Webinar Recording: 2019 Hospice Rule

FY2019 Hospice Rule: Understanding the Rule and the Reasons Behind it

In case you missed our webinar, here is the recording from our Executive Update on the FY2019 Hospice Payment and Quality Reporting Rule.

  • Hospice Wage Index Updates
  • Payment Rates
  • Cap Amounts
  • Physician Assistants
  • Hospice Quality Reporting Program
  • Non-Hospice Covered Services
  • Part D Meds
  • OIG Work Plan

This webinar will also help inform providers who are planning to submit comments on the proposed rule. The comment deadline is June 26.

Continue reading “Webinar Recording: 2019 Hospice Rule”

OASIS-D: The Devil in the Detail

The next generation of OASIS, OASIS-D, will go into effect on January 1, 2019. While not yet finalized (draft guidance is expected in July and final guidance in November), the changes are significant and could adversely impact publicly reported outcomes, Star ratings, value-based purchasing measures and reimbursement.

Learn How Fazzi Can Help Your Agency Prepare for OASIS-D

Potential Impact on Risk Adjustment
Some of the items being removed are used to calculate risk adjustment currently. We assume that CMS will need to take a fresh look at how risk adjustment is applied since these M-Items will no longer be available to use when calculating outcomes. There’s no way to correlate improvements or declines using the new OASIS items since the questions have never been on the OASIS before and statistical significance cannot be calculated. If risk adjustment isn’t revised, all the remaining OASIS responses used to calculate risk adjustment might now exert a greater percent of impact on outcomes. Therefore accurate OASIS responses are critical to ensure accurate outcome numbers.

Because of the items being removed, a patient could show less of a risk adjusted improvement. Therefore agencies could see a decline in risk adjustment in these areas:

Publicly Reported Outcomes Where Risk Adjustment May Be Lost Star Ratings Where Risk Adjustment May Be Lost
  • Improvement in Pain (M1242)
  • Improvement in Status of Surgical Wounds (M1342)
  • Improvement in Dyspnea (M1400)
  • Improvement in Bathing (M1830)
  • Improvement in Bed Transfers (M1850)
  • Improvement in Ambulation (M1860)
  • Improvement in Oral Medication Management (M2020)
  • Improvement in Pain (M1242)
  • Improvement in Dyspnea (M1400)
  • Improvement in Bathing (M1830)
  • Improvement in Bed Transfers (M1850)
  • Improvement in Ambulation (M1860)

Areas of Potential Overlap, Duplication and Confusion
With the addition of the new GG functional items, there are several areas of potential overlap and duplication with existing M-Items. Because the items are similar but not the same, they are cause for confusion and therefore inaccuracy. For example:

Exsisting M-Items Similar but Not the Same as These New GG Items
  • Ability to dress upper body (M1810)
  • Ability to dress lower body (M1820)
  • Bathing (M1830)
  • Toileting hygiene (M1845)
  • Feeding or eating (M1870)
  • Self-care (GG0130)
  • Toliet transferring (M1840)
  • Transferring (M1850)
  • Ambulation (M1860)
  • Mobility (GG0170)
  • Grooming (M1800)
  • Oral Hygiene (GG0130)

Dependent to Independent Sequencing Differences
Another area for potential confusion is the different scales for scoring patients. For the M-Items, Independent is captured in response ‘0’ but for the GG-Items, Independent is at the other end of the scale as response ‘06’.

In Conclusion
OASIS-D cannot be taken lightly or ignored until December. Planning now will protect outcome scores, Star ratings, and reimbursement. If you’d like information on how Fazzi can help your agency with the transition to OASIS-D, please click below.

Learn How Fazzi Can Help Your Agency Prepare for OASIS-D

Your OASIS-D and COQS Certification Questions Answered

Webinar Recording Now Available. 

We received some great questions during the Q&A webinar session about the Certified OASIS Quality Specialist (COQS) with OASIS_D Readiness and we wanted to share the recording with you.

How will the COQS bundle prepare me for OASIS-D?
When you register for the COQS bundle, you get access to the course materials for one year. That means you’ll automatically receive the OASIS-D version of the course for free! Additionally, if you become COQS certified, you’ll receive an OASIS-D Crosswalk Training and access to the OASIS-D Skills Test in December.

Is the exam included in the bundle?
Yes! The COQS bundle includes the 8-week online preparation course, the certification (or recertification) exam and the OASIS Field Guide.

Are there contact hours?
Yes! The COQS preparation course is approved for approximately 16 ANCC and BCHH-C contact hours.

What if I’m on vacation for a week or two during the program? Can I still sign up?
Yes! The program is designed so that you can work through modules any time after their weekly release, and all live webinars are recorded and available for your review at a later time that’s convenient for you.

For comprehensive FAQs and more information, click here.

No other OASIS certification program prepares you for OASIS-D for free! The 8 week online preparation course begins June 18th. Register by May 31st to save $100!

View the Webinar Recording

Register Now

Hospice Compare Updated

CMS has posted the quarterly Hospice Compare refresh of quality data on May 16, 2018.

All quality measures showed improvement since last quarter posting! Pain assessment showed the most improvement, followed by pain screening.

Updates to the family caregivers’ survey results showed six measures remained the same. However, rating of this hospice and willing to recommend this hospice both improved by 1%. An improvement in these two global measures is an excellent, positive trend with these new caregiver survey results.

Quality measure results are from data collected 3rd quarter 2016 thru 2nd quarter 2017, and Hospice CAHPS® survey results reported 3rd quarter 2015 thru 2nd quarter 2017.

View State Level Hospice Compare Charts

Last COQS Session of the Year – Including OASIS-D Readiness

The 8 week online course begins June 18th. Register by May 31st to save!

Join hundreds of your colleagues in receiving the industry’s newest and most valuable OASIS Certification, the Certified OASIS Quality Specialist (COQS) designation. For a fraction of the travel costs you might spend on other trainings, when you purchase the COQS online course package you receive everything you need to become OASIS certified for the next 3 years. That includes:

  • Full access to our 8-week online OASIS-C2 Certification course led by OASIS expert Anita Werner
  • Registration to complete the COQS 100 question online exam (Already certified? You can sign up for our 80-question recertification exam)
  • Our newly updated (January 1, 2018) OASIS-C2 Field Guide to Date Collection (retails $50 plus s/h)
  • OASIS-D Readiness

If you’ve been on the fence about registering for the program, now is the time! This will be our last online offering of the program in 2018, and with it you’ll get what you need to be ready for OASIS-D!

Users who purchase the COQS online training program receive access to the program for 1-year. This includes access to any course updates that are made during your subscription year. Not only will you receive the full COQS OASIS-D online certification course when it is available in 2019, but if you become COQS certified you’ll also receive a complimentary 1-hour OASIS-D crosswalk webinar session later this year.

There’s never been a better time to become OASIS certified than now! Register before May 31st and save $100!

Learn More and Register

435 Potential Code Changes for October 1

CMS just proposed 435 ICD-10-CM code changes to be effective October 1. Here’s the breakdown: 247 new, 139 revised and 49 invalid codes. You’ll find the proposed changes in tables 6A, 6C, and 6E by clicking here.

It seems relentless, right? Coding changes in October… OASIS D in January… and with HHGM payment reform looming for 2020, coding and OASIS accuracy will be even more important to ensure correct reimbursement.

The constant need to train employees — in the face of mounting payment pressures and staffing challenges – is one of the reasons that so many agencies are turning to Fazzi for Outsourced Coding and OASIS Review services.

If you’re not outsourcing yet – or you’re not completely satisfied with your current vendor, now is the time to learn more about Fazzi’s Outsourced Coding and OASIS Review services. Click the link below to learn more or contact us at info@fazzi.com or 800-379-0361.

Learn More About Fazzi’s Outsourced Coding and OASIS Review Services

The Workforce Crisis: Information and Strategies for Optimal Home Health and Hospice Staffing

Edition #3: Managing the Workforce Crisis: First Do No Harm! Creating Optimal Culture

In this edition, we discuss the importance of culture in attracting and retaining employees, especially Millenials. In our work with agencies across the country, we have observed many organizations that unintentionally and unknowingly make their own workforce challenge worse… Continue Reading 

Edition #2: Supply and Demand for Key Positions (If you were worried about nursing, wait until you see the Home Health aide projections!)

In this edition, we look at the projected supply and demand for key positions in home care and hospice.  We also introduce a one-stop resource to view state by state data on Registered Nurses (RNs), Home Health Aides (HHAs), Personal Care Aides (PCAs), Licensed Practical Nurses (LPNs),  Licensed Vocational Nurses (LVNs) and Physical Therapists (PTs)… Continue Reading 

Edition #1: The Many Facets of Optimal Staffing

Home Health and Hospice agency staffing concerns are growing rapidly along with the aging population we serve. Agencies of all sizes are reporting record numbers of vacancies… Continue Reading 


April Compliance Newsletter

According to the latest National State of the Industry Report™, agencies that were the highest performers on home health compare outcomes, conducted an employee engagement survey every two years or more often. Conducting regular employee engagement surveys is a best practice for a well-run agency, evidenced by the fact above – and because employee engagement contributes to retention which has become a critical issue for our industry.

What are some of the key takeaways from Fazzi’s employee engagement database? One important finding is that Home Health and Hospice employees give their leadership low scores. Analysis of our employee engagement database shows that the Leadership Doman scores are the second lowest after Compensation and Benefits (which are always the lowest). This graph shows the relative results among the domain areas.

Factors such as communication, having a voice in decision making and alignment between management and staff are among the ingredients that contribute to the ratings employees give their leadership.

Fazzi’s Employee Engagement service, the only survey specifically created for home health and hospice agencies, analyzes composite scores for each of the areas shown above to identify which should be the targets for improvement. Within those areas, you can also single out specific improvements. Then, the action steps can be planned to bring about needed improvements.

Want to know how your agency measures up? Contact us today

Changes Coming to OASIS in 2019!

CMS has posted the new OASIS-D instrument and a supporting statement at this link. The revisions effective January 1, 2019 are intended to comply with the 2014 IMPACT Act.

Changes to the assessment are extensive. CMS is removing 235 data elements across all OASIS items as a part of the Paperwork Reduction Act, however 6 new questions with multiple data items are added. For example, at Start of Care 75 data elements are removed, however 65 new elements are added.

Fifteen of the 28 OASIS questions removed provided risk adjustment for publicly reported outcomes. This means accuracy in the responses to remaining OASIS questions will be even more essential. Competence in OASIS-C2 will set the stage for success with OASIS-D. Our OASIS Package available through The Fazzi Learning Center will automatically be updated with the changes and all Fazzi Learning Center customers will receive a free “crosswalk” training on the changes during the fall of 2018. If you’re not already a Fazzi Learning Center customer and would like to learn more, please click here.

Market Saturation and Utilization

According to a national trend analysis by the Centers for Medicare & Medicaid Services (CMS), the average number of home health providers per county decreased by 7.31%, while hospice providers per county increased by 12.84% (October 2014 to March 2017).

The analysis and other utilization metrics can be viewed at the updated Market Saturation and Utilization Tool. These interactive maps include results at the national, state, or county level. The most recent data period is April 2016 to March 2017.

Sixteen health service areas are available for comparison including home health and hospice. The following metrics are available for comparison:

  • Number of Fee-for-Service Beneficiaries
  • Number of Providers
  • Average Number of Users per Provider
  • Percentage of Users out of FFS Beneficiaries
  • Number of Users
  • Average Number of Providers per County
  • Total Payments

If you are interested in competitor data by agency or county level, click here to visit our web page on Business Intelligence or email info@fazzi.com.

Home Health Compare Quality Charts Updated

The Home Health Compare results were updated on April 11, 2018.

For the Quality of Patient Care measures, 12 measures improved and 2 remained the same. No measures worsened. As with last quarter, improvement in bed transfer saw the most improvement of 1.3%. Improvement in management of oral medications and improvement in dyspnea both showed improvement of at least 1.0%. Multifactor fall risk assessment conducted and depression assessment conducted measures both saw no change. (Collection period July 1, 2016 to June 30, 2017.)

While the acute care hospitalizations measure improved again this quarter, from 16.2% to 15.9%, urgent, unplanned care in the emergency room continued to worsen with an increase of 0.1%. (Collection period July 1, 2016 to June 30, 2017.)

The national average for the Quality of Patient Care Star Rating remained at 3.5 stars. The percentage of agencies with 2.5 and 4 stars declined, and the percent of agencies with 4.5 and 5 stars increased.

Updates were also made for HHCAHPS measures and the national averages continue to remain the same. The data collection period for these measures and the Star Ratings is October 2016 to September 2017.

To see where the 5 star agencies are located, visit our Home Health Compare page and use the drop down for Star Ratings at the agency level. You can also compare measures by state, by year, by release date, and the top 10 or top 20 percent.