Home Health & Hospice Week

Home health agencies are going to have to wait a little longer for details about the Quality Improvement Organizations' upcoming Home Health Quality Campaign.

After HHAs complained about being left off the QIOs' 9th Statement of Work, the Centers for Medicare & Medicaid Services recently announced it would authorize a new home care-focused campaign (see Eli's HCW, Vol. XVII, No. 29, p. 231).

CMS doesn't mention the campaign in its summary of the SOW at http://www.cms.hhs.gov/QualityImprovementOrgs/downloads/9thSOWAnnouncement080508.pdf. The SOW does, however, refer to the care transitions project that will run in 14 states and "promote seamless transitions across settings" in-cluding home care.

CMS won't issue the campaign's lead contract until about January, so don't expect details until then, CMS' Debbie Turkay said in the Aug. 13 Open Door Forum for home care providers. "Phase two of the home health quality initiative is really still kind of in action," Turkay told listeners. "Stay tuned."

In the meantime, CMS urges agencies to continue the quality improvement work they began under the now-wrapped first campaign, she added.

• The mainstream press is paying attention to CMS' recently announced cuts to hospice payment rates via wage index.

CMS issued a rule July 31 reducing Medicare's hospice payment rates by nearly 5 percent over three years (see Eli's HCW, Vol. XVII, No. 28, p. 218).

"Hospice does not have the finances that they had before to provide the services," said Greg Sangster, administrator of Aspen Hospice of Mon-tana in Stevensville, MT, to the Ravalli Republic newspaper. "The hospice is left with a decision to cut back on the services they provide or continue to provide them and try to find some creative way to continue."

"That's going to be very difficult for small hospices in rural America," Sangster added.

Patients who can't get access to hospice will wind up in costly hospital stays, he also said. The newspaper ran the article, which urges readers to contact their congressional representatives to stop the cuts, after Aspen Hospice submitted a letter about the problem.

• Gas prices continue to tick down, much to the relief of home care workers. The federal Energy Information Association reports a national average gas price of $3.74 per gallon, down nearly 7 cents from the previous week.

Gasbuddy.com puts the national average at $3.71, with the cheapest gas in Missouri ($3.44 per gallon) and the most expensive in Hawaii ($4.56). But the national average is still up about 96 cents compared to a year ago, the EIA notes. That high price continues to place a heavy burden on visiting home care staff.

Genesis VNA and Hospice in Davenport, IA has increased the mileage rate it pays employees three times since January, executive director Mike Hamaker told the Quad-City Times.

The recent Internal Revenue Service jump to 58.5 cents for allowed mileage reimbursement translates to an additional $15,000 per year that Trinity Visiting Nurse and Homecare Association has to absorb, the home health agency president Gary Bargstadt told the newspaper.

Genesis and Moline, IL-based Trinity, both health system-based agencies, are combating the high gas prices with more efficient scheduling, telemonitoring and electronic solutions for paperwork.

Aides are hardest hit by the high gas prices. "Some staff are evaluating if they can stay in the home care field with having to put out additional costs for gas," Bargstadt told the Times. "When you go to one (work) location and stay all day it's different than having to drive all over."

• Durable medical equipment suppliers shouldn't rest on their laurels after winning an uphill battle for competitive bidding delay this summer, urges the National Association of Indepen-dent Medical Suppliers.

"The single most important action that suppliers must do over the next 90 days is to reach out and touch candidates for Congress," NAIMES urges. Suppliers must use a grassroots campaign to secure a permanent repeal of competitive bidding and other goals, the trade group says.

• HHAs can breathe easy that the hospital post-acute transfer provision that discourages home care referrals at least won't get any worse.

Back in April, CMS proposed expanding the window for the transfer policy from three days to seven (see Eli's HCW, Vol. XVII, No. 23, p. 183). That would have reduced hospitals' DRG payments for patients who transfer to home care within seven days for certain groups.

Now CMS has decided not to adopt that provision, following negative comments from the Med-icare Payment Advisory Commission, the Nation-al Association for Home Care & Hospice and others. "This decision will be a welcome relief to hospitals and home health agencies," NAHC says in its newsletter.

• Home care providers have another sign that HIPAA compliance may be getting tougher. Despite a recent $100,000 settlement with the HHS Office for Civil Rights over HHA-related information breaches, an article in the Des Moines Register blasts OCR for not enforcing HIPAA enough.

OCR resolves more than half of HIPAA complaints without investigation and hasn't levied any fines, the newspaper says. OCR "could toss those [fines] around like candy, if only to wake people up about the seriousness of compliance," Abner Weintraub of the HIPAA Group, a training company, told the Register.

OCR has resolved 6,800 complaints through corrective action orders, it told the newspaper.

• Time spent with friends is likely to pay big dividends for seniors, suggests a new study. The payoff is improved health, say researchers from the Harvard School of Public Health in Boston.

Simple social interaction may increase feelings of self-worth and emotional validation that could end up helping maintain memory, researchers say in a recent online edition of the American Journal of Public Health. Social interaction may also present older minds with new challenges, keeping the brain more agile.

Harvard lead researcher Karen Ertel's team team found that "people who were most socially integrated had memory decline of less than half the rate compared with those who were the least socially integrated," Ertel said.

• Anticholinergic medications may accelerate cognitive decline in older people. That's according to study findings presented at the recent American Academy of Neurology annual meeting in Chicago.

The research looked at the effect of anticholinergics, which include gastrointestinal medications and those used to treat incontinence, on the cognitive skills of 870 Catholic nuns and clergy members who were, on average, 75 years old. The study was part of a longitudinal study looking at dementia.

Findings: Researchers found that study participants who took drugs with anticholinergic properties suffered a 1.5 times faster rate of loss of mental abilities compared to those who didn't take such medications.

"Our findings point to anticholinergic drugs having an adverse impact on cognitive performance in otherwise normal, older people," said study author and physician Jack Tsao, in a release.

Tsao says more research will be required to identify what might be causing the rapid memory loss associated with anticholinergic drugs -- and to identify which drugs specifically may be more likely to cause the cognitive decline.

• Celtic Healthcare Inc. of Adams Town-ship, PA has acquired Forum Health of Youngs-town for $4.2 million. Celtic offers HHA, hospice, rehab, assisted living and care management services.

The acquisition is Celtic's second this year, notes the Pittsburgh Business Times. The company bought New Castle-based Jameson Visiting Nur-ses' Association in April.

"We're built to be a $50 million company," Arnie Burchianti, Celtic president and CEO, told the newspaper.