understanding the impact of hacs/poas and never events/adverse events nadyne hagmeier, rn hospital...
TRANSCRIPT
![Page 1: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/1.jpg)
Understanding the Impact of HACs/POAs and Never Events/Adverse Events
Nadyne Hagmeier, RN
Hospital Project Manager
![Page 2: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/2.jpg)
NQF Serious Reportable Events• In 2002, The National Quality Forum (NQF) created and
endorsed a list of serious reportable events (SREs) to increase public accountability and consumer access to critical information about healthcare performance.
• The list includes both injuries caused by care management (rather than the underlying disease) and errors that occur from failure to follow standard care or institutional practices and policies.
• The events are largely preventable, but also very serious.
• The errors are of concern to the public and healthcare providers and warrant careful investigation that should be targeted for mandatory public reporting.
![Page 3: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/3.jpg)
CMS Initiatives Addressing Never Events
![Page 4: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/4.jpg)
CMS Initiatives Addressing Never Events
![Page 5: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/5.jpg)
CMS Initiatives Addressing Never Events
![Page 6: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/6.jpg)
CMS Initiatives Addressing Never Events
![Page 7: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/7.jpg)
Additional Hospital Acquired Conditions• Catheter-associated UTI• Vascular catheter-associated infection• Surgical site infection –
– Mediastinitis following CABG– Certain orthopedic procedures of the spine, neck, shoulder and
elbow– Bariatric surgery for obesity – Laparascopic gastric bypass,
Gastroenterostomy, Laparascopic gastric restrictive surgery• DVT and Pulmonary embolism following total knee replacement and
hip replacement• Manifestations of poor glycemic control –
– Diabetic ketoacidosis, nonketotic hyperosmolar coma, hypoglycemic coma, secondary diabetes with ketoacidosis or hyperosmolarity
![Page 8: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/8.jpg)
National Coverage Determination
CMS is accepting public comments on its proposed policies through January 1.
Read the proposed decisions at:
www.cms.hhs.gov/mcd/index_list.asp?list_type=nca
![Page 9: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/9.jpg)
Present on Admission (POA)
• October 1, 2007:– IPPS hospitals are required to begin
submitting POA information on all primary and secondary diagnoses on Medicare claims
• January 1, 2008:– CMS begins processing POA data
• April 1, 2008:– Claims that do not contain proper POA data
will be returned for correct submission of POA information
![Page 10: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/10.jpg)
POA General Requirements
• POA indicator required for all claims involving Medicare inpatient admissions to general acute care hospitals
• POA is defined as present at the time the order for inpatient admission occurs -- conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA
• Assigned to principal and secondary diagnoses
![Page 11: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/11.jpg)
POA General Requirements (cont)• Issues related to inconsistent, missing,
conflicting, or unclear documentation must be resolved by the provider
• If a condition would not be coded and reported based on Uniform Hospital Discharge Data Set definitions and current official coding guidelines, then the POA indicator would not be reported
• POA indicator is not required for the external cause of injury code unless it is being reported as an “other diagnosis”
![Page 12: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/12.jpg)
POA Coding• Use the UB-04 Data Specifications Manual
and the ICD-9-CM Official Guidelines for Coding and Reporting to facilitate the assignment of the POA indicator for each “principal” and “other” diagnosis codes reported on the UB-04 and ASC X12N 837 Institutional
![Page 13: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/13.jpg)
POA Documentation
• Medical record documentation from any provider involved in the care and treatment of the patient may be used to support the determination of whether a condition was present on admission
![Page 14: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/14.jpg)
For more information on POA
• The HAC POA web page at http://www.cms.hhs.gov/HospitalAcqCond/ provides further information including the links to the law, regulations, change requests(CRs), and educational resources including presentations, MLN articles, and fact sheets
![Page 15: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/15.jpg)
Additional Resources• NQF:
http://www.qualityforum.org/ • Fact sheets:
– Hospital Acquired Conditions - http://www.cms.hhs.gov/HospitalAcqCond/Downloads/hac_fact_sheet.pdf
– Present on Admission-http://www.cms.hhs.gov/HospitalAcqCond/Downloads/poa_fact_sheet.pdf
• KHIMA:http://www.khima.com/news-information/news-
information.html
![Page 16: Understanding the Impact of HACs/POAs and Never Events/Adverse Events Nadyne Hagmeier, RN Hospital Project Manager](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649d1f5503460f949f3a00/html5/thumbnails/16.jpg)
Contact Information
Nadyne Hagmeier, RN Quality Data Reporting
Kansas Foundation for Medical Care, Inc.2947 SW Wanamaker Drive
Topeka, KS 666141-800-432-0770
This material was prepared by the Kansas Foundation for Medical Care, Inc. (KFMC), the Medicare Quality Improvement Organization for Kansas, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 9SOW-KS-BP_BEN-08-01