Home Health & Hospice Week

Sidestep this common survey pitfall with excellent physician communication.

With alternative sanctions coming down the pike this year, you’ll want to be doubly sure to avoid survey citations.

The top survey deficiency home health agencies received in 2011 was G158: “Care follows a written plan of care established and periodically revised by a doctor of medicine, osteopathy, or podiatric medicine.” That tag accounted for 19 percent of all deficiencies, said Pat Sevast of the Centers for Medicare & Medicaid Services.

The next-most-cited tag was 337, regarding drug regimen review, at 13.5 percent, Sevast told attendees of the National Association for Home Care & Hospice’s March on Washington meeting March 18.

In 2010, Missouri surveyors cited G15 in 25 percent of HHA surveys, according to a document from the state’s Bureau of Home Care and Rehabilitative Standards. Problems seen in surveys included:

• visits for all disciplines not made at the frequency ordered on the POC;

 • no explanation for missed visits;

• no documentation physician notified of missed visits and reason;

• lack of compliance with physician orders for assessment and teaching related to diabetic assessment and management, pain assessment and management, and wound assessment and care;

• lack compliance with other skilled assessment and teaching ordered by the physician;

• lack of orders for specific modalities such as heat, cold, ultrasound, electrical muscle stimulation, etc.;

• therapy orders stated as goals rather than specific procedures and modalities;

• lack of orders for changes in medications or treatments; and

• lack of complete resumption of care orders post-hospitalization.