Home Health & Hospice

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Home Health & Hospice

Information, education, and guidance on complex topics such as Medicare compliance, agency management, coding and documentation, billing, aide training, and clinical management to help home health and hospice clinical staff, coders, staff educators, and administrators break down confusing regulations into easy-to-understand processes and procedures.

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  • We use ranges on hospice patients. If we have a patient with ranges 1x-3x a month and the patient is only seen 1x that month, do missed visits need to be completed for the other two days the patient was not seen?

    You can use ranges on hospice patients. Missed visits are only needed if the agency does not meet the minimum of the range—so in this example, you would only notify the physician if the patient was not seen at least once in a month.

  • When we enter our discharge reason for home health, is it that the patient was transferred to an inpatient facility, or is the discharge reason that the patient expired?

    When our patients are admitted to an inpatient facility and we complete a transfer OASIS, we normally will choose not to discharge the patients and await their return home, resuming care at that time. We have a question about what happens if a patient dies while hospitalized and now needs to be discharged from home health. When we enter our discharge reason for home health, is it that the patient was transferred to an inpatient facility, or is the discharge reason that the patient expired?

  • Inside Story: Federal scrutiny for LOS and for-profit hospice facilities

    Editor’s note: The following is an excerpt from The Hospice Guide to Billing and Reimbursement: Durable Guidance and Strategy.

    Federal and state regulators as well as private payers are working hard to curb the costs of Medicare and Medicaid programs. Although the vast majority of hospice providers are operation within the law, regulators have identified some bad actors. For example, a recent Office of Inspector General (OIG) study of hospice care in ALFs raised concerns about the possibility of hospices focusing on certain types of patients under the current payment system. The OI study concluded that hospices have financial incentives to serve patients in ALFs because these patients tend to have diagnoses associated with longer stays (such as ill-defined conditions, mental disorders, or Alzheimer’s disease) that often require less complex care and result in higher payments per patient for the provider.

  • In Focus: CMS expands list of manifestation codes under ICD-10 effective October 2016

    This week, the Centers for Medicare & Medicaid Services (CMS) issues Transmittal 3591. It provides updates for the Integrated Outpatient Code Editor that will be applicable for various Medicare services starting October 1, 2016. The transmittal includes changes to ICD-10 codes, including for diabetes that may be of interest to hospice providers.

    Source: NAHC

  • Weekly Roundup

    In this week's roundup:

    • Home care study shows checklist possible aid in providing attention to condition changes. Something as simple as a checklist may help prevent costly readmissions through prompting caregivers to check for changes in a patient’s condition that might evolve into something serious if not treated.'
    • Man posing as home health owner please guilty in $4.2m in fraud case. Ramon Collado Gonzalez of Miami, Florida pleaded guilty Monday after feigning to the owner of Golden Home Health Care, according to the U.S. Attorney’s Office for the Southern District of Florida
    • NIH recommends vaccines for people over 50. The National Institute of Health (NIH) has recommended vaccines for people over the age of 50.

    Read full stories.

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

    As a Medicare-certified homecare agency, I historically hired aides that have completed the CNA/HHA course at a college of some sort. I am in need to hire, and it is difficult. I have an applicant that was working at an agency that closed. That agency was also Medicare-certified, but it appears this person had the CNA piece only and they did their own HHA competency. I checked with the state registry, and this person is on there, but there is no reference to HHA certification. She has taken courses relating to homecare for an agency she is currently working for, but what she sent appears to be primarily “orientation to homecare”-type things. I want to remain Medicare compliant and also want to hire this person. Are there competencies I can have her do, then send to the state to be included on the registry?
    In the past, I had chosen not to hire only aides that have the HHA piece, but now I am in a situation where I need to rethink that.


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