Home Health & Hospice Week

Don't let the newest policy change catch you flat-footed.

Both your bottom line and your compliance reputation will be at risk when new rules for OASIS pressure ulcer coding kick in next month, and teaching your clinicians the ropes won't be easy (see story, this page).
 
But following these experts' tips will help you win the training battle:
 
1. Explain why. The key will be to tell clinicians exactly why the pressure ulcer coding rules for OASIS have changed, counsels Lynda Dilts-Benson with Reingruber & Co. in St. Petersburg, FL. Home health agencies shouldn't count Stage 1 and 2 healed pressure ulcers because ulcers of those severities leave the skin at little to no risk for future break-down, the Centers for Medicare & Medicaid Services explains in the notice that is based on a recent National Pressure Ulcer Advisory Panel opinion.
 
This rationale "should make sense to clinicians," agrees Karen Vance with BKD in Springfield, MO. "There is logic in the change" and it's up to you to explain it so clinicians can get the related OASIS questions right.
 
2. Provide the facts. Print out the CMS notice, which is only a little over a page long and explains the rationale behind the change in detail, and give it to your clinicians as part of their training, Dilts-Benson suggests. "Give it to them in black and white," she urges.
 
3. Follow up. After training your clinicians, you'll want to audit OASIS assessments for this item, Dilts-Benson recommends. And the typical 10 percent chart audit probably won't be enough, she adds. Clinicians having trouble getting the item right will need individual retraining.
 
4. Adjust expectations. Don't expect your OASIS data from the pressure ulcer items to be reliable at first, Vance cautions. It will take time for the training to show results.