The Hospice Plan of Care (POC) serves as a crucial roadmap for addressing the complex needs of a patient facing terminal illness and the needs of their family. However, data from the Centers for Medicare and Medicaid Services (CMS) reveals continued concerns about incomplete or incorrectly enacted POCs. This underscores the necessity for a comprehensive…
Home Health Quality Reporting & OASIS
The 2024 Home Health Final Rule has us looking ahead to some significant changes to the Home Health Quality Reporting Program (HH QRP) and OASIS instrument. The changes will go into effect January 1, 2025 and will impact the OASIS instrument by adding one new item and removing two items. The quality reporting data will…
Hospice Top Medical Denial Reasons
Coding Clarification: Respiratory Conditions
Coding Respiratory conditions has created much confusion in the coding industry since the recent October 1st update that changed many of the excludes 1 to excludes 2. One example of this is that prior to October 1st, if the chart listed both emphysema and COPD, you were instructed to code the emphysema because there is…
Hospice Care: Extended Length of Stay: Medical Necessity and Documentation Requirements
In December 2023, Performant, the designated Recovery Audit Contractor (RAC) for the Centers for Medicare and Medicaid Services (CMS), introduced a new issue, Issue 0221 – Hospice Care: Extended Length of Stay: Medical Necessity and Documentation Requirements, to its approved list. This newly added issue centers on evaluating the “Extended Length of Stay” to verify medical…
Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2023
The Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2023, also known as the Elizabeth Dole Home Care Act of 2023, is a comprehensive bill focused on enhancing home care and caregiver programs provided by the Department of Veterans Affairs (VA). The legislation, passed on December 5, 2023 by the…
Comorbidity Adjustments and Agency Financials
The issuance of the Home Health Final Rule brings with it the opportunity to re-evaluate the financial position of your agency. If your agency has not yet begun to analyze this data, in particular the updated comorbidity adjustments, let me help you with a brief update. According to the final rule, only those subgroups of…
Implementing a Diabetes Disease Management Program: Bridging the Gap from Diagnosis to Lifestyle
In 2019, 37.3 million Americans had diabetes and another 96 million have prediabetes. Of the 37 million Americans, 28.7 million were diagnosed and 8.5 million were undiagnosed. The American Diabetes Association is calling it a nationwide epidemic. World Diabetes Day is celebrated each year on November 14th to bring awareness to the disease and empower…
Diabetes Awareness Month
November is Diabetes Awareness Month. In 2006, the United Nations officially designated November 14th as World Diabetes Day. It is marked every year on Sir Frederick Banting’s birthday, who discovered insulin along with Charles Best in 1922. Diabetes affects over 500 million people worldwide and about 37 million Americans. For those with diabetes and their…
Self-Determined Hospice Cap (SDHC) Report
Due Now: Credit Balance Reporting now due for the Quarter ending 9/30/2023regardless of whether any credits need to be reported. What to Submit: The one-page Credit Balance Report – Form CMS-838. Ensure that it is signed by an authorized representative. It may be necessary to submit additional Credit Balance Report Detail pages. When To Submit: …
