Home Health & Hospice Week

New items on topics from high-risk drugs to social determinants of health will add to HHAs’ headaches.

If Medicare finalizes a proposal in the 2020 home health payment rule as-is, you’ll have a whole slew of new SPADE elements to address at assessment time.

The Centers for Medicare & Medicaid Services has proposed adding these 22 standardized patient assessment data element items, along with many sub-elements.

• Brief Interview for Mental Status (BIMS) — OASIS items C0100, C0200, C0300, C0400, C0500.
• Assessment of Cognitive Function (CAM) — C1310 A-D.
• Patient Health Questionnaire–2 to 9 (PHQ–2 to 9) — C0150 A-H, C0160.
• Cancer Treatments — O0110 A-J, O (each lettered section with multiple sub-elements).
• Nutritional Approaches — K0520 A-D.
• High-Risk Drug Classes — N0415 A, E-F, H-J.
• Medical Conditions and Comorbidities — J0510, J0520, J0530.
• Impairments — B0200, B1000.
• Social Determinants of Health (race, ethnicity, preferred language, interpreter services, health literacy, transportation, and social isolation) — A1005, A1010, A1110, A1250, B1300, D0700.

Resource: CMS spends 33 of the 2020 proposed rule’s 118 pages discussing the SPADE additions. Medicare’s OASIS contractors Abt Associates and RAND Corp. include the proposed SPADE items and their specifications in a 149-page report at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/Post-Acute-Care-Quality-Initiatives/Downloads/Proposed-Specifications-for-HH-QRP-Quality-Measures-and-SPADE.pdf.