Home Health & Hospice Week

"Coping" is key work during first few weeks, insiders report.

Home health agencies can move toward month two of mandatory use of Medicare's newest home health advanced beneficiary notice (HHABN) with renewed commitment to ongoing training.

Reports from the field: Agencies and industry representatives contacted by Eli report that staff are managing well during the first weeks of the new home health advance beneficiary notice--but that they aren't without questions.

"The field staff have to call frequently to check the accuracy of the forms they are using and to request assistance with the wording of the headings on the forms," reports says Pam Warmack, chief operating officer and senior consultant with Clinic Connections in Ruston, LA.

"The volume of questions I receive has diminished and are getting much more specific in terms of real-life, somewhat atypical situations," adds Robert Wardwell, vice president of regulatory and public affairs for the Visiting Nurse Associations of America in Silver Spring, MD.

To keep your compliance efforts on track, consider the follow training tips:

1. Have a resident HHABN expert in each office. You'll save time--and keep the focus on care--if field staff know there's one person on staff who can steer them reliably toward completing the  HHABN correctly.

Assigning one person to serve as resident expert can also help ensure agency-wide compliance and consistent practices.

Tip: Be sure that person is generally accessible by phone or other means.

2. Use patient scenarios to put a real-life spin on training, says Warmack.

Real-life example: Patients who have been on service a long time may need only an annual HHABN, advises Judy Adams of LarsonAllen in Chapel Hill, NC. Identify these patients now and check them off your to-do list.

As a starting point, employ examples provided by CMS in Change Request 5009, suggests Warmack.

Consider this case: A beneficiary is receiving several skilled nursing services during visits that are scheduled 3 times a week. One service within that discipline, a Protime draw 1 time a week, is discontinued. Other skilled nursing services (wound care and education) continue, such that skilled nursing visits continue to occur 3 times per week.

In this case, you don't need to issue an HHABN when the Protime draws are discontinued ...quot; only when skilled nursing is reduced in frequency.

3. Use cheat sheets. For one highlighting HHABN exceptions, refer back to Eli's Home Care Week, Vol. 15, No. 32.

4. Customize your forms, within CMS limits. For guidance on how to customize, see CR 5009 starting at page 35.

Resource: For tips on reducing the HHABN burden through customizing your forms, see Eli's Home Care Week, Vol. 15, No. 35.