Home Health & Hospice

Weekly Roundup

Homecare Insider, December 28, 2015

Lack of oversight blamed for bleak home health labor picture

Home care workers achieved a victory when the Department of Labor ruled they are entitled to overtime and minimum wage protections. New payment rules went into effect in the fall. However, the National Employment Law Project (NELP) reports that nearly 2 million home care workers are underpaid and the industry lacks both oversight and employer accountability.

Home health agencies argue the newly enacted rules are hurting their bottom line, and some agencies are cutting caregiver hours and rescheduling shifts to limit overtime as a result. The earning potential for these workers remains very low, NELP states. Home care workers earn a median hourly wage of $9.83 to $10.28. Only about 40% work full time, year-round, and the average annual salary of a home care worker in 2013 was $18,598. Nearly half of home care workers live in households that receive public assistance benefits such as Medicaid, food stamps and housing and heating assistance. The overwhelming majority are women, and more than half are people of color, according to the NELP report.

Source: NELP

CMS data shows cost disparities in home health services

Data show cost disparities exist for home health services, much like the differences in costs for hospital procedures and tests. Certain bundled home care services cost the government more than other types, and that average cost of services varies by hundreds of dollars from state to state, according to California Healthline. For example, Florida, New York, and Utah show especially high levels of outlier claims. High outlier payments are often attributed to abuse of the system, high rates of patients with chronic conditions, or patients not understanding their benefits.

Source: California Healthline

Hospice Salary and Benefits report available

Productivity among nurses and aides increased last year, but so did turnover rates for both groups, according to the 2015-2016 Hospice Salary & Benefits Report, published by Hospital & Healthcare Compensation Service (HCS) in cooperation with the National Association for Home Care & Hospice (NAHC). Productivity among RNs was 4.33 visits per day in 2014, compared to 4.39 in 2015. For LPNs, the number of visits increased from an average of 5.04 to 5.15. Aides managed an average of 5.31 visits per day in 2015, an increase from 5.21 the year before.

Turnover rates for RNs increased by almost 2%, rising to 20.55%, and aides' turnover rates edged up more than 3%, to 20.91%. More than 780 hospices participated in the study.


Hospice claims should include anti-cancer, anti-emetic drugs

Starting in January, hospices should stop removing codes for anti-cancer and anti-emetic drugs from their claims, and instead should include these drugs on claims. The change comes as a result of Transmittal 1528/Change Request 9255, which was issued in August. Both CMS and the Medicare Administrative Contractors (MACs) request that hospices start submitting claim adjustments for all previous claims that should have included anti-cancer and anti-emetic drugs and that fall within the timely filing period. 

Source: NAHC