Transcript Slide 1
Home Health Agencies
Darlene Augustine, Health Quality Administrator
Department of Health
Division of Home Health
Number of Medicare Home
Health Agencies
2008
401
2009
410
2010
434
2011
447
4/1/2012 405
Top 5 Home Health Deficiencies
Conformance with Physician’s orders (G0165)
Assignment & Duties of Home Health
Aide (G0224)
Physician’s Plan of Care (G0160)
Acceptance of Patients, POC, Med Sup (G0158)
Compliance with Fed, State, Local Laws
(G0118)
HHA Survey Protocols
Focus – Data driven survey
Changes scope of standard survey
Evaluates 9 of 15 Conditions
Patient –focused, outcome –oriented
Limited paper review
Review of outcome data prior to survey
HHA Survey Investigation Worksheets
HHA Survey Protocols
Efficient:
Increased use of HHA interview, data
Paper review limited to PE or Extended
Guidelines for citation of deficiencies
Effective:
Targeted patient care standards
Enhanced consistency in deficiency citations
Survey Protocols
Standard survey – Level 1 standards
Most relate to patient care processes
Partial Extended survey – Level 2 standards
Guidelines for further investigation
Condition level guidance
Related conditions for further investigation
Extended survey – condition cited, all examined
Standard Survey Protocols
Level 1 standards
Focus on delivery of quality patient care
Address 9 of 15 Conditions
Increased use of interviews
Minimal need to review non-clinical paper
Compliance with all Level 1 – survey ends
Standard Survey Expands
Expected outcomes not met for 1 or more
Level 1 standards
Surveyor recognizes other issues
Survey becomes Partial Extended survey
Level 2 standards are evaluated
Surveyor discretion -Review additional
standards under same condition or related
conditions
Condition Level Deficiencies
Guidelines for citing conditions
Guidelines, not requirements
May be cited for serious findings unrelated to
Level 1 or 2 standards
Immediate jeopardy - always condition
Extended survey – all conditions reviewed
Home Health Complaints – 4/1/11
– 4/1/12
Total # HHA – 405
# HHA w complaints – 50
% of Substantiated Complaints – 14
% of Unsubstantiated Complaints- 36
Medicare Hospice Agencies
2008
2009
2010
2011
2012
171
179
185
187
191
19 In-patient facilities
Top 5 Hospice Deficiencies
Time Frame for Assessment Completion (L523)
Content of Comprehensive Assessment (L524)
Plan of Care (L543)
Review of the Plan of Care (L552)
Coordination of Services (L554)
Medicare Hospice Complaints
4/1/11 – 4/1/12
Total # of Hospice Agencies- 191
Total # of Hospice Complaints- 31
% of Substantiated Complaints- 10
% of Unsubstantiated Complaints- 21
OASIS
Top Online Resources
OASIS Implementation Manual www.cms.hhs.gov/OASIS/05_UserManual.asp
CMS Q&As https://www.qtso.com/hhadownload.html
OASIS Certificate & Competency Board www.oasiscertificate.org
OASIS
Pa OASIS Education Coordinator
Sandra Kowalczyk
([email protected])
Contact # (570) 963-4212
Contact
Department of Home Health
http://www.health.state.pa.us
Division of Home Health
132 Kline Plaza, Suite A
Harrisburg, Pa 17104
717-783-1379