Archive for 'Did You Know?'

New Hospice Claims Edits To Hit In July

Posted on 17. Feb, 2010 by .


Are you putting the correct site-of-service data on your hospice claims?

More hospice claims data means more billing rules for hospice providers. Now that hospices report site-of-service data on their hospice claims, Medicare is going to start editing claims to make sure different levels of hospice care have the correct site, the Centers for Medicare & Medicaid Services says in Feb. 5 Transmittal No. 121 (CR 6778). Starting in July, you can expect to see claims returned if your level of care doesn’t correspond to the correct site of service.

For example: Hospices may furnish general inpatient (GIP) care only in a hospice inpatient unit, a participating hospital, or skilled nursing facility, CMS explains in the transmittal. The system will also check for correct sites for respite care, which must occur in a hospice facility, SNF, regular nursing facility, or participating hospital, and continuous home care (CHC), which must occur at home.

CMS is also correcting its regulations to state that for continuous home care, nursing care from an RN or LPN must make up at least 50 percent of the time billed, CMS adds in Feb. 5 Transmittal 1907 (CR 6778).

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Are you making one of these 10 common hospice compliance mistakes?

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Test Your OASIS C Savvy

Posted on 10. Feb, 2010 by .


How well do you really understand M2000 and M2002?

Scenario: On Friday you admit Mr. B, a patient with complex needs who is new to your agency. On your second visit on Saturday you compile a list of medications for M2000 (Drug regimen review). Later that day, back in the office, you review the medications and discover a significant medication issue (e.g., side effects that concern the patient). You contact the physician’s office to report your concern and an hour later you receive a call back from the physician on call, who is not the patient’s physician and is unfamiliar with this patient. The on-call physician decides the issue can safely wait and tells you to contact the patient’s regular physician on Monday. How do you answer M2002?

M2002 (Medication follow-up) asks: Was the physician or the physician-designee contacted within one calendar day to resolve clinically significant medication issues, including reconciliation?

Answer choices are 0-No and 1-Yes.

Do you know the answer? Quiz your clinicians before you click ‘read more’ for the answer. (more…)

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Cleveland Clinic Looks to Home Care, EHR to Reduce Readmissions

Posted on 02. Feb, 2010 by .


Home health providers: Are you in a ‘black box?’

Medicare spends about $12 billion a year on “potentially preventable” hospital readmissions, according to MedPAC. With the feds hankering to cut health care costs, it’s only a matter of time before Medicare starts bundling hospital and post-acute care, experts predict. That means hospitals and HHAs need to learn how to communicate and cooperate with one another better if they’re going to be profitable.

Cleveland Clinic thinks integrated electronic health records will be key to helping health systems thrive as bundling looms, reports CMIO Magazine. (If you’re like me and scratching your head about what ‘CMIO’ means, it’s ‘Chief Medical Informatics Officer.) (more…)

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HHA Management: Gas Prices Up, Mileage Rate Down

Posted on 26. Jan, 2010 by .


You may save money on your travel costs, depending on how you reimburse your staff.

Your visiting staff are likely feeling the pinch when they head to the gas pump. The average U.S. price for gas is $2.74 per gallon, according to the federal Energy Information Administration. That’s still way less than when gas prices peaked at more than $4 per gallon in the summer of 2008, but nearly double the price this time last year.

As usual, the continental U.S. state where workers are paying the most for gas is California, where gas costs an average of $3.02 per gallon, according to Web site The cheapest gas is available in Wyoming for $2.52 per gallon.

The higher prices at the pump may not translate into higher costs for your home health agency or hospice, however. That’s because the Internal Revenue Service mileage reimbursement rate for 2010 is 50 cents per gallon, down from 55 cents per gallon in 2009. “The mileage rates for 2010 reflect generally lower transportation costs compared to a year ago,” the IRS said in a release last month. (more…)

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Home Care Worker Guards Homeland Security

Posted on 11. Jan, 2010 by .


Home care patient bragged he could hide explosives in his wheelchair.

We all know home care workers are heros, but we might think of them more as Florence-Nightingale heros rather than save-the-planet heros. Revise that image now. A tip from a Spokane, Washington home health aide put a potential bomber behind bars, a local paper reports.

The home health aide became suspicious when her patient began researching bombs on the Internet and getting strange liquids in the mail. Bitter after his recent divorce, patient John D. Raymond alarmed the aide when he “mentioned to her that he could hide materials on his wheelchair and no one would notice,” according to the search warrant.

The home health aide tipped off authorities, who later found the explosive TATP in Raymond’s apartment. TATP “has been used by suicide bombers in Israel and was chosen as a detonator in 2001 by the thwarted ‘shoe bomber’ Richard Reid,” according to CNN.

One thing’s for sure. If you work in home care, no day is ever ‘just another day at the office.’

AUDIO TRAINING EVENT: Overworked or Overwhelmed? Stress Strategies for Healthcare Professionals. With Jeff Davidson, MBA, CMC.

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Trends: Percentage of Family Caregivers Employing Paid Help Decreases

Posted on 05. Jan, 2010 by .


Check out the profile of adults caring for seniors over 50

Family caregivers taking care of a person who’s not in a nursing home are less likely these days to employ paid help than they were in 2004, according to a new report from the National Alliance for Caregiving and the AARP and funded by MetLife Foundation.

“Use of paid aides, housekeepers or other staff declined from 41% in 2004 to 35% in 2009,” according to the report. During the same time period, primary caregivers turned more to unpaid caregiving help, probably as a result of the recent recession and the 2008 financial meltdown, the report speculates. (more…)

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Hospice Research: Racial Disparities Impact End-of-Life Care

Posted on 16. Dec, 2009 by .


Black patients are more likely to express trust on God’s will.

Black cancer patients may find that their dying wishes aren’t heeded as frequently as their white counter-parts.

A new study from Boston-based Dana-Farber Cancer Institute found that black cancer patients’ end-of-life treatment preferences were followed less frequently than white patients.

White patients who asked to receive aggressive end-of-life care were three times more likely to receive it than black patients with the same requests, according to a release from the Institute. (more…)

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Don’t Count On Outliers Forever

Posted on 09. Dec, 2009 by .


CMS still may eliminate the PPS payment option entirely.

Home health agencies smarting at the looming 10 percent cap on home health PPS outlier payments may face even bigger woes ahead. If abusive billing of the outlier option continues even under the 10 percent cap that begins Jan. 1, the Centers for Medicare & Medicaid Services may cut outlier payments from the prospective payment system altogether. So says CMS in a new question and answer about the outlier payment changes.

“If CMS finds that the new CY 2010 outlier policy is not effective and/or achieving our goals, an alternative … would be to eliminate the outlier policy altogether (in future rulemaking),” the agency warns in the Q&A.

Plus: In a separate Q&A, CMS clarifies that claims are subject to the new outlier cap if they are paid at the 2010 rate.

A link to the Q&As is online here.

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HHA Trends: More Disabilities Among Your Baby Boomer Patients

Posted on 16. Nov, 2009 by .

Are you ready for these guys as they age? Photo: Woodstock, Derek Redmond

Are you ready for these guys as they age? Photo: Woodstock, Derek Redmond

If you’re feeling an OT crunch now, just wait.

Home health agencies planning for the future of their business should pay close attention to results of a UCLA study. People in the 60-69 age group are more likely to have disabilities than folks in their 60s had in years past, the study found, and this trend indicates HHAs will have to contend with a more disabled elderly population overall in the coming years as Baby Boomers age.

Researchers saw this spike in disabilities among the 60s set, even as disability rates remained steady among the 70s and 80s cohorts. As a group, people in their 70s and 80s today have the same disability level, and sometimes an even lower disability level, than people in their 70s and 80s did in years past.

ADLs: Researchers “assessed disability trends in four areas: basic activities associated with daily living, such as walking from room to room and getting into and out of bed; instrumental activities, such as performing household chores or preparing meals; mobility, including walking one-quarter mile or climbing 10 steps without stopping for rest; and functional limitations, which include stooping, crouching or kneeling,” according to the release.

Why do people who are now in their 60s have a harder time getting around? The demographic reaching its 60s has higher rates of obesity and a lower overall socioeconomic status that previous cohorts, researchers conjecture.

Long-term business strategy planning, phooey. Do you just want to get your HHA through next year? Here’s help for 2010.

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HHA Pays $2 Million For Care Plans Lacking Physician Signatures

Posted on 10. Nov, 2009 by .


Don’t think Medicare won’t find out if you submit care plans without a doctor’s signature.

Evansville, Ind.-based Omni Home Care and its Florida-based parent Omni Home Health are now on the hook with the Justice Department for a whopping $2 million for just that mistake, according to numerous press reports. (Read one release here.)

Facts: Between 2006 and 2008, Omni submitted claims for plans of care that required a physician’s signature. However, the agency ignored certification and re-certification rules so that it could receive payment.

Omni agreed to pay back the money it wrongly collected from CMS.

Takeaway: Make sure you strictly follow certification guidelines unless you want to wind up in hot water right along with Omni. As a reminder, a physician must sign plan of care forms for the initial home care, and must re-certify the plan at least every 60 days.

How to prepare for RAC audits. Audio learning with Dr. Duane Abbey.

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