OASIS Alert

Industry Notes

Preventing falls is one of the measures stressed in this year's National Patient Safety Goals for home health agencies from accrediting body the Joint Commission. The goals should look pretty familiar -- they are all repeats from 2011's list, the accreditor formerly known as JCAHO says on its website. The other home health NPSGs for 2012 include identifying patients correctly, using medicines safely, preventing infections, and identifying patient safety risks.

More information is online at www.jointcommission.org/standards_information/npsgs.aspx.

  • Use the CDC's oldie but goodie on handwashing hygiene to help keep your staff -- and their patients -- healthier. The Centers for Disease Control & Prevention hand hygiene guideline "came out in 2002 and hasn't changed," says infection control and epidemiology consultant James Marx of Broad Street Solutions in San Diego.

But keep an eye out for revisions in the future. "I imagine it will be up for some reviews" this year, Marx adds.

The guideline is at www.cdc.gov/mmwr/pdf/rr/rr5116.pdf. The CDC's hand hygiene website with links to training tools and other resources is at www.cdc.gov/handhygiene.

  • Should you put the brakes on your ICD-10 transition plan? Just three months ago, CMS representatives firmly told medical practices that the ICD-10 implementation date would not be pushed back beyond Oct. 1, 2013 -- but what a difference a few months makes.

The Dept. of Health and Human Services (HHS) announced on Feb. 16 that the ICD-10 implementation date will indeed be postponed. The agency stated that it "will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10)."

"ICD-10 codes are important to many positive improvements in our health care system," said HHS Secretary Kathleen Sebelius in a statement. "We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead," Sebelius said. "We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system."

The announcement followed hints that CMS was planning a pushback. On Feb. 14, acting CMS administrator Marilynn Tavenner said she intended to "re-examine the pace at which we implement ICD-10," which would require the agency to go through the standard federal rulemaking process. Tavenner made her comments to great applause at the American Medical Association's National Advocacy Conference, attendees said.

Physicians' "big ruckus about ICD-10" is probably one of the chief reasons for the delay, suspects home health coding expert Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, HCS-O, of Selman-Holman Associates in Denton, Texas. And in an election year, the Obama administration is likely happy to spread around some regulatory burden reduction, Selman-Holman says on her blog.

Sebelius's announcement seems to fall short of providers' call for a full repeal of ICD-10. However, a slower pace could at least buy time for providers that have not yet considered the impact of ICD-10 on their systems.

Stay on track: Despite the announcement of a slower timeline, you should continue to work toward compliance with the new diagnosis coding system, which appears to still be in place for future implementation, coding experts urge.

Not a fan: Selman-Holman criticizes HHS for implementing the delay. "Continuing to use an antiquated system like ICD-9-CM increases regulatory burden," she claims on her blog. "Payors and providers, including HHS, have spent millions of dollars readying for ICD-10-CM. A delay now will increase the money spent and the time spent."

Selman-Holman wonders if the U.S. may skip ICD-10 and switch directly over to ICD-11, which is scheduled to debut in October 2015.

And don't be surprised if HHS keeps you hanging on the final ICD-10 implementation date. Due to politics, a decision on the final deadline may not come until after the presidential election concludes this year, experts predict.

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