Survey Success: A Report on How Surveyors are Interpreting ...

Survey Success: A Report on How Surveyors are Interpreting and Applying the New Home Health Conditions of Participation

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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

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CMS Home Health Interpretive Guidelines

Final IG ? 8.31.2018 QSO Memo 18-25-HHA



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Significant Changes

HANDOUT

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HHA CoP FAQ

QSO Memo 19-07-HHA 01.23.2019

nfo19-07-HHA.pdf

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Revised Survey Protocol

QSO Memo 18-13-HHA Rev 01.16.2018



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National Data

TOTAL National

- Complaint - Standard AVERAGE/SURVEY National

Deficiencies

7277 926 6351

2.7

Condition

347 87 260

Standard

6930 839 6091

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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

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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

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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;

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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.

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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

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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

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