In the News:  Home Health Quality Improvement Organization Support

In the News: Center for Home Care Quality and Research [CHCQR]

Home care leaders from across the nation were invited to Washington, DC for the Center for Home Care Quality and Research’s national conference, titled Promoting Excellence in Geriatric Home Care in July 2008. This conference chose to examine the priority care areas of Medication Management, Physical Function, Cognitive Function, Chronic Pain, Palliative Care and Advanced Illness Management and Care Coordination, Management and Transitions.

In the News:  Revisit Fees Final Rule Published

As a result of the 2007 Continuing Appropriations Resolution, Public Law No. 110-5, H.J.Res.20, §20615(b)(2007), the Department of Health and Human Services was directed to establish and charge user fees to health care facilities when survey revisits are needed as a result of survey deficiency citations. Survey types affected by these fees include initial certification, recertification, or substantiated complaint surveys.

In the News: Home Health Demonstration Pay For Performance (P4P) Update

The Department of Health & Human Services, Centers for Medicare & Medicaid Services recently released an update on the Home Health P4P Demonstration Project.

In the News:  Educational Initiatives Update

The Medicare Learning Network provides training, handouts, products and other resources for providers and contractors. These are focused towards several functions.

In the News:  Federal Government Happenings

Attention has been focused on the Medicare funds being reimbursed to home health and hospice providers. As a result there has been renewed scrutiny on these providers’ reimbursement structure.

In the News:  Change Requests and Conditions of Participation

During the Centers for Medicare and Medicaid Services [CMS] May Open Door Forum, discussion focused on signature requirements for hospice physician orders, specifically for certification of election of hospice benefits.

In the News:  Pediatric Medication Safety

With the recent news release and attention focused on pediatric medication errors, it is important to assess staff competency and knowledge of medications and medication calculations for all ages of patients.  As reported by the Joint Commission children are at a greater risk for medication errors. This increased risk occurs at a rate of three pediatric errors to one adult error.  Key to this statistic are the risks associated with medication calculations and the high-risk medications that have a greater potential for adverse reactions.

In the News: Electronic Health Care Information and Tools

Several recent Centers for Medicare & Medicaid Services (CMS) initiatives have focused on the use of electronic information management.  In late April, CMS hosted a Special Open Door Forum on the Electronic Health Records Demonstration project.

In the News:  Home Health Quality Improvement Organization Support Center (HH QIOSC)

Quality has taken center stage in health care delivery throughout 2007 and into 2008 and the Home Health Quality Improvement (HHQI) National Campaign has been a major influence in this initiative.  The overall goal for this National Campaign was to create a shared vision among home care providers of reducing hospitalizations.  The approach spanned the year, and throughout the course of the year, best practice intervention tools and resources have been made available.  All packages use a multi-disciplinary approach and include resources, guidelines, case studies, and best practice education.

In the News: Transdermal System Medication Recalls: Duragesic, Fentanyl, Icy Hot

Several February MedWatch releases have a direct impact on patient care within the community based care delivery setting.  These releases were targeted for pain management specialists, other health care professionals and patients.  Two of these FDA MedWatch releases were focused on transdermal pain medication administration delivery systems. Duragesic® and Fentanyl transdermal, available by prescription only, are used to manage persistent, moderate to severe chronic pain that needs to be treated around the clock.

In the News:  Governmental Agency Activities

The Centers for Medicare and Medicaid Services [CMS] recently made changes and revisions to ease some issues that hospice providers previously faced.

In the News:  Infection Control and Patient Safety

The recent Home Care Bulletin (Issue #1, 2008) released by the Joint Commission provided a summary of the key findings relative to revisions in the following Standards Chapters:

• Infection Prevention and Control
• Management of Information
• Improving Organization Performance

In the News:  Food and Drug Administration Releases

Several recent releases from the Food and Drug Administration [FDA] are of interest to home care and hospice providers.  In a recent December release and alert, the FDA issued a recall for pre-filled heparin syringes due to contamination.  These were pre-filled Lock Flush Solutions 5 ml of solution in 12-ml syringes, Lot # 070926H.  A bacteria contamination was present in these heparin IV flush syringes that can lead to serious health effects as a result of an infection.  Consumers and health providers should check lot numbers on all heparin flush syringes in patients’ homes as well as any available for use by staff.  

In the News: Center for Medicare and Medicaid Services Activities

The Center for Medicare and Medicaid Services [CMS] has been reviewing its coverage parameters for home prothrombin assays.  This review included a research study that looked at existing evidence supporting the benefits of this testing.  Currently coverage is restricted to mechanical heart valve patients, but the recommendations coming out of this study propose that Medicare coverage of home prothrombin time (INR) monitoring be expanded to include both chronic atrial fibrillation and deep venous thrombosis when certain conditions are met.  

In the News:  Joint Commission Standards Improvement Initiatives

Home health and hospice care providers should note the recent releases available from the Joint Commission. They include the revised 2009 Leadership chapter standards and the proposed revisions to the Rights and Responsibility chapter. These releases are part of the ongoing Joint Commission’s Standards Improvement Initiative [SII]. The primary focus of this initiative as outlined by the Joint Commission is to clarify standards language, ensure that standards are program-specific, delete redundant/non-essential standards and consolidate similar standards. The targeted effective date for standards improvement initiative revisions for providers accredited through the Joint Commission’s Home Care Accreditation program, which includes home care, hospice and home medical equipment providers, is January 2009. [http://www.jointcommission.org/Standards/SII/]

In the News: Office of the Inspector General’s 2008 Workplan

Earlier this month, the Office of the Inspector General [OIG] released its Fiscal Year 2008 workplan. This 111-page document once again provides information on the initiatives to be undertaken by the OIG on behalf of Centers for Medicare and Medicaid Services [CMS] programs. Overall The OIG utilizes about 80% of its resources in CMS related work.

In the News:  Revisit Fees Final Rule Published

As a result of the 2007 Continuing Appropriations Resolution, Public Law No. 110-5, H.J.Res.20, §20615(b)(2007), the Department of Health and Human Services was directed to establish and charge user fees to health care facilities when survey revisits are needed as a result of survey deficiency citations. Survey types affected by these fees include initial certification, recertification, or substantiated complaint surveys.

In The News:  Home Health Prospective Payment System Final Rule

The final rule for the refinement and update of the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2008 was recently released by the Centers for Medicare and Medicaid Services [CMS]. CMS indicates that this is part of its efforts to focus on access to services and improvement of quality and efficiency in care and services. CMS has stated that the refinements reflect more accurate payment for services. While CMS has indicated that these revisions will bring about an increase in disbursements for home health services in 2008, these refinements are also intended to be budget neutral.

In the News:  Natural Disasters Abound

In the past, one natural disaster season appeared to follow another, but this summer every provider’s disaster management plan is being tested, and patient and family education relative to natural disasters is a key element of this plan.  The organization’s disaster and emergency management plan must focus on the primary natural disasters affecting the organization’s care and service delivery area and usually follows a seasonal pattern, such as teaching about snow emergencies during winter months in the North and about hurricanes during hurricane season in the South.  However in looking at the national weather map, determining essential topics of education is no longer a simple process.  In July there have been numerous weather-related events throughout the country, including hurricane watches, intense heat, wildfires, drought, tornadoes, torrential rains and flooding.  In August, more of the same is predicted.  Preparing patients, staff and families for these events is a monumental task and must be reinforced throughout the course of care.