Home Health & Hospice Week

Home Health Compare revision goes ahead without underlying OASIS revamp. If you're waiting for the Centers for Medicare & Medicaid Services to fix all those nagging problems with the OASIS instrument, you'll be waiting a good while longer.
 
Finalizing and implementing any changes to the OASIS tool is probably two to three years off, a CMS official said in the Feb. 17 Home Health Open Door Forum. CMS is taking input on the OASIS instrument from a number of parties, including the OASIS Technical Expert Panel (TEP) and the National Quality Forum.
 
CMS has decided to make changes to Home Health Compare without waiting on those revisions, the staffer explained. The agency will adopt 10 of the 15 HHA quality measures the NQF endorsed earlier this month (see Eli's HCW, Vol. XIV, No. 7, p. 50).
 
Changes to the OASIS instrument would be especially likely to affect the acute care hospitalization and emergent care measures, the staffer noted. Chronic Care Population Still ID'd After its revision this fall, Home Health Compare will retain its footnote indicating that certain New York HHAs serve a chronic long-term population, the CMS official said. "Because these patients are different from traditional home care patients, the quality measures reported for these agencies are not directly comparable to other agencies and may not reflect the actual quality of care and services," a link with the footnote explains.
 
CMS is evaluating ways to identify chronic care populations in other states as well, the staffer promised. But doing so is proving difficult.
 
Other topics addressed in the forum include:

  Hospital referrals. It isn't just a heavy workload that is holding up the final rule requiring hospitals to publicly report their home care referral statistics to organizations with which they have financial relationships. "There's a particular problem" that is keeping the rule, which will reveal how many referrals go to a hospital's own agency, in clearance limbo, a CMS official revealed in the forum. But CMS declined to elaborate further on the problem.
 
The agency hopes to issue the rule this year, the staffer said. The requirement was included in the Balanced Budget Act of 1997 and CMS proposed a rule on it in April 2002.

  Hospice staffing. Hospices can use contracted staff for nursing services if they elect an exception to the core services condition of participation due to a documented staffing shortage, CMS reminded listeners. Details on how to elect the exception are at www.cms.hhs.gov/medicaid/survey-cert/sc0502.pdf.