018

  Staff should use contact precautions with a contact precaution kit. In general, wear protective...

Policies/procedures-volunteers and staffing [E-0024] is one of the most common standard-level deficiencies under the revised CoPs. Why?

• Homecare Q&A, Issue 15, October 19, 2018

  During an emergency, CMS has the expectation that agency staff should be able to assist in their...

What should I do if I take on a patient with a diagnosis that fits within one of the six clinical groups under PDGM?

• Homecare Q&A, Issue 14, September 21, 2018

  The 2019 proposed PPS rule references this concern in several areas.

What recommendations/strategies do you have for gathering documentation fast so we can bill quicker under PDGM?

• Homecare Q&A, Issue 14, September 21, 2018

  CMS estimates the median length of days for request for anticipated payment (RAP) submission is 12...

Is a home health face-to-face visit required for Medicare Advantage plans?

• Homecare Q&A, Issue 14, September 21, 2018

  CMS doesn't require Medicare Advantage plans to have a face-to-face document for home health.

In the following scenario, should my agency write an order stating the patient is in compliance of taking medications as ordered?

• Homecare Q&A, Issue 14, September 21, 2018

  In the scenario you describe, your agency admitted a patient when she was discharged home from the...

In this scenario, is my agency required to conduct a transfer then ROC, or not?

• Homecare Q&A, Issue 14, September 21, 2018

  In the scenario you discuss, your agency had a patient that was a full admission to the hospital.

Explain CMS' moratoria for agencies in certain areas and how the demonstration recently changed.

• Homecare Q&A, Issue 14, September 21, 2018

  The demonstration gives an opportunity for providers and suppliers otherwise subject to the...

Is it legal to have one of our home health patients pay the same CNA privately on the days the patient is not being seen under the home health benefit?

• Homecare Q&A, Issue 13, September 4, 2018

  Does the patient require hours your agency is not providing, but should be?

Can you give pointers on "environmental cleaning and disinfection" as mentioned in draft guidelines for the revised CoPs?

• Homecare Q&A, Issue 13, September 4, 2018

  You should have a policy in place that describes things like a bag barrier and how to clean your...

What advice do you have about how an agency could improve when it comes to timely initiation of care?

• Homecare Q&A, Issue 13, September 4, 2018

  This is a difficult question to answer, not knowing your agency processes. But there are several...

Can you explain in this scenario whether our surveyor is correct and what our agency should do?

• Homecare Q&A, Issue 13, September 4, 2018

  In the scenario you discuss, your agency is in Indiana and are currently going through a federal...

Is it acceptable for a physician to sign a home health plan of care when he/she is not the physician named in the locator box on the plan of care?

• Homecare Q&A, Issue 13, September 4, 2018

  In the scenario you discuss, the signing physician is also the MD certifying the patient for home...

Are there things we should do differently with claims to prepare for PDGM?

• Homecare Q&A, Issue 12, July 25, 2018

  PDGM is going to be such a rapid cycle flurry of action.

What's an example of a billing aberrancy that's prompting contractors to target agencies in targeted probe-and-educate reviews?

• Homecare Q&A, Issue 12, July 25, 2018

  We see inappropriate recertifications all over the place.

Looking for some guidance on a patient with a closed stage IV pressure ulcer who now presents with non-blanchable redness to the same injury site but skin is intact.

• Homecare Q&A, Issue 12, July 25, 2018

  Once the wound is fully granulated and the wound surface is covered with epithelial tissue, the...

How should I act in the following scenario involving power of attorney (POA)?

• Homecare Q&A, Issue 12, July 25, 2018

  First determine if the POA is medical and if the patient is incapacitated.

Would M2001 be accurate if marked "No - no issues found" in a scenario I'll describe below?

• Homecare Q&A, Issue 12, July 25, 2018

  It is up to clinicians to determine, in their clinical judgement, if the omission is a clinically...

Can advanced practice nurses (APNs) sign orders for home health patients?

• Homecare Q&A, Issue 12, July 25, 2018

  APRAs cannot write orders for a plan of care or subsequent verbal orders.

What outside-the-box strategies do you have when it comes to recruitment and retention?

• Homecare Q&A, Issue 12, July 25, 2018

  There are several strategies to consider.

If a patient requires assistance to complete ADLs but is independent with all gait and mobility, can the person still be considered homebound per Medicare guidelines due to the taxing effort of getting ready to leave the home?

• Homecare Q&A, Issue 11, July 15, 2018

  This question cannot be answered, as each eligibility is established with each particular patient.

We have a policy that the patient must sign the tablet (EMR) post-visit. If a patient lives in an ALF and has dementia, is it OK to ask the patient to sign?

• Homecare Q&A, Issue 11, July 15, 2018

  There is no CMS regulation to have the EMR/tablet/daily visit record signed.

What if the PT and OT are ordered at SOC and the PT does an evaluation and no further treatments are ordered/planned but the OT does an eval and stays in alone for the episode?

• Homecare Q&A, Issue 11, July 15, 2018

  Per §1814(a)(2)(C) and §1835(a)(2)(A) of the Social Security Act, the patient must be in...

Is it OK to accept a doctor's signature on one page of a multi-page order as being signed?

• Homecare Q&A, Issue 10, June 11, 2018

  It is important for the pages of the plan of care to be clearly numbered if there is more than one...

Is it necessary to document the RVVO piece of a verbal order?

• Homecare Q&A, Issue 10, June 11, 2018

  The Joint Commission (TJC) includes a requirement under the Provision of Care, Treatment and...

Can we send an LPN to have consents signed and do wound care at SOC if the RN can’t come timely?

• Homecare Q&A, Issue 10, June 11, 2018

  PNs - along with occupational and physical therapy assistants - aren't qualified to establish the...

What suggestions do you have for how agencies can achieve success on pre- or post-payment reviews?

• Homecare Q&A, Issue 10, June 11, 2018

  Agencies need to begin now to ensure that they are getting valid face-to-face documentation with...

How likely is that CMS adopts a payment model other than the Home Health Groupings Model? And other than there being budget neutrality this time around, what aspects might change from what was proposed last year?

• Homecare Q&A, Issue 8, April 17, 2018

  We?re going to see something along the lines of the Home Health Groupings Model.

Does eliminating therapy thresholds under a revised payment model such as HHGM mean that regardless of how many therapy visits an agency provides, payments will remain the same?

• Homecare Q&A, Issue 8, April 17, 2018

  It remains to be seen what the new payment model will look like.

For hospice, can activity done over the phone with a patient by a chaplain or social worker be considered a visit if the call is extensive and covers several items from the plan of care (POC)? What about for the purposes of meeting HIS quality measures?

• Homecare Q&A, Issue 8, April 17, 2018

  No conversation on the phone can be billable, as is the same for HIS quality measures.

How do we count the 14-day certified home health aide supervisory visit? Is the day of the visit day 1 or is the day after the visit day 1?

• Homecare Q&A, Issue 8, April 17, 2018

  The supervisory visits need to be no less frequently than every 14 days from the date of the first...

I'm a new administrator and I;m just not sure how much I should be delegating, it seems like I should be doing a lot myself, but it's too much. Any advice?

• Homecare Q&A, Issue 7, April 3, 2018

  An extremely common area where administrators, espe-cially those who are new to the position, can...

New online training for surveyors highlights the importance of a detailed plan of care

• Homecare Direction, Issue 3, March 29, 2018

  CMS’ newly posted surveyor training reiterates the need for home health agencies to ensure...

MedPAC--yet again--recommends 5% home health payment reductions

• Homecare E-News, Issue 13, March 26, 2018

  The Medicare Payment Advisory Commission (MedPAC) is once again recommending a 5% Medicare payment...

Consider these 9 ways to avoid the hazards of an OSHA investigation

• Homecare Direction, Issue 3, March 26, 2018

  The lack of an appointed head of the Occupational Safe-ty and Health Administration (OSHA) has...

MedPAC encourages Medicare beneficiaries to use higher-quality PAC providers

• Homecare E-News, Issue 12, March 19, 2018

  During the Medicare Payment Advisory Commission’s (MedPAC) public meeting on Thursday, March...

What does our administrator job description need to cover?

• Homecare Q&A, Issue 6, March 17, 2018

  As with any position in the company, it is important to set clear expectations for the position...

CMS extends moratoria on new home health agencies in 6 metro areas

• Homecare E-News, Issue 6, February 5, 2018

  CMS has once again extended its moratoria on new home health agencies and new branches of existing...

Our agency looks at the PEPPER reports, but what pieces of information are most important?

• Homecare Q&A, Issue 2, January 17, 2018

  Note PEPPER’s six target areas: Average case mix. This target area calculates average case...

What are the 2018 ICD-10 changes?

• Homecare Q&A, Issue 2, January 17, 2018

  There are approximately 363 new codes, 142 deletions, and more than 250 code revisions in the 2018...

Buckle up: IRS drives mileage rates up one cent for 2018

• Homecare E-News, Issue 3, January 15, 2018

  The IRS has announced that standard mileage rates for the use of a car in 2018 rose to 54.5 cents...

How can we better handle marketing efforts?

• Homecare Q&A, Issue 1, January 3, 2018

  This is an area that can lead to trouble for an agency and its administrator. De-veloping new...

DOL appeals ruling that invalidated white-collar exemption changes

• Homecare E-News, Issue 49, December 22, 2017

  The Department of Labor (DOL) recently decided to appeal a ruling that effectively ended changes to...

Humana, private equity firms to acquire Kindred Healthcare in $4.1 billion deal

• Homecare E-News, Issue 49, December 22, 2017

  Ending the year with a jaw-dropping acquisition in the home care industry, health insurer Humana...

CMS removes dozens of items from OASIS, adds items to comply with IMPACT Act

• Homecare Direction, Issue 12, December 18, 2017

  Many items will be eliminated from the OASIS and several others will be added to the assessment...

How can I effectively audit and monitor risk areas of my agency?

• Homecare Q&A, Issue 24, December 17, 2017

  With the myriad of responsibilities a home health administrator must discharge each day, auditing...

New OIG report spotlights personal care services for fraud

• Homecare E-News, Issue 47, December 11, 2017

  A December 2017 OIG report details how personal care services (PCS) have risen in Medicaid fraud...

Prepare for new CoPs: Draft interpretive guidelines for the CoPs answer some questions, create others

• Homecare Direction, Issue 12, December 11, 2017

  CMS’ long-awaited draft version of the interpretive guidelines for the revised Home Health...

CJR localities halved; hip fracture episode payment model eliminated

• Homecare E-News, Issue 46, December 4, 2017

  CMS has finalized its plan to cancel four mandatory episode payment models for common cardiac and...

CMS will not move forward with Home Health Groupings Model in 2019

• Homecare Direction, Issue 12, December 4, 2017

  Actions that home health agencies and advocacy or-ganizations took to combat CMS’ proposed...

How do we challenge our survey?

• Homecare Q&A, Issue 23, December 1, 2017

  Regardless of whether you determine to challenge a survey, the Plan of Correction must be...

We are revamping our job descriptions. What advice do you have for creating good job descriptions?

• Homecare Q&A, Issue 23, December 1, 2017

  Job descriptions that do not reflect the reality of what staff members actually do or are expected...

CMS releases new guidance about subunits

• Homecare E-News, Issue 45, November 27, 2017

  CMS has issued new guidance that explains how agencies can go about converting subunits to...

In which format and structure should we conduct our physician queries?

• Homecare Q&A, Issue 22, November 17, 2017

  Choosing the right format will depend on what information is lacking. Queries are not “one...

TJC approves revised standards in advance of CMS' emergency prep requirement

• Homecare E-News, Issue 43, November 13, 2017

  After CMS review, The Joint Commission has finally prepublished revisions to the Emergency...

How do we identify a new ADR in hospice?

• Homecare Q&A, Issue 21, November 2, 2017

  MACs use the Fiscal Intermediary Standard System (FISS) to process Medicare Part A claims...

How can we ensure our performance improvement projects are successful?

• Homecare Q&A, Issue 21, November 2, 2017

  The most successful performance improvement projects (PIP) have several attributes in common:

We struggle with documenting M1860 accurately. Any help?

• Homecare Q&A, Issue 21, November 2, 2017

  Many agencies have had great success with Ambulation/Locomotion (M1860), but others have...

How can we improve our HHCAHPS scores?

• Homecare Q&A, Issue 21, November 2, 2017

   There are many steps agencies can take to improve their HHCAHPS scores. Among them are the...

Is there a regulation that states that RNs cannot trim the toenails of a patient with diabetes?

• Homecare Q&A, Issue 21, November 2, 2017

  A nurse should be skilled in cutting toenails, but because of the increased risk of liability if...

November is Home Care and Hospice Month

• Homecare E-News, Issue 42, November 2, 2017

  November marks Home Care and Hospice month, according to CMS. Now is the time to ensure your...

CMS decides not to move forward with Home Health Groupings Model in 2019

• Homecare E-News, Issue 42, November 2, 2017

  Agencies can breathe a deep sigh of relief. CMS won’t launch its drastically revised home...

NAHC attendees receive details about targeted re-views and odds HHGM will happen

• Homecare Direction, Issue 11, November 1, 2017

  The big buzz at the National Association for Home Care & Hospice (NAHC) an-nual conference in...

NAHC interim president: Odds of HHGM happening in 2019 are 50/50

• Homecare E-News, Issue 40, October 23, 2017

  The odds of the home health industry avoiding the Home Health Groupings Model in 2019 have...

Do we need clinical staffing benchmarks?

• Homecare Q&A, Issue 20, October 17, 2017

  Agencies must identify not only the appropriate compensation for staff but also the...

How can we prevent readmissions related to pain?

• Homecare Q&A, Issue 20, October 17, 2017

  Have clinicians follow up the next day when patients have a change in pain medications or...

How can we use electronic clinical pathways to improve outcomes?

• Homecare Q&A, Issue 20, October 17, 2017

  Consider adopting clinical pathways to increase nursing visit efficiency, decrease...

Where is it specifically written that an NP or a PA cannot sign homecare orders?

• Homecare Q&A, Issue 20, October 17, 2017

  There is no language specifically stating an NP or PA cannot give orders. Rather, the rules...

How would we bill the following scenario?

• Homecare Q&A, Issue 20, October 17, 2017

  On Monday, a nurse assesses the patient’s condition, assesses the wound, and applies a new...

CHAP now approved for California

• Homecare E-News, Issue 39, October 16, 2017

  Community Health Accreditation Partner (CHAP) is now an approved accreditation organization to...

New Medicare card design, fact sheet released by CMS

• Homecare E-News, Issue 38, October 9, 2017

  As part of ongoing efforts to raise awareness about the upcoming change to Medicare numbers and...

If I was to leave this job, do I still qualify as an administrator for home health under the new home health CoPs or am I just grand fathered in under the old rule because I have held this position (my current position)?

• Homecare Q&A, Issue 19, October 3, 2017

  Yes, the personnel qualification requirements for HHA administrators at §484.115(a) will...

Protect patients during hurricanes by identifying their need for immediate care

• Homecare Direction, Issue 10, October 2, 2017

  The way Texas and Florida agencies reacted to the recent catastrophic hurricanes should serve as a...

Staff trainer quiz

• Homecare Direction, Issue 9, September 29, 2017

  1. Which of the following is not a main risk factor for developing kidney disease, as discussed in...

Staff trainer: Kidney disease

• Homecare Direction, Issue 9, September 29, 2017

  The kidney is a bean-shaped organ that is about the size of a fist. Everyone has two kidneys...

Focus on starting care timely to impact star ratings, meet QAPI requirement

• Homecare Direction, Issue 9, September 29, 2017

  Updating the referral date for all patients who experi-ence a delay in discharge from inpatient...

Emergency prep tip: Pay attention to patients' DME needs

• Homecare E-News, Issue 36, September 25, 2017

  In advance of a disaster such as a hurricane, also consider whether each patient has necessary...

Educate patients and staff on CABG care to improve rehospitalization rates, get referrals

• Homecare Direction, Issue 9, September 25, 2017

  The rehospitalization rate for coronary artery bypass graft (CABG) surgery patients receiving...

What kind of personnel policies should we have?

• Homecare Q&A, Issue 18, September 19, 2017

   Some example of areas that an agency’s personnel policies should address are:

Tip: Follow policy on staff discipline and discharge

• Homecare E-News, Issue 35, September 18, 2017

  The agency’s policies and procedures will include a discipline and discharge policy. It is...

Home health agency helps elderly displaced by Harvey find homes

• Homecare E-News, Issue 35, September 18, 2017

  A Texas-based home health agency is teaming up with the Red Cross to help senior citizens forced...

Coding corner: FY 2018 coding guide-lines: "In" will be equivalent to "with" starting October 1

• Homecare Direction, Issue 9, September 18, 2017

  Conditions linked in the Alphabetic Index by the word “in” should be considered...

What should our agency be aware of during hurricane season?

• Homecare Q&A, Issue 18, September 17, 2017

  Excellent question, given the active season we’ve been having. You must comply with...

DACA will affect older Americans, reports New York Times

• Homecare E-News, Issue 34, September 11, 2017

  Last week, the Trump administration announced a move to end the Deferred Action for Childhood...

Declaration of Public Health Emergency for United States Virgin Islands, Commonwealth of Puerto Rico and State of Florida, CMS waivers enacted

• Homecare E-News, Issue 34, September 11, 2017

  The President declared a state of emergency for the United States Virgin Islands, Commonwealth of...

MAC spokesman: Probe-and-educate review has high error rate, could expand

• Homecare Direction, Issue 8, August 25, 2017

  Two months after CMS said there was no plan for another round of the probe-and-educate review for...

CMS proposed rule changes bundled payments

• Homecare E-News, Issue 32, August 21, 2017

  A proposed rule (CMS-5524-P) released by CMS on August 15, 2017 would make the Comprehensive Care...

Hospice Compare released; hospices must step up efforts on pain assessments

• Homecare E-News, Issue 32, August 21, 2017

  Hospice Compare’s launch Aug. 16 confirms that, for the most part, hospices already perform...

How can we create effective physician queries for better clinical documentation improvement (CDI)

• Homecare Q&A, Issue 16, August 17, 2017

  Why are physician queries so critical to accurate documentation and coding? The answer can be...

Is there anything agencies can do to stop HHGM from coming in 2019?

• Homecare Q&A, Issue 16, August 17, 2017

  If the HHGM as currently conceived is to be avoided, the industry must provide a large volume of...

Why is the HHGM eliminating the use of therapy service thresholds to case mix-adjust payments?

• Homecare Q&A, Issue 16, August 17, 2017

  This change is significant but not terribly surprising.

Why is CMS switching to a 30-day payment model?

• Homecare Q&A, Issue 16, August 17, 2017

  Based upon a data analysis, CMS concluded that on average the first 30 days of an episode were...

What happens under HHGM when an agency has a claim rejected as a questionable encounter?

• Homecare Q&A, Issue 16, August 17, 2017

  CMS states in its comments that claims for “questionable encounters” will be returned...

HHGM uses the patient's principal diagnosis to place the patient within one of six clinical groupings. Will all episodes easily fit within those categories?

• Homecare Q&A, Issue 16, August 17, 2017

  No. In the 2018 proposed PPS rule, CMS notes that 19% of episodes it reviewed in preparing for...

Homecare Q&A, August 17, 2017

• Homecare Q&A, Issue 16, August 17, 2017

  Homecare Q&A, August 17, 2017

Create a patient rights verification form to prevent survey citations related to revised CoPs

• Homecare Direction, Issue 8, August 14, 2017

  Create a checklist to verify that your agency has explained to patients and/or their legal...

Industry expert: New payment system detailed in PPS rule will be a "game changer"

• Homecare Direction, Issue 8, August 7, 2017

  Home health stakeholders are readying themselves for drastic changes to the way CMS plans to pay...

How can we prepare for the pre-claim demo?

• Homecare Q&A, Issue 5, August 3, 2017

  Become more proactive. You no longer can wait for face-to-face documentation to arrive within...

How does the new HHGM payment rule for 2019 affect my therapy services?

• Homecare Q&A, Issue 15, August 3, 2017

  In the new proposed home health PPS rule, CMS states agencies providing a larger percentage of...

Moratoria on enrollment for certain home health agencies extended

• Homecare E-News, Issue 29, July 31, 2017

  According to the Federal Registrar, enrollment of new Medicare home health agencies, subunits, and...

New HHGM for 2019 is major overhaul

• Homecare E-News, Issue 29, July 31, 2017

  The introduction of the Home Health Groupings Model (HHGM) into the proposed rule means preparing...

Agencies' payments will drop in 2018

• Homecare E-News, Issue 29, July 31, 2017

  While the HHGM is the most significant long-term change for agencies’ payments, in the short...

New emergency preparedness guidelines provide clues for what surveyors will focus on

• Homecare Direction, Issue 7, July 21, 2017

  Review emergency preparedness policies and procedures at least annually, and make sure they...

We are looking to decrease our rehospitalization rate but we do have a decent number of patients with multiple chronic conditions. What can we do? Can telehealth help? Some of our patients are so frail.

• Homecare Q&A, Issue 14, July 17, 2017

  It’s true that you will struggle. A study of hospitalizations using a national all-payer...

When can we expect to see interpretive guidelines? What should our agency be doing given the new CoP delay?

• Homecare Q&A, Issue 14, July 17, 2017

  The clock has been reset, and agencies that haven’t taken steps to prepare for the revised...

Changes to make with new Medicare cards

• Homecare E-News, Issue 27, July 17, 2017

  The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove social security...

OSHA electronic reporting raises concerns for healthcare providers

• Homecare E-News, Issue 27, July 17, 2017

  Less than one week before the July 1 compliance date, OSHA officials delayed a new electronic...

Turn the Trump transition into success for your agency

• Beacon Institute On-Demand Webcast Library, Issue 2, February 28, 2017

  Turn the Trump transition into success for your agency

Federal judge issues nationwide preliminary injunction to overtime exemption rule

• Homecare E-News, Issue 45, November 28, 2016

  Last week, a federal judge with the U.S. District Court for the Eastern District of Texas issued a...

Effect of election on Medicare

• Homecare E-News, Issue 44, November 21, 2016

  The National Association of Home Care & Hospice is following how the presidential election...

OIG Work Plan for home health and hospice released

• Homecare E-News, Issue 44, November 21, 2016

  The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released...

In Focus: Authors of study suggest framework for optimizing home health value

• Homecare E-News, Issue 40, October 24, 2016

  The final report from the Alliance for Home Health Quality and Innovation (AHHQI)’s Future...

Weekly Roundup

• Homecare E-News, Issue 30, August 6, 2016

  In this week's roundup: Pre-claim review pilot goes live in Illinois—2 days late. The...

Weekly Roundup

• Homecare E-News, Issue 28, July 25, 2016

  In this week's roundup: New HHA PEPPER is now available. A new release of the Program...

I want to make sure I am in compliance regarding teaching and training activities. How do you properly document teaching?

• Homecare Q&A, Issue 14, July 17, 2016

  Teaching and training plays a significant role in homecare and is addressed in the Medicare Benefit...

What can the physician write for duration of care with patients who open and close with leg ulcers?

• Homecare Q&A, Issue 14, July 17, 2016

  According to the National Association for Homecare & Hospice (NAHC):

Weekly Roundup

• Homecare E-News, Issue 26, July 11, 2016

  In this week's roundup: False claims penalties to double. Penalties for fraud by healthcare...

In Focus | Supreme Court Refuses Minimum Wage Case

• Homecare E-News, Issue 25, June 27, 2016

  The U.S. Supreme Court has declined to hear Home Care Association of America v. Weil, which means...

Weekly Roundup

• Homecare E-News, Issue 25, June 27, 2016

  In this week's roundup: CMS revises ICD-10 codes. CMS officially finalized the first major...

Weekly Roundup

• Homecare E-News, Issue 24, June 20, 2016

  In this week's roundup: Study: Home health cuts costs of CJR. The use of home health...

In Focus: NAHC submits comments on OASIS-C2

• Homecare E-News, Issue 22, June 6, 2016

  The National Association for Home Care & Hospice (NAHC) has raised concerns regarding...

Weekly Roundup

• Homecare E-News, Issue 22, June 6, 2016

  In this week's roundup: House members slam home health prior authorization proposal.  A...

What advice do you have regarding policies in homecare agencies? We are reviewing ours and aren't sure if we should have more or less.

• Homecare Q&A, Issue 11, June 3, 2016

  First and foremost, a policy and a procedure are two entirely different animals. A policy is...

Weekly Roundup

• Homecare E-News, Issue 21, May 23, 2016

  In this week's roundup: Overtime laws could change the game for home health: The Department...

What factors should help determine home health aide utilization?

• Homecare Q&A, Issue 10, May 17, 2016

  Factors that can impact the number of home health aide referrals as well as the number of visits...

What experience and training do you need to require of an aide for hire?

• Homecare Q&A, Issue 8, April 19, 2016

  As a Medicare-certified homecare agency, I historically hired aides that have completed the CNA/HHA...

Weekly Roundup

• Homecare E-News, Issue 13, March 28, 2016

  The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has launched...

Weekly Roundup

• Homecare E-News, Issue 12, March 21, 2016

  The CMS Office of Minority Health last week unveiled a snapshot of chronic disease-related service...

Weekly Roundup

• Homecare E-News, Issue 11, March 14, 2016

  An article titled “A Case Exemplar for National Policy Leadership: Expanding Program of...

Weekly roundup

• Homecare E-News, Issue 7, February 15, 2016

  CMS intends to start a Medicare Probable Fraud Measurement Pilot for home healthcare services...

Patients who experience a decline in their condition upon their discharge from home health are impacting our outcome scores.

• Homecare Q&A, Issue 1, January 3, 2016

  You are correct, M1034 is risk adjusted. Please be sure clinicians are answering response “3...

In Focus | Lack of Oversight Blamed in Poor Home Health Labor Standards

• Homecare E-News, Issue 51, December 28, 2015

  Homecare workers achieved a victory when the Department of Labor ruled they are entitled to...

Weekly Roundup

• Homecare E-News, Issue 51, December 28, 2015

  CMS data shows cost disparities in home health services Not unlike hospital procedures and tests...

In Focus | CMS releases home health data

• Homecare E-News, Issue 50, December 21, 2015

  The Centers of Medicare & Medicaid Services (CMS) has released a new public data set, the Home...

Weekly Roundup

• Homecare E-News, Issue 50, December 21, 2015

  The tentative date for the next Home Health, Hospice & Durable Medical Equipment (DME) Open...

Where do we begin with implanting best practices? What benefits come with doing so?

• Homecare Q&A, Issue 24, December 17, 2015

  In simplest terms, a best practice is a process or procedure that consistently produces superior...

Which assessments should the nurse do when the patient receiving only personal care services now needs and qualifies for Medicare coverage? What about when the patient switches from Medicare to Medicaid?

• Homecare Q&A, Issue 24, December 17, 2015

  The first step in answering these questions is to know the requirements for data collection and...

In Focus | Understanding value-based purchasing in the final rule

• Homecare E-News, Issue 49, December 14, 2015

  Although the final rule contained several notable changes to the proposed VBP pilot set to launch...

Weekly Roundup

• Homecare E-News, Issue 49, December 14, 2015

  The Centers for Medicare & Medicaid Services (CMS) will host an open door forum on Thursday...

Weekly Roundup

• Homecare E-News, Issue 48, December 7, 2015

  The National Quality Forum (NQF) announced its plan to review standardized performance measure...

Are we responsible for caring for assistive devices?

• Homecare Q&A, Issue 23, December 4, 2015

  Yes. Maintaining, cleaning, and caring for the assistive device can be done by the home health...

How can we document to support supply utilization and payment?

• Homecare Q&A, Issue 23, December 4, 2015

  Documentation will be important to support supply utilization and payment. Claims must include...

What content would be in a best practice statement for homecare providers?

• Homecare Q&A, Issue 23, December 4, 2015

  Best practice should identify clinical actions—assessment, teaching, procedures...

In Focus | PACE program approved, opens opportunities for HHAs

• Homecare E-News, Issue 46, November 23, 2015

  President Obama recently signed into law the Innovation Act, which allows more people and...

Weekly Roundup

• Homecare E-News, Issue 46, November 23, 2015

  Vets waiting, even dying, for home health care; telemedicine gains momentum After the Inspector...

How can we prepare for staff interviews during a survey?

• Homecare Q&A, Issue 22, November 17, 2015

  How can we prepare for staff interviews during a survey?

How do home visits work when you are having a survey?

• Homecare Q&A, Issue 22, November 17, 2015

  How do home visits work when you are having a survey?  

Inside Story | Fostering a culture of accountability

• Homecare E-News, Issue 44, November 9, 2015

  Before you can work toward achieving accountability, you need to ensure that you understand what...

Weekly Roundup

• Homecare E-News, Issue 44, November 9, 2015

  On Monday, November 2, the Department of Health and Human Services (HHS) Office of Inspector...

Inside Story | The role of the care plan and visit notes in maintaining a compliant clinical record

• Homecare E-News, Issue 43, November 2, 2015

  The written care plan is not simply busywork. It is essential in the organization, delivery...

In Focus | 2016 Home Health Final Rule Released

• Homecare E-News, Issue 43, November 2, 2015

  After receiving 118 comments from the public during the official comment period, the Centers for...

In focus | Study finds home health readmission rates decline, but home health use differs by location

• Homecare E-News, Issue 42, October 26, 2015

   The Alliance for Home Health Quality and Innovation (AHHQI), a national non-profit consortium...

What kind of events count as "potentially avoidable"? What will and should be in the CASPER Outcome-Based Quality Improvement Report?

• Homecare Q&A, Issue 20, October 16, 2015

  What kind of events count as "potentially avoidable"? What will and should be in the...

I have a question regarding the face-to-face requirements for homecare.

• Homecare Q&A, Issue 20, October 16, 2015

  I have a question regarding the face-to-face requirements for homecare...

Can you please explain what specifically needs to be under the supervisions of licensed professionals?

• Homecare Q&A, Issue 19, October 2, 2015

  Can you please explain what specifically needs to be under the supervisions of licensed...

We have received a request from a physician office to have one of our employees be on-site to accept and process referrals for home health and hospice.

• Homecare Q&A, Issue 19, October 2, 2015

  We have received a request from a physician office to have one of our employees be on-site to...

Can we perform home health aide supervision through a telephone call?

• Homecare Q&A, Issue 15, August 3, 2015

  Calling the patient is a way to check on what’s happening, but it does not substitute for the...

Can we bill Medicare for supervisory visits?

• Homecare Q&A, Issue 15, August 3, 2015

  No, supervising home health aides is a cost of doing business. Whenever possible, the nurse or...

Do we need an order for home health aide supervision?

• Homecare Q&A, Issue 15, August 3, 2015

  It is a federal requirement to supervise home health aides. There is no requirement to write an...

Is it acceptable to write "per patient request" for selected duties on the home health aide assignment?

• Homecare Q&A, Issue 15, August 3, 2015

  The aide care plan or assignment must provide enough direction so the aide knows exactly what to do...

Can we use a mannequin for evaluating an aide's competency?

• Homecare Q&A, Issue 15, August 3, 2015

  The aide must perform tasks, such as bathing, transferring, and oral hygiene, on a patient or a...

Must we perform an annual competency evaluation for home health aides?

• Homecare Q&A, Issue 15, August 3, 2015

  There is no requirement to do a competency evaluation of home health aides after they have passed...

Can we provide two home health aides to provide care for a quadriplegic patient?

• Homecare Q&A, Issue 15, August 3, 2015

  Yes, Medicare will cover two visits if two individuals are needed to perform a covered service...

Is it true that instead of discharging patients when goals are met, we can recertify them under management and evaluation?

• Homecare Q&A, Issue 15, August 3, 2015

  What this agency heard is in error and could lead to denials. Just as with any Medicare-covered...

How are we supposed to use observation and assessment for patients on telemonitoring?

• Homecare Q&A, Issue 15, August 3, 2015

  Telemonitoring or telehealth is one technology that can help a patient in the home. It cannot...

If there are verbal orders at start of care, do we need to use Locator 23?

• Homecare Q&A, Issue 14, July 16, 2015

  This locator applies only if verbal orders are involved in the start of care process. It...

I have read that CMS in 2015 has added to the Medicare manual that physicians need to estimate how much longer the skilled services will be required. Is there any clarification on this, and are we seeing any claims being denied due to this?

• Homecare Q&A, Issue 14, July 16, 2015

  According to the final rule for 2015, physicians must state the length of skilled services for...

Does Medicare cover ostomy supplies for ureterostomies?

• Homecare Q&A, Issue 14, July 16, 2015

  All ostomy supplies are covered under the NRS. For a current NRS master supply list, see the...

What content would be in a best practice statement for homecare providers?

• Homecare Q&A, Issue 13, July 2, 2015

  AA best practice should identify clinical actions—assessment, teaching, procedures...

Homecare Q&A

• Homecare Q&A, Issue 13, July 2, 2015

  July 3, 2015

Instead of extending the Medicare sequestration into 2024, how do recent legislative proceedings and political reporting suggest Congress intends to fund the reauthorization of the Trade Adjustment Assistance (TAA) program?

• Homecare Insider, Issue 23, June 15, 2015

  Instead of extending the Medicare sequestration into 2024, how do recent legislative proceedings...

What is the proper way to enter in orders for disciplines and treatments on the 485?

• Homecare Q&A, Issue 12, June 15, 2015

  What is the proper way to enter in orders for disciplines and treatments on the 485?

Can we use standing orders for many of our specialty programs, like wound care?

• Homecare Q&A, Issue 11, June 3, 2015

  Can we use standing orders for many of our specialty programs, like wound care?

Can a nurse practitioner who runs her own practice make a referral to a home health agency?

• Homecare Q&A, Issue 11, June 3, 2015

  Can a nurse practitioner who runs her own practice make a referral to a home health agency?

Are other agencies billing for the final skilled visit when the discharge reason is no longer homebound?

• Homecare Q&A, Issue 11, June 3, 2015

   A clinician arrives at the home, where skilled services are provided. Based on the...

How are we supposed to use observation and assessment for patients on telemonitoring?

• Homecare Q&A, Issue 10, May 17, 2015

  How are we supposed to use observation and assessment for patients on telemonitoring?

What are the new therapy reassessment requirements that CMS solidified in its 2015 PPS final rule?

• Homecare Q&A, Issue 10, May 17, 2015

  What are the new therapy reassessment requirements that CMS solidified in its 2015 PPS final rule...

What does the proposed standard Patient Care 485.65: Quality Assessment & Performance Improvement mean for my agency?

• Homecare Q&A, Issue 9, May 3, 2015

  My agency has been reviewing the proposed Conditions of Participation (CoP). We are looking at the...

Do we answer M0063, Medicare Number, with the patient?s now-defunct Medicare number or the new Medicare Advantage (MA) policy number?

• Homecare Q&A, Issue 8, April 17, 2015

  When a patient joins an MA plan, he or she takes on a subscriber number, but the patient’s...

Any tips for preventing future legal fallout in such cases?

• Homecare Q&A, Issue 7, April 3, 2015

  Unfortunately, when a fall occurs in the presence of agency staff, people assume that it...

How do I ensure each care team is led appropriately by the case manager?

• Homecare Q&A, Issue 6, March 17, 2015

  Effective teams need leadership. By using the term “case manager,” the home health...

How can I ensure more effective meetings at our agency?

• Homecare Q&A, Issue 5, March 3, 2015

  We spend a tremendous amount of time in meetings. Many of them are boring, nonproductive, and...

Will home health remain exempt from overtime compensation in most circumstances like it has for 40 years?

• Homecare Insider, Issue 1, January 5, 2015

  Will home health remain exempt from overtime compensation in most circumstances like it has for 40...