Archive for 'Hot Topics'

Face-To-Face Physician Requirement Applies To Hospices Only, CMS Clarifies

Posted on 28. Apr, 2010 by .


Hospices are in for more medical review under health care reform package.

The new health care reform package is throwing a lot of new requirements at home care providers, and the result can sometimes be confusion.


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Know What Makes a Pressure Ulcer “Unavoidable”

Posted on 21. Apr, 2010 by .


New stance shows your ulcer-prevention intent — no matter the final outcome.

Your clinicians are trained to prevent pressure ulcers, but sometimes all their hard work simply isn’t enough — and your agency shouldn’t have to pay the price for something that’s inevitable.

So says the National Pressure Ulcer Advisory Panel (NPUAP) after its February consensus conference that brought together a group of 24 pressure ulcer experts to define and characterize “unavoidable” pressure ulcers. (more…)

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How Well do You Know Your Inpatient Procedure Codes?

Posted on 14. Apr, 2010 by .


The 14 day rule may not measure what you think it does.

Now that OASIS C has been around a while, you may be feeling more at ease with the new diagnosis code “M” items. But have you settled in comfortably completing M1012 (Inpatient Procedure)? Our experts help you to get better acquainted with this new item.


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Direct Care: Older Personal and Home Care Aides Looking After Elderly

Posted on 07. Apr, 2010 by .


Labor market faces an aging workforce in short supply.      

The US will have 1.2 million direct-care female workers who are 55 years and older by 2018, or 30 percent of the country’s direct-care workforce. This increase — rising from 22 percent in just 10 years — is among the projections made by technical assistance provider PHI on employment demographics for direct-care workers.

Meanwhile, there is a projected 46 percent increase in demand for personal and home care aides by 2018; a 35 percent increase is expected for all direct-care workers, according to the study. In contrast, an alarmingly low growth rate of the female population aged 25-54 will decline from 14 percent in 1998 to 2 percent by 2018. (more…)

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HHA Helps Keep Patients at Home …

Posted on 23. Mar, 2010 by .


Nicci Kobritz

… and out of nursing facilities … What you can learn to help your own patients

Sometimes, home health agencies lose patients when they get well, but just as often they lose patients who move along the continuum to nursing facilities. But one HHA has discovered a way to help their patients live almost independently.

Longevity is a division of Youthful Aging Home Health, and is designed to advise older adults on options for continuing to live independently in their own home. Improving memory and physical mobility become the keys to sustaining independence.

“Longevity accomplishes this goal through our six-point formula for health management and wellness.  It reduces the need to relocate into the retirement continuum from home to independent living to assisted living and then to a nursing facility,” says Nicci Kobritz, RN, NP, president of Youthful Aging Home Health Care in Sarasota, Fl.

Clients pay only for what they need so they can maintain flexibility, choice and control. Longevity’s target market includes the older adult who:
•    chooses to continue retirement at home;
•    is experiencing complex health conditions; and (more…)

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Don’t Let Semi-Independent Bathers Wash Out Your M1830 Response

Posted on 17. Mar, 2010 by .


OASIS Tip: Note patients’ ability to get into the tub or shower to choose correct number.

The Centers for Medicare & Medicaid Services made its bathing item (M1830) safer for patients, but it removed most of the clarifying language that accompanied the old item (M0670)  — leaving you in a lurch.

One scenario that causes confusion is figuring out how to respond when a patient has no tub and only needs bathing help when trying to wash areas that are hard to reach, CMS says in its OASIS C instructions. Many agencies aren’t sure whether to select a “4” for independent bathing outside of the tub or shower or a “5” for bathing that requires supervision or assistance outside of the tub or shower.

Do this … (more…)

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OASIS C Tip: Urinary Incontinence

Posted on 10. Mar, 2010 by .


Here’s where you’re getting inaccurate data during OASIS C assessments.

Simply asking your female patients about conditions prior to onset of care as OASIS C requires isn’t enough to spot urinary incontinence issues.

And left undetected, urinary incontinence issues can lead to other case management challenges, such as an increased risk of pressure ulcers. But urinary incontinence is often not in a home care nurse’s radar, a new study finds.

Researchers surveyed 875 women aged 25 to 80 years enrolled by Kaiser Permanente Northwest. Based on their responses, 56 percent experienced urinary incontinence in the past 12 months and nearly 40 percent experienced it in the past 7 days, according to a recent study published in the American Journal of Medicine.

Problem … (more…)

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Hospice Caregiver Case Study

Posted on 03. Mar, 2010 by .

Time together for Taylor and Tonkka

Time together for Taylor and Tonkka

How one hospice caregiving team came up with a creative way to ease one family’s fears.

So many equate hospice to death, but for one hospice program at CarePartners in Asheville, NC,  a team of talented and compassionate professionals and volunteers have demonstrated to families and patients that it’s about living, not dying.

Taylor’s Story

Taylor is a 16-year old girl diagnosed with MERRF, a genetic disorder that affects the functions of cells. Prior to being admitted to hospice in December 2009, Taylor’s sister, Brittany, passed away from the same disease in April 2009. As a result, when Taylor entered the hospice program, she was fearful and knew what fate had in store. Her parents were equally afraid and focused on her death, rather than her life. Taylor’s care team had a big task in front of them – to engage the family’s trust and to make Taylor smile again. (more…)

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5 Ways to Protect Your Home Health Workers from Occupational Hazards

Posted on 24. Feb, 2010 by .


These checklists help you keep workers safe and improve retention.

If you’re looking for ways to keep your HHA employees safe and on the job, the Centers for Disease Control has a nifty new 51-page resource for you, and we’ve got some information about how you can improve upon an important point it missed.

Occupational Hazards in Home Healthcare, which is co-written by the National Institute of Occupational Safety and Health identifies the top hazards, as well as good tips.

Don’t miss the checklists at the end of the booklet that help workers think about how things as simple as the shoes they wear or talking on the cell phone while driving can impact their safety.

Some top dangers, according to the report, include:



guns and other weapons; (more…)

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In-Home Palliative Sedation Checklist for End-of-Life Cancer Care

Posted on 23. Feb, 2010 by .


We’ve got the link to this handy tool from Spanish researchers

Hospice providers won’t want to miss a well-researched checklist recently published in the journal Palliative Medicine.

Researchers in Spain present new information that will help palliative care teams administer safe sedation to patients at home, reports McKnight’s Long-Term Care News & Assisted Living. Their findings debunk the theory that palliative sedation (PS) hastens death among terminally ill patients.

The researchers retrospectively reviewed medical records for 370 patients in palliative home care. In home settings, very little is known about what kinds of sedatives are administered or who receives them. Researchers looked at situations where caregivers used different types of drugs to relieve intolerable suffering of end-of-life cancer patients. Among the 370 patients in the study, 245 (66 percent) died at home, and 125 (34 percent) died in a hospital or hospice.

As a result of their research, the Spain-based research team has developed a standard checklist for in-home palliative care patients. This treatment checklist can be used to evaluate the frequency and efficacy of PS on cancer patients dying at home. (more…)

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