April is Occupational Therapy Month and The American Occupational Therapy Association’s 2024 theme is Occupational Therapy: Advancing Health, Wellbeing and Quality of Life. What is Occupational Therapy? Simply put, occupational therapy enables people of all ages to participate in daily living. Our lives are made up of occupations-meaningful everyday activities. These occupations can include many…
Challenges In Providing Continuous Home Care To Hospice Patients
The Medicare Hospice Benefit affords patients four levels of care to meet their needs: routine home care, respite care, general inpatient care (GIP), and continuous home care (CHC). For hospice providers, the majority of Medicare days of care were at the routine home care level of care for both percent of payments made and percent…
State Operations Manual (SOM) Appendix B Revisions
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…
