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SNAP SHOT
HOME HEALTH and HOSPICE: Clean Hands Count: Prevent and Control Infections, CMS MLN Connects, March 11, 2020 – CMS, State Survey Agencies, and Accrediting Organizations (AOs) require health care entities to have Hand Hygiene (HH) procedures, based on national standards or professional organizational guidelines, which decrease the spread of infection. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommend the preferential use of Alcohol-Based Hand Rub (ABHR) over soap and water in most clinical situations.
HOSPICE: CMS Issues COVID-19 Prevention Guidance for Hospices, Hospice News, March 10, 2020 – The U.S. Centers for Health & Human Services (CMS) has issued guidelines for protecting health care workers who operate in the home and community from COVID-19, including hospice providers.
The CMS materials contain guidance for screening for and treatment of the virus in addition to when patients should be transitioned to higher acuity care. The agency recommended that hospices identify high-risk individuals prior to making home visits or on arrival and immediately screen for symptoms that could indicate a COVID-19 or other respiratory infection, particularly for patients who had close contact with a person who had traveled to restricted countries, such as China, within the previous 14 days, or who had contact with a person known or suspected to have been exposed to the virus.
OCHCH recommends that agencies add this guidance for infection control specific to COVID-19 to your agencies infection control and prevention plan. Also, remember to add Corona virus to your all-hazards list!
HOSPICE: Guidance for Limiting the Transmission of COVID-19 for Nursing Homes, CMS List Serve, March 14, 2020 – For ALL facilities nationwide: Facilities should restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation. In those cases, visitors will be limited to a specific room only. Facilities are expected to notify potential visitors to defer visitation until further notice (through signage, calls, letters, etc.).
Exceptions to restrictions:
• Health care workers: Facilities should follow CDC guidelines for restricting access to health care workers. This also applies to other health care workers, such as hospice workers, EMS personnel, or dialysis technicians, that provide care to residents. They should be permitted to come into the facility as long as they meet the CDC guidelines for health care workers.
HOSPICE: What Providers Need to Know about Volunteer Hours – Several Hospice providers have asked if there have been any updates from CMS about relaxing the 5% volunteer requirement? OCHCH has not received any updates about relaxing volunteer requirements and we will update members if we do receive any guidance. Therefore the 5% volunteer requirement is still in place.
I am recommending to providers to document key factors which have impacted your agency such as a National State of Emergency, Ohio State of Emergency. OCHCH is working closely with state agencies and the Govenor’s office to communicate provider challenges and advocate for our industry during this unprecedented time.
HOME HEALTH: Medicare FFS Response to COVID-19, CMS, March 16, 2020 - The HHS Secretary declared a public health emergency, which allows for CMS programmatic waivers based on Section 1135 of the Social Security Act. An MLN Matters Special Edition Article SE20011 on Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus is available. Learn about blanket waivers issued by CMS. These waivers prevent gaps in access to care for beneficiaries impacted by the emergency.
You do not need to apply for the following approved blanket waivers:
Home Health Agencies
- 42 CFR 484.20(c)(1): This waiver provides relief to Home Health Agencies on the timeframes related to OASIS Transmission (Blanket waiver for all impacted agencies).
- To ensure the correct processing of home health emergency related claims, Medicare Administrative Contractors (MACs) are allowed to extend the autocancellation date of Requests for Anticipated Payment (RAPs).
HOME HEALTH: Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies (HHAs), CMS, QSO-20-18-HHA, March 10, 2020 – CMS is committed to the protection of patients in the home care setting from the spread of infectious disease. This memorandum responds to questions they have received and provides important guidance for all Medicare and Medicaid participating Home Health Agencies (HHAs) in addressing the COVID-19 outbreak and minimizing transmission to other individuals.
OCHCH recommends that agencies add this guidance for infection control specific to COVID-19 to your agencies infection control and prevention plan. Also, remember to add Corona virus to your all-hazards list!
HOME HEALTH and HOSPICE: NAHC Urges CMS to Make Changes to Fight Coronavirus, Keep Patients in their Homes, NAHC Report, March 11, 2020 – The National Association for Home Care & Hospice (NAHC) has written a letter to CMS Administrator Seema Verma, pointing out that providing quality health care in the home is one of the best ways to prevent transmission of the novel coronavirus COVID-19. Therefore, it makes sense for CMS to make a series of policy changes to make it easier for home care and hospice to fulfill its potential in battling this pandemic.
>>>RCD & PDGM Needs–
OPERATION: tackle is OCHCH’s campaign that supports your agency’s PDGM & RCD needs.
NEXT COMBINED - OCHCH WEEKLY PDGM/RCD CALL is FRIDAY, March 20, 2020 at 10am!
Join Zoom Meeting
https://zoom.us/j/292539889
Meeting ID: 292 539 889
Dial by Phone
+1 929 205 6099
DON’T MISS THIS OPPORTUNITY!! Please mark your calendars for EVERY FRIDAY @ 10am. The calls will last no more than an hour.
The first part of the call will address PDGM.
The last part of the call will be spent on RCD updates and Q&As.
**ATTENTION: For the OCHCH WEEKLY PDGM/RCD CALL we have set up a NEW way to Call-in through ZOOM!!!
If you have trouble getting on the Call – PLEASE CALL OCHCH 1-614-885-0434 Ext.206, or e-mail ryan@ochch.org
>>>RCD UPDATES –
Transition from Cycle 1 to Cycle 2 – What you need to know! Ohio Home Health providers are nearing the end of the first cycle of RCD. We wanted to update you on important information on the transition from Cycle 1 to Cycle 2.
FYI - How to Retrieve Your RCD Affirmation Rate and Claims Approval Rate – CLICK HERE
eRCD is Now Active - eRCD is a new feature on the Provider Dashboard within eServices that provides you with the ability to monitor your Review Choice Demonstration (RCD) results. You will enjoy features such as your RCD affirmation or claim approval rate, and current Additional Documentation Request (ADR) and Pre-Claim Review (PCR) decisions.
NEW TOOLS:
eServices: Inbox Filtering Feature Refines Review Choice Demonstration (RCD) for Home Health Services Search
Pre-Claim Review (PCR) and Low Utilization Payment Adjustments (LUPAs), Palmetto GBA updated March 1, 2020 – With the transition to the Home Health Patient-Driven Groupings Model (PDGM), CMS will phase in the inclusion of LUPAs within the Review Choice Demonstration. Please review and share with your staff.
ATTENTION: Check out the updated RCD Toolkit located in the members’ section of the OCHCH site. Just login to “My Profile” and in the left column under “HELP DESK ONLINE” click on “RCD Toolkit.”
The links to the RCD Call Recordings for the months of November, December, January, and February are available in the RCD Toolkit.
DO YOU HAVE A RCD QUESTION FOR PALMETTO GBA?
FOLLOW THESE INSTRUCTIONS FOR THE QUICKEST WAY TO A LIVE RCD AGENT.
Dial 855-696-0705
Press “0” at the main menu
Press “0” again
Press “3” for HHH
Press “1” for an RCD agent
REMINDER: All RCD provider questions must go through the Palmetto GBA Provider Contact Center (PCC) at 855-696-0705. However, if your questions are not being answered, you are not receiving a call back in a timely manner, or you need assistance to contact Palmetto GBA, PLEASE contact OCHCH by using helpdesk@ochch.org and use subject title, “RCD” and include the UTNs, OR call 614-885-0434 Ext 209.
Monthly Review Choice Demonstration (RCD) Provider Teleconference Schedule – Next date is April 1, 2020.
Unique Tracking Number (UTN) Location on the Final Claim, Palmetto GBA – This job aid instructs providers on where to enter the 14 digit alpha-numeric unique tracking number (UTN) provided in the PCR notification on the final claim for Electronic claims, Data Entry or the UB04 Claim Form. Please share with appropriate staff.
>>> PDGM UPDATES –
NEW TOOLS – MLN Matters Articles:
The Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM) - This article provides information on the continuing role of therapy under the newly implemented home health prospective payment system (HH PPS) case-mix adjustment methodology, named the Patient-Driven Groupings Model (PDGM), for home health periods of care starting on and after January 1, 2020.
Check out the updated PDGM Toolkit located in the members’ section of the OCHCH site. Just login to “My Profile” and in the left column under “HELP DESK ONLINE” click on “PDGM Toolkit.”
If you have questions PLEASE contact OCHCH by using helpdesk@ochch.org and use subject title, “PDGM,” OR call 614-885-0434 Ext 209.
OCHCH has a number of recordings available on our website of previous PDGM education webinars for your purchase or access. Moving forward OCHCH is committed to bringing you continued education on the implementation of PDGM and its impacts on our industry.
The links to the PDGM Call Recordings for the month of December, January, and February are available in the PDGM TOOLKIT.
Patient-Driven Groupings Model (PDGM) Grouping Tool Help Document link – The purpose of the grouping tool Excel file is to help users understand how the payment grouping parameters, which are part of the PDGM, would be used to determine case-mix assignments that are part of the payment calculation under the Home Health Prospective Payment System (HH PPS).
Payments and Payment Adjustments under the Patient-Driven Groupings Model, Palmetto GBA – This article provides information on the implementation of the new Home Health Prospective Payment System (HH PPS) case-mix adjustment methodology named the Patient-Driven Groupings Model (PDGM). The PDGM will be implemented for home health periods of care starting on and after January 1, 2020. This MLN Matters Number: SE19028 is a very comprehensive tool to share with staff so they develop a better understanding of the PDGM.
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