On March 15, 2024, CMS released Memorandum QSO-24-07-HHA. The memorandum summarizes changes made to State Operations Manual (SOM) Appendix B – Guidance for Surveyors: Home Health Agencies based on final rules which have amended home health conditions of participation. Key changes include:
Emergency Preparedness
Is your Emergency Preparedness Plan up to date? Monitoring your plan periodically ensures your staff and patients are prepared for disasters in your community. Develop/Review your All Hazards Plan: Identify new hazards, weigh the likelihood of current hazards, review recent hazards. Assess Recent Emergency Response: What worked well, what needs improvement, were there communication breakdowns,…
Navigating ADRs
Do you struggle with how to navigate Additional Development Requests (ADRs) and ensure accurate reimbursement? These tips will help put you on the right track. Understand the Purpose of ADRs: ADRs occur when payers request additional documentation to justify payment for specific services. Focus on the most common type: Pre-Payment Medicare Approved Contractor’s (MAC) “medical…
American Heart Month
As February winds down, we are reminded that it is American Heart Month – a time when the nation spotlights heart disease, the No. 1 killer of Americans. President Lyndon B. Johnson, among the millions of people in the country who’d had heart attacks, issued the first proclamation in 1964. Since then, U.S. presidents have…
Hospice Plan of Care
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…
