Author: Amy Ross

Emergency Preparedness

Hurricane season is upon us.  The flu season is looming, and COVID-19 continues.  In the midst of all of this, hospice and home health organizations need to ensure their emergency preparedness policies and procedures are reviewed and updated at least every two years.  Within recent years, the healthcare industry has faced multiple changes—COVID related, emerging…

OSHA General Duty Clause

With the approach of Labor Day, the US pays tribute to the contributions and achievements of its workers.  Recent years’ events have been intense as healthcare organizations have worked hard to keep their employees safe from COVID-19.  OSHA standards play a large part of protecting workers in healthcare settings with standards for bloodborne pathogens, personal…

Social Determinants of Health (SDoH)

Within the past few years, there has been an uptick in government focus on health equity.  Beginning in 2023, Medicare-certified home health agencies will be contributing data to CMS with new OASIS-E items which are dubbed “social determinants of health (SDoH)”.    The components of SDoH are ethnicity (specifically asking about Hispanic, Latino/a, or Spanish origin),…

Claim Denial

Nothing can be quite as deflating to hospice leadership and staff as these words.  Whether hospices are in the midst of TPE or other medical review, a common denial reason is failure to support the six-month terminal prognosis.  Diagnosis alone may not suffice in establishing the physician’s prediction of the patient’s life expectancy.  Hospices with…

CMS Waivers

In a webinar presented by the National Association of Home and Hospice Care last week, Katie Wehri Director of Home Care & Hospice Regulatory Affairs at NAHC, warned hospices to examine their need to continue the use of the Public Health Emergency for COVID-19 waivers.  As you know, the CMS waivers were established to assist…

High-Risk Drug Classes

As the new OASIS data set–OASIS-E—is approaching for implementation on January 1, 2023, Medicare-certified home health agencies must prepare their clinicians and quality assurance staff for the changes.  One of the new items is N0415, High-Risk Drug Classes. This item identifies if the patient is taking any of six high-risk medications, and if there is…

OASIS-E

The OASIS -E is set to be implemented in January, and the CY 2023 Home Health Prospective Payment System Rate Update includes CMS’ estimated time spent for the data entry of various OASIS collection time points.  This estimation is based on reported CY 2020 assessment totals per assessment type.  Using this CY 2020 data, CMS…

COVID-19…Still Here

In the seemingly never-ending COVID-19 saga, the US is experiencing a surge of a new Omicron variant.  Unfortunately this particular variant, BA.5 is reported to be the most contagious one so far, and currently, the most dominant strain in the United States.  The CDC has a model called Nowcast which estimates the more recent proportions…

Home Health Value-Based Purchasing

The Home Health Proposed PPS Rule for CY 2023 contains some proposals for the Expanded HH Value-Based Purchasing program.  The program officially begins January 1, 2023.  The term “baseline year” has now been replaced with the terms “HHA baseline year” and “Model baseline year”.  The HHA baseline year is now proposed to be the calendar year used…

Hospice Transfers

The new CMS rule regarding hospice transfers is set for implementation on Tuesday, July 5th.  In case you missed it, the MLN Matters MM12619 was released in February.  The Common Working File will no longer accept gaps of care to occur during a transfer.  This means the claim will be rejected if there is a gap in…