Home Health & Hospice Week

If you think your patients' confidential identity information is always safe in your staffers' hands, think again.

The Minnesota Department of Health's

Office of Health Facility Complaints (OHFC) has substantiated a complaint against a St. Paul home health aide accused of using her patient's identity to open a line of credit, KSTP channel 5 news reports.

The aide's employer, Home Instead Senior Care of Coon Rapids, first caught wind of the scam when one of its clients received a credit card he never applied for. He contacted his bank and began the process of tracing how his credit was being used.

During that time, the aide attempted to pay a $572.26 cell phone bill using the illegal card.

Aide's excuse: The aide first attempted to avoid criminal charges by claiming that the client wanted to take over her cell phone contract. When that didn't work, she changed her story, saying the attempted charge was for new wheels for the client's scooter. However, neither story checked out. Home Instead asked the OFHC to investigate the case and is working with authorities to properly penalize the aide, and protect their client's private information.

Look for tips and tricks for protecting your patients' data in upcoming issues of HCW.

• How focused you'll be on swine flu vaccinations this fall is still being hammered out. The Centers for Disease Control and Prevention is seeking advice on its upcoming H1N1 vaccination drive. The CDC plans to gather the public's thoughts on the extent of what this fall's H1N1 influenza vaccination drive should be. The agency will travel around the country to consult with citizens about the vaccination program, says Roger Bernier, senior advisor in the CDC's National Center for Immunization and Respiratory Diseases. "We're at some danger of either overreacting or underreacting," says Bernier, who hopes the agency will avoid both possibilities by initiating a comprehensive dialogue with the public and incorporating the lessons it learns.

The CDC has scheduled a meeting this month in one city in each of the 10 Department of Health and Human Services regions.

• Suppliers waiting for the onset of competitive bidding now have a firm deadline for the program. The Centers for Medicare & Medicaid Services will begin accepting bids for durable medical equipment in nine metro areas starting Oct. 21, CMS' Competitive Bidding Implementation Contractor said on its Web site.

The bid window will be open for 60 days, and CMS will announce the bid rates and begin contracting with suppliers in June of next year, the CBIC said. The program will go into effect in January 2011. Suppliers can begin signing up for bid system user IDs and passwords on Aug. 17, according to CMS estimates.

There are a few changes from the original Round One bid, CMS noted in a release. Puerto Rico will now be excluded from the bid areas, and negative pressure wound therapy items and Group 3 complex rehabilitative power wheelchairs will be excluded from the list of bid items. Otherwise the bid areas and items remain the same.

You can access more bidding information, including the detailed timeline and entire slate of educational sessions and materials, at www.dmecompetitivebid.com.

• The research on negative pressure wound therapy has just been completed by the Centers for Medicare & Medicaid Services and the Agency of Healthcare Research and Quality, and NPWT proponents may not like the findings. "The available evidence does not support significant therapeutic distinction of a NPWT system or component of a system," CMS said. In other words, no one NPWT system or part deserves its own HCPCS code.

NPWT applies a localized vacuum to draw the edges of the wound together while providing a moist environment to promote rapid wound healing. NPWT is based on two theories: (1) the removal of excess interstitial fluid decreases edema and concentrations of inhibitory factors and increases local blood flow; and (2) stretching and deformation of the tissue by the negative pressure can disturb the extracellular matrix and introduce  biochemical responses that promote wound healing.

The study backing up CMS' decision can be accessed online at www.ahrq.gov/clinic/ta/negpresswtd/npwtd01.htm.

• OASIS C will put new focus on medication review, and a new study on heart failure patients supports the importance of this effort in home care.

Physician-pharmacist collaboration cut the hospitalization rate for heart failure in the first year by 45 percent compared with patients who did not receive this intervention, according to study authors Elizabeth Roughead from the University of South Australia and colleagues.

Pharmacists visited heart failure patients in their homes to review their medications and identify medication-related problems. They then reported their findings to the patients' doctor, who was responsible for follow-up.

End goal: The purpose of this retrospective study was to determine whether a collaborative medication review would improve outcomes for Australian heart failure patients in the home setting. To see the study, "The effectiveness of collaborative medicine reviews in delaying time to next hospitalisation for heart failure patients in the practice setting: results of a cohort study," go to http://circheartfailure.ahajournals.org. Select "more" under "Publish ahead of print," then look under August 19.

• Just when you thought you had the supply closet rules down pat, the Centers for Medicare & Medicaid Services is making some changes.

New rule: DMEPOS suppliers can maintain inventory at a practice location owned by a physician or non-physician practitioner for the purpose of distribution -- if the suppliers meet certain conditions, according to a change request issued on August 7. The revisions are effective on September 8, 2009.

First way: Rather than maintain inventory at a physician's practice, DMEPOS suppliers can sell their wares to the physician or non-physician practitioner, CMS says. The practice can then manage the inventory,  including billing for and supplying new items. CMS will evaluate these arrangements on a case-by-case basis.

Second way: Suppliers are also allowed to maintain inventory at physician's and practitioners' locations if they follow CMS's strict guidelines, which state:

• suppliers must transfer DMEPOS titles to enrolled physicians' and practitioners' practices when the items are given to benes;

• physicians and practitioners must bill for supplies and services using their own enrolled DMEPOS billing numbers;

• suppliers can never provide benes with services concerning DMEPOS fittings or use;

• physicians and practitioners must instruct benes to contact them -- not suppliers -- if patients have problems or questions.

• Only one DMEPOS supplier can be enrolled or located at a given practice location, the CR warns.

• This revision applies to all DMEPOS suppliers who maintain inventory at practice locations for the purpose of DMEPOS distribution and who submit claims to the National Supplier Clearinghouse Medicare Administrative Contractor.

Read the full notice at www.cms.hhs.gov/Transmittals/downloads/R297PI.pdf.

• Patients and caregivers may find a new Medicare resource useful. Ask Medicare, the enewsletter for caregivers, is gaining a lot of positive feedback from across the spectrum.

The Web site helps beneficiaries' caregivers make sense of the ins and outs of the Medicare system and is part of Centers for Medicare & Medicaid Services' 'My Health My Medicare' campaign. Through this campaign, CMS says, it can help people with Medicare understand and evaluate their health and prescription drug coverage and motivate them to take advantage of all Medicare has to offer.

The site is online at www.cms.hhs.gov/MyHealthMyMedicare/10_AskMedicare.asp.

• Having a spouse as the primary caregiver for a patient with Alzheimer's disease can significantly slow the clinical progression of the disease, according to a study funded by the National Institute on Aging.

After three years, researchers found that the closer the relationship of the caregiver to the patient, the slower the cognitive and functional decline. The study showed spouses had the most significant effect.

• Anew diabetes study fails to support cost savings and outcome expectations. Two groups of beneficiaries in New York received intensive nurse case management for diabetes via televisits and regular care from 2000 to 2007, say study authors from Mathematica Policy Research and CMS.

But costs for those beneficiaries over subsequent years were 71 to 116 percent higher than the control group that didn't receive telemedicine, says a study in the July issue of Diabetes Care Journal. Furthermore, clinical outcome effects were merely "modest," the authors say. "The intervention's costs were excessive (over $8,000 per person per year) compared with programs with similarsized clinical impacts," the study concludes.

• If you get a phone call from home health researchers, don't send that call to voicemail, urges the National Association of Home Care & Hospice. That's because NAHC wants to help agencies improve their financial and quality performance, and it needs as much help as it can get, says Val Halamandaris, NAHC president and CEO. The group is working with researchers to survey home health leaders as part of the "largest study in home care history" on the state of the industry," he explains.

Researchers will reach out to leaders from every segment of the industry over the next two months. A report on the findings will be presented at NAHC's annual meeting in October.