OASIS Alert

A new study confirms what many home care providers could readily tell you -- the level of care a patient receives from an informal caregiver has an influence on rehospitalization rates.

"Increasing age, obesity, lower levels of cognitive functioning, and receiving less care from [an] informal caregiver are related to lower functional ability and may increase the possibility of rehospitalization," found a study published in the October-December issue of Advances in Nursing Science. "Being male, having a higher level of cognitive functioning, living alone, receiving more care from an informal caregiver, and receiving assistance other than activities of daily living are related to high functional ability and decreases the possibility of rehospitalization," says the study headed up by faculty from the University of Wisconsin-Milwaukee's School of Nursing.

• 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 recent years' lists. The accreditor formerly known as JCAHO's other home health NPSGs for 2013 include identifying patients correctly, using medicines safely, preventing infections, and identifying patient safety risks.

• Make sure your documentation for episodes that barely exceed the LUPA threshold will stand up to scrutiny, or you could face steep denials.

In a recent review of home health agency claims containing five to seven visits, HHH Medicare Administrative Contractor NHIC denied 68 percent of claims, the MAC says on its website. NHIC reviewers denied 33 claims because documentation did not support the skilled nursing services as being medically necessary, the contractor says. "A frequent cause of denials in this situation is when the documentation did not show the need for observation and assessment of the patient's condition," the MAC details.