Home Health & Hospice Week

OASIS suspended for directly impacted.

Home care providers have been smack dab in the middle of Hurricane Katrina as both victims and rescuers.

Thousands of home care employees and tens of thousands of home care patients were displaced by the storm (see Eli's HCW, Vol. XIV, No. 31). Home care worker Sarah Johnson yelled for help for her elderly, frail patient outside the New Orleans Convention Center Sept. 1 in a widely run photo from the Houston Chronicle.

Home care worker Pamela Franklin Carter and her family left New Orleans with just a few changes of clothes and have been living in a Shreveport, LA budget motel, according to the Sacramento Bee.

And home care business owner Linda Magee and her family left New Orleans without even that much, reports the Houston Chronicle. "Not even a pair of tennis shoes," Magee told the paper. She plans to relocate to Houston for at least a year.

But home care providers are also among those who are offering their assistance. Houston home care worker Betty Lewis showed up at the Astrodome Aug. 31 determined to help out, even though officials would not let her in. "I'm not going to be leaving. I'm getting in there," Lewis told the Chronicle.

Photographs of visiting nurses administering tetanus shots to victims and relief workers have run in multiple newspapers.

Home Care Associations Set Up Task Force

To coordinate the home care industry's relief efforts, the National Association for Home Care & Hospice has created a hurricane task force. The group petitioned the governors of the affected states to classify home care personnel as emergency responders and to place home care providers at the top of the list for rationed gasoline, among other things.

The task force also petitioned the Department of Health and Human Services and the Centers for Medicare & Medicaid Services for relief from certain Medicare Conditions of Participation and payment rules.

Home care staff interested in volunteering should contact task force co-chair Barbara Citarella at RBC Limited by email at rbc@netstep.net, NAHC says.

HHS says it needs volunteers including those who are administrators, finance officers, nursing assistants, chaplains, social workers, pharmacists, dieticians, respiratory therapists, RNs, housekeepers, LPNs, supply managers and mental health workers. Volunteers who can withstand field conditions can sign up at https: //volunteer.hhs.gov or by calling toll-free number 1-866-KAT-MEDI.

HHS will pay volunteers travel costs and a per diem, but no salary, the agency says in a release.

CMS says "health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricane Katrina, will be paid for services provided and will be exempt from sanctions for noncompliance, unless it is discovered that fraud or abuse occurred."

Home care providers that can't volunteer in person are donating money and supplies (see related story, next article). One example is Waterloo, IA-basedVGM, which is offering a hotline, help in getting oxygen and durable medical equipment to evacuated patients, billing assistance and more.

The American Association for Homecare is matching offers of services or equipment made to info@ aahomecare.org with local relief efforts, its Web site says.

OASIS Abbreviated, Deferred

HHS is trying to make things easier on affected providers. Secretary Michael Leavitt signed an order on Aug. 31 to waive specific Medicare, Medicaid and HIPAA requirements including some COPs for health care providers who want to provide medical care to the hurricane victims. Leavitt included this waiver in his order that declared a public health emergency for Louisiana, Mississippi, Alabama and Florida.

For directly affected HHAs, CMS has granted a 30-day deferment on home care patients' comprehensive assessments and all OASIS time points except Start of Care. SOC OASIS assessments (RFA 1) must include only the patient tracking sheet and 24 payment items, CMS instructs in a question-and-answer set on its Katrina Web site.

Agencies won't be able to submit their abbreviated SOC assessments to the state OASIS system, so they won't have outcome reports for those episodes, CMS explains. And they'll receive warnings for their assessments that are submitted late due to the deferment.

"Agencies are expected to use this policy only as needed, and to return to business as usual as soon as possible," CMS says in the Q&A.

HHAs can't omit the deferred OASIS assessments altogether, CMS warns. They must submit them within a month of when they should have been made.

Hospice heads up: CMS also instructs hospices to arrange for care for their patients rather than discharge them. "Hospices should consider using a variety of options including contacting the State for assistance and guidance, teaming up with other area hospices to share staff and resources, and utilizing contract services," CMS says in the Q&A.

CMS is relaxing normal operating procedures to speed health care services to the needy. For example, the agency will waive the normal burden of documentation for providers who serve displaced beneficiaries. In addition, federal Medicaid officials are working with state Medicaid agencies to resolve interstate payment agreements for beneficiaries served outside their home states.

Regional home health intermediary and DMERC Palmetto GBA has issued a list of disaster-related accommodations it is allowed to make, including suspending additional development requests (ADRs), delaying medical review, and accepting backup records when originals are destroyed.

However, DME suppliers could still see a delay in claims processing due to victims of the disaster being routed to states in DMERC regions that do not match their residence on file with Social Security, AdminaStar Federal says in a recent message to providers. The Region B DMERC is working to ensure those claims are adjudicated properly.

HHAs could see problems with subsequent episodes' requests for anticipated payment (RAPs) when patients' previous episodes' OASIS assessments were deferred, CMS warns.

Note: CMS' OASIS Q&A and other information is online at www.cms.hhs.gov/katrina.