Survey Success: A Report on How Surveyors are …
Survey Success: A Report on How Surveyors are Interpreting and Applying the New Home Health Conditions of Participation
10/4/2019
Survey Success: A Report on How Surveyors are Interpreting and Applying the New Home
Health Conditions of Participation
CMS Home Health Conditions of Participation Final HH CoPs ? 01.13.2017
1
10/4/2019
CMS Home Health Interpretive Guidelines
Final IG ? 8.31.2018 QSO Memo 18-25-HHA
? 2019 National Association for Home Care & Hospice
3
Significant Changes
HANDOUT
? 2019 National Association for Home Care & Hospice
4
2
10/4/2019
HHA CoP FAQ
QSO Memo 19-07-HHA 01.23.2019
nfo19-07-HHA.pdf
? 2019 National Association for Home Care & Hospice
5
Revised Survey Protocol
QSO Memo 18-13-HHA Rev 01.16.2018
? 2019 National Association for Home Care & Hospice
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3
10/4/2019
National Data
TOTAL National
- Complaint - Standard AVERAGE/SURVEY National
Deficiencies
7277 926 6351
2.7
Condition
347 87 260
Standard
6930 839 6091
? 2019 National Association for Home Care & Hospice
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National Data ? Deemed Status Providers
TOTAL National
- Complaint - Standard AVERAGE/SURVEY National
Deficiencies
702 354 348
1.1
Condition
62 45 17
Standard
640 309 331
? 2019 National Association for Home Care & Hospice
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4
10/4/2019
Top 10 Deficiencies
NATION G574 G536 G572 G710 G682 G578 G590
G580 E-0039 G1022
Plan of care must include the following Review of medications Plan of care Provide services in the plan of c are Prevention Conformance with physician orders Promptly alert physician to relevant change POC Only as ordered by a physician EP testing program Discharge and transfer summaries
DEEMED
G574
G572
G590
G578
G608
Coordinate care delivery
G710
G570 G580
Care planning, coord of svcs, and quality of care
Verbal orders
G1024 Authentication
G700
Skilled professional services
5
10/4/2019
G574
LEVEL 1
?484.60(a)(2) The individualized plan of care must include the following: ? All pertinent diagnoses; ? The patient's mental, psychosocial, and cognitive status; ? The types of services, supplies, and equipment required; ? The frequency and duration of visits to be made; ? Prognosis; ? Rehabilitation potential; ? Functional limitations;
? 2019 National Association for Home Care & Hospice
11
G574
? Activities permitted; ? Nutritional requirements; ? All medications and treatments; ? Safety measures to protect against injury; ? A description of the patient's risk for emergency department visits and hospital
readmission, and all necessary interventions to address the underlying risk factors. ? Patient and caregiver education and training to facilitate timely discharge; ? Patient-specific interventions and education; measurable outcomes and goals
identified by the HHA and the patient; ? Information related to any advanced directives; and ? Any additional items the HHA or physician may choose to include.
? 2019 National Association for Home Care & Hospice
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6
10/4/2019
G574
o Not including all items o Medications o Risk for ED visits and rehospitalization AND underlying risk factor
and necessary interventions o Advanced directives information
? 2019 National Association for Home Care & Hospice
13
G574
? No interventions on the plan of care for the first diagnosis listed on the plan of care
? Interventions/goals that address targets/parameters but do not state what these are, i.e. weight, blood glucose, pain level, etc.
? Inconsistencies ? Incomplete orders
? 2019 National Association for Home Care & Hospice
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7
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