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Home Health Agencies

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.

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Home Health Agencies

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  1. Home Health Agencies Darlene Augustine, Health Quality Administrator Department of Health Division of Home Health

  2. Number of Medicare HomeHealth Agencies • 2008 401 • 2009 410 • 2010 434 • 2011 447 • 4/1/2012 405

  3. 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)

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Home Health Complaints – 4/1/11 – 4/1/12 • Total # HHA – 405 • # HHA w complaints – 50 • % of Substantiated Complaints – 14 • % of Unsubstantiated Complaints- 36

  11. Medicare Hospice Agencies • 2008 171 • 2009 179 • 2010185 • 2011 187 • 2012 191 • 19 In-patient facilities

  12. 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)

  13. 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

  14. 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

  15. OASIS • Pa OASIS Education Coordinator • Sandra Kowalczyk (skowalczyk@pa.gov) Contact # (570) 963-4212

  16. 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

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