OASIS Alert

Unplanned hospitalizations remain stubbornly stuck.

In the December 2005 update to Home Health Compare--using data from Sept. 1, 2004 through Aug. 31, 2005--only three of the 10 measures showed improvement in the national average.

The winners: "Patients who get better at bathing" (M0670) increased from 61 to 62 percent. "Patients who get better at taking medications correctly by mouth" (M0780) improved from 39 to 40 percent. And "patients who are short of breath less often" (M0490) went from 58 to 59 percent.

As in every period since November 2003, "Patients who had to be admitted to the hospital" remained unchanged at 28 percent and "patients who needed urgent unplanned medical care" stayed stuck at 21 percent. The next update of Home Health Compare is due in March.

• Regional home health intermediary Cahaba GBA has initiated a number of new medical review edits based on diagnosis codes (see OASIS Alert, Vol. 6, No. 12). But agencies no longer have to worry about medical review targeted at claims with primary diagnoses of 250.XX (Diabetes mellitus) or 707.XX (Chronic ulcer of skin), V58.3 (Attention to surgical dressings and sutures) or V58.81 (Fitting and adjustment of vascular catheter). Probe reviews of those claims didn't turn up substantial errors, the RHHI says.

• The Centers for Medicare & Medicaid Services has finally revised the home health advance beneficiary notice. The new notice is available at www.cms.hhs.gov/BNI/03_HHABN.asp. Agencies may start using the new notice now, CMS says, but must use it after May 31

• CMS is reducing the number of Open Door Forums it schedules due to budget constraints, the agency said in a notice to providers. It will hold the Home Health, Hospice and DME ODF only every six weeks instead of monthly.