Compliance Newsletter

Key Drivers for Improving the Overall Results of Hospice CAHPS Results

Amid challenging new regulations and escalating reimbursement constraints, why is the Hospice CAHPS® survey good for hospice? Gina Mazza, Partner, Director of Regulatory and Compliance Services at Fazzi outlines the four important reasons Hospice leaders should consider CAHPS when setting strategic goals. Learn more by downloading the white paper, CAHPS: Why it’s Good for Hospice!

CoPs Delayed and PreClaim Stopped

As you’ve probably heard, CMS paused Pre-Claim Review in Illinois, postponed indefinitely its start in Florida and the other states and issued a proposed rule that will change the new CoP rule effective date to January 13, 2018. The industry is abuzz with questions and Fazzi has the answers. To get the latest facts and learn what you should be doing now, regardless of these change, Fazzi recently provided a brief executive update webinar. View the webinar recording.

The Tricks of Transfers

M1850-Bed to Chair Transfer is one of the most challenging OASIS questions. The language used in the responses is particularly ‘tricky’. This is one of the few instances in OASIS where “OR” actually means “OR” and not “AND”. Response #1 indicates a patient requires minimal assistance or the use of an assistive device. It’s important to remember Response #1 cannot be selected when a patient needs both assistance from a person and an assistive device. Instead, select Response #2. This response indicates a person can both bear weight and pivot but can’t transfer themselves without more than minimal assistance from another person. The actual wording of the response reads “unable to transfer self” and this makes clinicians hesitate to select the response. Guidance is very clear on this from Q&A releases. Don’t miss your opportunity to show outcome improvements and proper reimbursement!

Fazzi Can Help You Improve Your Return Rate

Did you know that Fazzi offers Mixed Mode data collection for Home Health and Hospice CAHPS? Fazzi’s CAHPS Mixed Mode return rate is higher than the national average – coming in at around 40%! With patient and family satisfaction so important to Star Ratings and Value-Based Purchasing and public reporting of Hospice CAHPS right around the corner; response rates are important. To learn more, contact us.

The 2016-2017 National State of the Industry Report

Fazzi Associates, in collaboration with our National Steering Committee, is pleased to bring you the results of our latest best practice study for home care and hospice.  Derived from in depth interviews with 751 agency leaders representing every sector of our industry, this national study is the fourth of its kind and the most comprehensive in the history of home care and hospice.

The intention of the study is to provide information and insight to help all agencies improve quality, profitability, efficiency and patient satisfaction. That’s why we undertake and fund this project and that’s why we offer its findings for free.

The 49-page report covers more than 30 topics of interest to home health and hospice agency leaders, from use of telehealth and outsourced services to productivity, clinical team structure, employee engagement and much more.  Many of the findings clearly provide agency leaders with insights that may be of help to their agency.  Issues addressed include:

  • Clinical models that most impact quality and financial outcomes.
  • Role of accreditation on outcomes.
  • Staffing ratios and their impact on quality and financial outcomes.
  • Difference in outcomes by size or auspices or location.
  • Difference in outcomes based on payment models.
  • Impact and growth in outsourced coding and their implications.
  • Role of productivity on outcomes.
  • Biggest concerns by agencies.
  • Role of telehealth and other technologies on outcomes.
  • Impact of employee engagement surveys on employee retention.

Continue reading “The 2016-2017 National State of the Industry Report”

Home Health Compare Quality Charts Updated

The Home Health Compare results were updated on April 12, 2017.

Other than depression assessment conducted remaining unchanged, all national averages for the Quality of Patient Care measures showed improvement!  Most of the measures with the greatest improvement were those included in the Star Ratings.  The data collection period for these measures is from October 1, 2015 to September 30, 2016.

All quality measures included under Value-based Purchasing showed improvement except for urgent, unplanned care in the emergency room which remained the same, and acute care hospitalizations (collection period July1, 2015 to June 30, 2016).  The acute care hospitalizations measure has worsened slightly again for this quarter. This measure remained at 16.0% from January to July 2016 and worsened in October 2016 to 16.2%, to 16.3% in January 2017, and to 16.5% this data collection period.

All national averages for HHCAHPS measures remained the same as last quarter. The data collection period for these measures is from October 2015 to September 2016.

The national average for the Patient Care Star Ratings increased from 3.0 to 3.5 stars.

Visit our Home Health Compare page with drop downs to compare by state, by year, and by release date. You can also select comparisons for the top 10 percent or top 20 percent. We also provide a drop down to agency level for Star Ratings.

Why Has the Demand for Supervisory Training Grown?

In an industry where it is critical that staff in all departments be knowledgeable about new developments and new demands, training is always a high priority. Some demands are new, i.e. new regulations or new clinical procedures and some demands have always been around, i.e. how to best supervise, motivate and ensure quality staff performance.

It is easy to understand why new trainings are always being developed for new changes and requirements. It is less obvious why age old requirements such as the qualifications to be a great supervisor have suddenly become much more in demand. But, the answer is simple. More and more agency leaders have come to realize that highly skilled and motivated supervisors impact more than the quality and performance of their staff. Strong well trained supervisors impact the bottom line of an organization… the financial bottom line.

Poor Supervision, Turnover and Cost

Here are some basic facts:

  • A study by Brad Gilbreath in the Journal of Work and Stress reported in Psychology Today, stated that the number one reason “for lower than expected work productivity is not workers, but bosses.” Steve Oppermann in an article in FedSmith went on to say “that poor boss performance may affect the long term health of company employees, and that will become a financial issue.”
  • A study by Gallup reported that “employees don’t leave companies, they leave managers and supervisors. The impact that a supervisor has in today’s workplace can be either very valuable or very costly to the organization and the people who work there.”
  • Combine these studies with a study by the Society for Human Resource Management that found employers will need to spend the equivalent of 50% to 75% of an employee’s salary in order to find and train their replacement.

Do the math. If you have an employee earning $80,000 salary and benefits, it will cost your organization an additional $40,000 (50%) to $60,000 (75%). That is just to replace one employee. Other studies would say this number is conservative. Continue reading “Why Has the Demand for Supervisory Training Grown?”

Compliance Newsletter

OASIS-C2 Q&A Released.

Did you know CMS has released a compilation of all the OASIS Q&A that apply to OASIS-C2? The last time this type of merging of guidance occurred was in April 2015, and six additional quarterly Q&A guidance documents were released after that time. Now you can look at the October 2016 collection of Q&A’s whenever you need guidance and will no longer need to search through seven different documents. Click here to download the compilation file. When you use the drop-down box you’ll be able to save the PDF files for the four categories: Category 1-Applicability, Category 2-Comprehensive Assessments, Category 3-Follow-up Assessments, and Category 4-OASIS Data Set-Forms and Items. Monitor this page for the quarterly Q&A releases in January, April, July, and October every year.

New Home Health Conditions of Participation for Medicare and Medicaid (CoP) Finalized!

The HHCoPs have been revised and are effective on July 13, 2017. Ready to review and determine how your agency will comply with the final rule updating the Home Health Conditions of Participation for Medicare and Medicaid (CoP)? Gina Mazza provided this executive overview of the key components to the new CoPs earlier this month. Click here to view the webinar recording. Continue reading “Compliance Newsletter”

Fazzi Announces Leadership Transition

Bob Fazzi, Managing Partner

This has been an exciting time for Fazzi. We have grown, added a number of incredibly strong, seasoned and passionate staff and have added new programs and services, particularly those related to Value-Based Purchasing. With growth comes the need to strengthen our overall leadership structure. Within this context, I am pleased to announce that Tim Ashe, RN, MS, MBA has been promoted to Chief Operating Officer and is now responsible for the firm’s day to day leadership.

Tim Ashe, RN, MS, MBA

Tim joined Fazzi in 2006 and became a Partner in 2007. Since that time, he has led our Operational Consulting Division to provide organizational, operational, turn around, and change management services to home care and hospice agencies across the country. Under his leadership, Fazzi has helped hundreds of agencies improve outcomes and profitability through best practices in organizational structure, clinical and operational processes, and new models for staffing, supervision and care management. More recently, Tim also assumed responsibility for our Outsourced Billing, Finance and Information Technology divisions. A long-time leader in the field of home care and hospice, Tim’s expertise and career has included a unique blend of clinical, operational, fiscal and academic roles. He is a frequent presenter at national and state conferences and is often asked to contribute to industry forums. Tim is also the Co-Director of the 2016-2017 National Home Care and Hospice State of the Industry Study.

Continue reading “Fazzi Announces Leadership Transition”

Home Health Compare Quality Charts Updated – January 2017

The Home Health Compare results were updated on January 26, 2017.

Nearly all national averages for the Quality of Patient Care measures showed improvement except multifactor fall risk assessment conducted which remained unchanged. Measures with the greatest improvement were diabetic foot care and patient education implemented and improvement in ambulation. The data collection period for these measures is from July 1, 2015 to June 30, 2016.

All quality measures included under Value-based Purchasing showed improvement except for the acute care hospitalizations which worsened slightly (collection period April1, 2015 to March 31, 2016). This measure remained at 16.0% from January to July 2016 and worsened in October 2016 to 16.2%, and then again to 16.3% this data collection period.

All national averages for HHCAHPS measures remained the same as last quarter. The data collection period for these measures is from July 2015 to June 2016.

Six measures were dropped from Home Health Compare public reporting this quarter per the final 2017 HH PPS rule; pain assessment conducted, pain interventions implemented, pressure ulcer risk conducted, pressure ulcer prevention included in the plan of care; pressure ulcer prevention implemented, and heart failure symptoms addressed.

Patient Care Star Ratings chartThe Patient Care Star Ratings showed an increase of agencies in the 2.5 star rating category, and an decrease in the number of agencies with 4.5 stars. The national average Star Rating remained the same at 3.0 stars.

Visit our Home Health Compare page with drop downs to compare by state, by year, and by release date. You can also select comparisons for the top 10 percent or top 20 percent. We also provide a drop down to agency level for Star Ratings.

Predictions in an Unpredictable Year – 2017

The Trump administration has yet to define their strategies on home care and hospice, let alone on the entire American healthcare system as a whole. What is clear is that they want significant changes. What is not clear is what this means. Stay tuned!

Within this framework, we do have thoughts. In the big arena, we believe that the core vision and components of Obama Care will stay. We do not believe that the Trump administration will drop 20 million Americans from insurance. They will not eliminate care for those with pre-existing conditions. And, they will not eliminate the right of children to stay on their parents’ plans until age 26. Neither the incoming President nor the new Congress are advocating these changes.

But, change is coming. We are moving into a time of uncertainty, major uncertainty. And, within the framework of uncertainty, there are a number of realities that meet our criteria of high probability and high impact. Here are five predictions with recommendations. Continue reading “Predictions in an Unpredictable Year – 2017”

Congratulations to Fazzi’s Patient Satisfaction Award of Distinction Recipients

2016 Top 25 HHCAHPS and Hospice CAHPSAs this year comes to a close we would like to acknowledge the home health and hospice agencies that have received Fazzi’s 2016 Patient Satisfaction Award of Distinction. The HHCAHPS and Hospice CAHPS Top 25 award is presented annually to organizations that subscribe to Fazzi’s Patient Satisfaction Service and have demonstrated superior performance in overall patient and family satisfaction results.

These national best practice agencies are proven leaders and have placed in the top 25% of Fazzi’s patient and family satisfaction national database based on a comparative analysis of overall satisfaction. We are incredibly proud of these agencies’ significant accomplishments and pleased to be their partner in one of the most important quality initiatives.

View the 2016 HHCAHPS recipients | 2016 Hospice CAHPS Top 25 recipients. For more information about our HHCAHPS and Hospice CAHPS services contact us today, or 1-800-379-0361.

Can your Coders Answer 171 Data Points Accurately in 34-38 Minutes?

stopwatchHere is an important data point for you to consider as you assess the quality and productivity of your coding function…

In an abbreviated Coding/OASIS review of 23 M Items, the coder needs to answer 171 data points accurately. And to meet acceptable productivity standards, they must do so wi
thin 34-38 minutes.

How important are 171 data points in 23 M Items? Critically important — They impact your current reimbursement, published outcomes, future reimbursement, and future take backs.

This is just one of the reasons why so many agencies are choosing to outsource. According to the latest National Home Care and Hospice State of the Industry Study, 29.4% of agencies larger than $500,000 in Medicare revenue are outsourcing their coding — a number that has more than tripled since 2014.

Coding is a specialized, time sensitive skill that can be difficult for individual agencies to maintain at a reasonable cost with high quality. That’s why there’s Fazzi coding services – we’re the largest coding company serving home health and hospice.

If you would like to discuss the potential of ROI outsourcing your coding to Fazzi, please contact us today. 2017 is almost here!