Home Health & Hospice Week

Look for a boost in your Home Health Compare scores.

Have you been frustrated by the lack of good options for answering for M1910 -- Has the patient had a multi-factor Fall Risk Assessment? for your non-ambulatory patients? Being forced to answer "no" does a number on your Home Health Compare scores, but until now there wasn’t an easy way to answer "yes."

Good news: The Missouri Alliance for Home Care’s multi-factorial fall risk assessment tool is now validated for the home health population.

Get the Background

M1910 requires that your multi-factor falls risk assessment includes at least one standardized tool that has been "scientifically tested and validated as effective in identifying a specified condition or risk in population with characteristics similar to the patient being evaluated. A standardized tool includes a standard response scale, and must be appropriately administered based on established instructions," according to the Centers for Medicare & Medicaid Services OASIS Q&As. But the availability of a standardized tool appropriate for assessing falls risk in bedbound community-dwelling elders has been a problem.

Until now, there was no widely-available standardized fall risk assessment tool that was appropriate for non-ambulatory patients. For example, the commonly used Timed Up and Go tool is validated, but not multi-factorial. As a result, when a non-ambulatory patient was unable to participate in the tasks required to complete the standardized assessment used to determine fall risk, you could only select Response 0 -- No for M1910 even though it lowered your Home Health Compare scores through no fault of your agency.

Celebrate Validation

In response to the need for a multi-factorial falls risk assessment tool that has been validated in the home health community, MAHC set to work on the process for validating their multi-factorial fall risk assessment tool, MAHC-10, said Mary St. Pierre, Vice President for Regulatory Affairs with the National Association for Hospice & Homecare in a recent e-mail.

Dr. Mary Calys, physical therapist with North Kansas City Hospital, and Dr. Kendra Gagnon and Dr. Stephen Jernigan, both with the Department of Physical Therapy and Rehabilitation Science at the University of Kansas Medical Center tested MAHC-10, according to a MAHC press release. Their research paper "A Validation Study of the Missouri Alliance for Home Care Fall Risk Assessment Tool," appears in the Sept. 6 issue of Home Health Care Management & Practice, a peer-reviewed journal.

Bottom line: You can use MAHC-10 with all patients, including those who are bedbound or have severe mobility limitations, MAHC says in the release. This newly validated tool enables agencies to meet the OASIS requirements for an initial screening for fall risk for a full range of patients, and to mark a "Yes" response on M1910 where previously only "No" was appropriate.

Your agency can use the MAHC-10, found on page 357, at no cost. Get the details here: www.homecaremissouri.org/projects/falls/documents/ValidationPressRelease.pdf.

Consider Falls Benchmarking

If your agency is looking for new methods to reduce falls and improve patient outcomes, you may want to consider participating in MAHC’s Fall Reduction Benchmark program. The multi-disciplinary home care fall reduction initiative aims to:

• Reduce falls
• Improve patient outcomes
• Establish a baseline of falls in home care

Participants receive quarterly reports which provide an overview of all the fall data collected as well as their agency’s individual analysis. Clinicians can use the reports to track outcomes, identify trends, and improve care.

"A minimal annual registration fee paid by the participating agencies covers the cost of data collection and statistical analysis," MAHC says. In addition to the quarterly reports, participants receive training and on-going support; communication on fall prevention developments; and interactive communications where participants and MAHC staff share feedback and look for ways to enhance the program’s value.

Resources: For more information or to request an enrollment form, contact Carol Hudspeth at 573-634-7772 or carol@homecaremissouri.org.

Read the MAHC-10 validation study here: http://hhc.sagepub.com/content/early/2012/09/04/1084822312457942.full.pdf+html. Find the MAHC-10 form online here: www.homecaremissouri.org/projects/falls/documents/Oct2012FINALValidatedFallriskassessmenttool.pdf.