Home Health & Hospice Articles by Topic: Administration and Management

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...

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...