home health agencies melia belonus, director bureau of community program licensure &...
DESCRIPTION
Top 5 Home Health Deficiencies Plan of Care (G0159) Conformance with Physician Orders (G0165) Acceptance of Patients, POC, Med Sup (G0158)TRANSCRIPT
Home Health Agencies
Melia Belonus, DirectorBureau of Community Program Licensure & Certification
Cindy Boyne, DirectorDivision of Home Health
Number of HomeHealth Agencies
2007 379
2008 401
2009 410
2010 434
4/30/11 447 384 are Medicare certified
Top 5 Home Health Deficiencies Plan of Care (G0159)
Conformance with Physician Orders (G0165)
Acceptance of Patients, POC, Med Sup (G0158)
Top 5 Home Health Deficiencies
Plan of Care (G0160)
Compliance with Fed, State, Local Laws (G0118)
New 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
New 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
484.10 Patient RightsStandard Survey
Partial Extended Survey
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
Number of Hospice Agencies
2006 147 2007 163 2008 171 2009 179 2010 185
25 In-patient facilities
Top 5 Hospice Deficiencies New COP’s Plan of Care (L543)
Update of Comprehensive Assessment (L533)
Time Frame for Assessment Completion (L523)
Content of Comprehensive Assessment (L524)
Content of Plan of Care (L547)
Hotline
0
20
40
60
80
100
120
2007 2008 2009 2010
Complaint
Misc
Wrong #
Info
Calls for Other State AgenciesCalls for HHAs
Billing & Medicare
Home Health Complaints – 4/1/10 – 3/31/11 Total # HHA – 447 # HHA w complaints – 46 % HHA w Complaints – 10%
Total # Complaints - 54 Substantiated - 19 Unsubstantiated - 35
%Substantiated - 35%
Hospice Complaints 4/1/10 – 3/31/11 Total # Hospices – 185 # Hospices w Complaints – 23 %of Hospices w complaints – 12%
Total # Complaints - 24 Substantiated – 6 Unsubstantiated – 18
% Substantiated – 25%
Helpful Tips Event Reporting System (ERS)
Chapter 51 reporting requirements Unique login online submission of events
Message Board www.health.state.pa.us/facility Log in NOT required Announcements, updates, alerts ERS User’s manual available
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
Duane Sapar ([email protected]) or Michael Hodge ([email protected])
They can be contact at (717) 783-1379
Contact Department of Home Health
http://www.health.state.pa.us
Division of Home Health132 Kline Plaza, Suite AHarrisburg, Pa 17104717-783-1379