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.

 

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

Edition #3 of the White Paper Series, The Workforce Crisis: Information and Strategies for Optimal Home Health and Hospice Staffing

In this edition, we discuss the importance of culture in attracting and retaining employees, especially Millennials. 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 “Managing the Workforce Crisis: First Do No Harm! Creating Optimal Culture”

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 

 

Projected Supply and Demand for Key Positions in Home Care and Hospice

Home care and hospice will always compete with other sectors of healthcare for employees. That means that regardless of supply, agency leaders need to develop a wide range of strategies to attain and maintain optimal staffing levels. Visit Fazzi’s Workforce Data page, 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).

View Workforce Data

OASIS D is Now Available for Review and Comment

The Journey Has Begun!

Anita Werner, RN, BCHH-C, COQS, Senior Compliance Consultant at Fazzi Associates

Here’s what we know about OASIS D so far:

  • CMS has posted the new OASIS D instrument and a supporting statement at this link.
  • Comments are due May 11 which can be submitted via this link.
  • CMS expects to issue draft guidance in July and final guidance in November.
  • 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.

Here are excerpts from CMS supporting statement:

  • GG0130-Self Care, GG0170-Mobility, J1800-Falls Since SOC/ROC, and J1900-Number of Falls are included to meet IMPACT Act requirements for post-acute care settings to standardize assessment and reporting of (1) Falls with Major Injury, and (2) Functional Assessment of and Care Planning for Function.
  • M1311 has been standardized across post-acute care settings to now be used to measure Changes in Skin Integrity: Pressure Ulcer/Injury with removal of M1313.
  • GG0100-Prior Functioning and GG0110-Prior Device Use are added to standardize this data collection across post-acute care settings.
  • 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.

Fazzi is here to help you with these changes! 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 – not too early and not too late!. If you’re not already a Fazzi Learning Center customer and would like to learn more, please click here.

Stay tuned for additional updates on the journey to OASIS D.

Informational Webinar: Learn About Case Management Credentials

Get your questions answered in this informational webinar recording

You will learn:
• Why are these credentials important?
• What’s in the preparation course?
• What does the exam cover?

View the Informational Webinar Recording

The next online preparation course for the Certified Home Health Case Manager (CHHCM) and the Certified Hospice Case Manager (CHCM), begins April 23. Register by April 15th to receive the preparation course and exam package for $399 (save $100). Agencies that register 10 or more people for this package are eligible for a further discount of $375 per seat.

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

Edition #2 of the White Paper Series, The Workforce Crisis: Information and Strategies for Optimal Home Health and Hospice Staffing

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

Case Management Certification Preparation Course Begins April 23

case management credentials

The next preparation course for our industry’s only Case Management Certifications, the Certified Home Health Case Manager (CHHCM) and the Certified Hospice Case Manager (CHCM), begins April 23. Instructed by Cindy Campbell, a nationally recognized leader, speaker and management consultant to the full continuum of healthcare at home.

  • Early bird pricing for the course and exam package is $399 for one exam through April 15. 
  • Agencies that register 10 or more people for this package are eligible for a further discount of $375 per seat. 

View FAQ and Register

Why are these credentials so valuable:

  • Because case management proficiency is central to Quadruple Aim: enhancing the patient experience, lowering costs, managing burgeoning populations while increasing joy in the work itself.
  • Because the new Home Health Conditions of Participation (CoPs) and the expanding Hospice Item Set (HIS) and other regulatory changes require new levels of expertise. Today, case managers must master goal directed, patient centered care planning; clinical best practices; interdisciplinary team management; time management; documentation and more – all while putting the patient first and, yes, loving the job!
  • These credentials demonstrate that a person possesses the knowledge and expertise to perform this critically important function.

About the CHHCM and CHCM:

  • These credentials can be achieved by taking the CHHCM and/or CHCM examination online through the Fazzi Learning Center.
  • An eight-week online preparation course for these examinations begins April 23.
  • With the bundle package, participants may choose the Home Health Track or the Hospice Track or they may do both. They may also choose to take the CHHCM exam or the CHCM exam or pay a small upgrade fee to do both.
  • Certificate holders get a wealth of free resources. You’ll enter a collaborative community of case management professionals and receive ongoing complimentary best practice webinars and other resources.
  • Participants will be inspired by course instructor Cindy Campbell’s expertise, energy and zeal for case management (even those who may fear that outstanding case management is becoming a “lost art”).