Transcript Slide 1

Home Health Agencies
Darlene Augustine, Health Quality Administrator
Department of Health
Division of Home Health
Number of Medicare Home
Health Agencies
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2008
401
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2009
410
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2010
434
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2011
447
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4/1/2012 405
Top 5 Home Health Deficiencies
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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
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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
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Efficient:
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Increased use of HHA interview, data
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Paper review limited to PE or Extended
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Guidelines for citation of deficiencies
Effective:
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Targeted patient care standards
Enhanced consistency in deficiency citations
Survey Protocols
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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
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Level 1 standards
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Focus on delivery of quality patient care
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Address 9 of 15 Conditions
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Increased use of interviews
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Minimal need to review non-clinical paper
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Compliance with all Level 1 – survey ends
Standard Survey Expands
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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
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Guidelines for citing conditions
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Guidelines, not requirements
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May be cited for serious findings unrelated to
Level 1 or 2 standards
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Immediate jeopardy - always condition
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Extended survey – all conditions reviewed
Home Health Complaints – 4/1/11
– 4/1/12
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Total # HHA – 405
# HHA w complaints – 50
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% of Substantiated Complaints – 14
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% of Unsubstantiated Complaints- 36
Medicare Hospice Agencies
2008
 2009
 2010
 2011
 2012
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171
179
185
187
191
19 In-patient facilities
Top 5 Hospice Deficiencies
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Time Frame for Assessment Completion (L523)
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Content of Comprehensive Assessment (L524)
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Plan of Care (L543)
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Review of the Plan of Care (L552)
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Coordination of Services (L554)
Medicare Hospice Complaints
4/1/11 – 4/1/12
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Total # of Hospice Agencies- 191
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Total # of Hospice Complaints- 31
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% of Substantiated Complaints- 10
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% of Unsubstantiated Complaints- 21
OASIS
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Top Online Resources
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OASIS Implementation Manual www.cms.hhs.gov/OASIS/05_UserManual.asp
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CMS Q&As https://www.qtso.com/hhadownload.html
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OASIS Certificate & Competency Board www.oasiscertificate.org
OASIS
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Pa OASIS Education Coordinator
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Sandra Kowalczyk
([email protected])
Contact # (570) 963-4212
Contact
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Department of Home Health
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http://www.health.state.pa.us
Division of Home Health
132 Kline Plaza, Suite A
Harrisburg, Pa 17104
717-783-1379