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OIG report looks at abuse and neglect of Medicare beneficiaries

The Department of Health and Human Services Office of Inspector General issued two new reports that address the identification, reporting and investigation of incidents of potential abuse and neglect of our nation’s most vulnerable populations, including seniors and individuals with developmental disabilities. OIG issued an early alert in 2017 based on the preliminary findings of […]

Palmetto GBA posts info for next two RCD teleconferences

Agencies in Illinois, North Carolina, Ohio, Florida or Texas can get updates from Medicare Administrative Contractor (MAC) Palmetto GBA about the Review Choice Demonstration (RCD) by listening to Palmetto’s teleconferences in July and August. The July event will be held 10 a.m. to 11 a.m. EST July 3. Call (877) 789-3907 and use conference ID […]

Make sanction policy, hit other marks to avoid big fines for small HIPAA breaches

A recent HIPAA breach that involved transmission of protected health information (PHI) to only one party — a reporter — nonetheless cost a Connecticut practice $125,000, in part because the practice didn’t take simple precautions. In February 2015, a patient of Allergy Associates of Hartford, P.C., a four-doctor, three-office practice, had talked to a local […]

Turnover rate for private duty caregivers rises significantly from prior years

The national turnover rate for private duty caregivers in 2018 ballooned to 81.6% — by far the highest turnover rate in the 10 years Home Care Pulse of Rexburg, Idaho, has tracked this data. That’s according to the recently released 2019 Home Care Benchmarking Study, which includes responses from 688 providers representing more than 1,100 […]

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CMS posts much anticipated MDS 3.0 RAI Manual v1.17

On Monday, May 20, the Centers for Medicare & Medicaid Services (CMS) posted the MDS 3.0 RAI Manual, v1.17, containing many of the requirements that providers will need to follow to prepare for the Patient-Driven Payment Model (PDPM) effective October 1, 2019. New changes will be reflected in HCPro’s MDS 3.0 RAI User’s Manual. The […]

Proposed bill would innovate use of home health services

The Home Health Payment Innovation Act of 2019, H.R. 2573, would preserve Medicare recipients’ access to home health services and provide a pathway for innovative approaches to using these services. According to LeadingAge, which supports the bill, H.R. 2573 would prevent unwarranted payment rate cuts of Patient Driven Groupings Model (PDGM) by basing any behavioral […]

Ask the expert: Medicare Part A coverage for a PEG tube

Q: I have a patient that has 100 days of Medicare Part A and a percutaneous endoscopic gastrostomy (PEG) tube—the primary source of nutrition—in place since 2008 due to laryngeal cancer. All rehab therapy is discontinuing in three days. Can I continue Medicare Part A, related to the PEG tube? A: As long as 26% […]

Educate clinicians about M1820, an item affecting functional points under PDGM

Source: Home Health Line Ensure clinicians have proper training about how to respond to the OASIS-D item involving patients’ ability to dress their lower body safely. M1820 (Ability to dress lower body) is one of six OASIS items that affect functional case-mix adjustment under the PPS, and it will be one of eight items that […]

CMS releases tables detailing the 2019 quality measures for home health

Source: Home Health Line CMS has published updated details on potentially avoidable events, process and outcome measures for 2019. The updated tables also include details on star-ratings measures and quality measures new to Home Health Compare in 2019. Claims-based outcome measures “Medicare spending per beneficiary” and “Discharge to community” are joining the ranks of publicly […]