Home Health & Hospice Week

Bad news: You still have to furnish the patient rights verbal notice on the next visit.

The ability to once again use pseudo-patients for aide competency testing is a welcome surprise in the new final rule that aims to lighten Medicare providers’ regulatory burdens. But there was another provision affecting home health agencies in the proposed rule that did not make it to finalization.

In the original rule, “we proposed to remove the requirement at § 484.110(e) that the requested clinical record copy must be provided at the next home visit, while retaining the requirement that the information must be provided within 4 business days,” the Centers for Medicare & Medicaid Services notes in the final rule released Sept. 25.

Comments on the proposed rule “universally supported the proposal to remove the requirement that HHAs must provide to patients a copy of information contained in the clinical record by the time of the next HHA visit,” CMS notes in the final rule. And multiple commenters asked for further relief by relaxing the four-day deadline that would still be in place.

But CMS opts not to finalize the popular change “at this time,” according to the rule. Instead “we will consider the issues raised by commenters in the broader context of interoperability and health information exchange, and will use these comments to inform future rulemaking.”

In foregoing the change, CMS missed out on an opportunity to lighten HHAs’ loads and to save them $55 million annually (see Eli’s HCW, Vol. XXVII, No. 34).

Bath Skill Still Required

CMS also failed to fix another problem with the aide competency section of the Home Health Conditions of Participation, points out Sharon Litwin with 5 Star Consultants in Camdenton, Missouri. The CoP still requires the aide to demonstrate competency in “appropriate and safe techniques in per- forming personal hygiene and grooming tasks that include … (B) Sponge, tub, and shower bath.”

The problem is the “and” in that statement. “Tub baths are uncommon for home health patients due to safety issues and there are rare circumstances in which an aide can be competencied on this,” Litwin points out. “Maybe with the pseudo patient allowed once again, it will be easier to competency, but [an agency] still would have to have access to a tub in order to use a pseudo patient,” she notes.