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Proposed rule includes change to antipsychotics regulation

CMS announced a new proposed rule (CMS-3347-P) this week, and among many changes, such as the delay of Phase 3 implementation, are changes to the use of antipsychotic medication. In the proposed rule, CMS states that “some nursing homes are circumventing the pressure to reduce antipsychotic drug use by seeking an appropriate diagnosis from a […]

OIG reports address deficiencies, abuse in hospice care

Two reports were released last week by the U.S. Department of Health and Human Services Office of the Inspector General (OIG) demonstrating the results of in-depth studies of Medicare hospice recertification and complaint survey data from state agencies and accredited organizations between 2012 and 2016. The reports examine issues of deficiencies and abuse in hospice care. […]

CMS seeking feedback on potential future quality measures and assessment data

A significant portion of the 2020 PPS proposed rule deals with potential measures and associated assessment elements that could come to the home health industry in the future. While CMS is not planning to finalize any of these measures or standardized patient assessment data elements (SPADES) as part of the rulemaking process this year, CMS […]

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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 […]

Intake and output monitoring

You should monitor residents who have fluid imbalances or are at high risk of dehydration by calculating intake and output (I&O) each shift.

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 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 […]