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| October 19, 2023 | |||||||||||||||||||||||||||||
 News UpdateNew Report: Voices of Home Care Reveal Better Understanding of Workforce Challenges for Policymakers
MissionCare Collective (MCC), in partnership with the National Association for Home Care & Hospice (NAHC), proudly unveils a pivotal report, “One Voice. Many Stories.” This report alongside a new home care workforce video channel, spotlighting twenty-two raw and genuine conversations with home care workers, casts a light on the invaluable contributions, challenges, and insights of home health aides and Certified Nursing Assistants (CNAs) who are too often overlooked in our society.
Source: NAHC, Oct. 12, 2023
In September 2023, the Centers for Medicare & Medicaid Services (CMS) posted proposed updates to the 1915(c) Home and Community Based Services (HCBS) Waiver Application and Technical Guide in the Federal Register for public comment. According to CMS, the changes include technical edits and updates throughout both documents, such as adding an option for states to indicate whether HCBS can be delivered via telehealth and integrating settings criteria with person centered service planning requirements.
Source: Centers for Medicare & Medicaid Services (CMS), Oct.11, 2023
Four members of Congress led by Reps. Beth Van Duyne (R-Texas) and Earl Blumenauer (D-Oregon) have called for changes to the forthcoming Special Focus Program (SFP) from the U.S. Centers for Medicare & Medicaid Services (CMS).
Jimmy Panetta (D-CA) and Brad Wenstrup (R-OH) were also signatories on the letter to CMS Administrator Chiquita Brooks-LaSure and White House Office of Management and Budget Director Shalanda Young. The four lawmakers contend that the SFP, as currently designed, would not adequately identify poor performing hospices in need of the program.
Source: David Mark, Hospice News, Oct. 4, 2023
NGS, a Medicare Administrative Contractor (MAC) servicing 19 states, recently released tips for documenting homebound status.
The top tip: Don’t use standard phrases like “taxing effort to leave the home.” Documentation should be clear and specific, NGS notes.
Other helpful documentation to support homebound status should include but is not limited to, the patient’s diagnosis, duration of the condition, clinical course, prognosis, nature and extent of functional limitations or other therapeutic interventions.
NGS also says there is no specific distance for a beneficiary to ambulate that would rule out homebound status, but the documentation should note details on the patient’s considerable or taxing effort. For example, mentioning pain limitations, fatigue, dyspnea, a limited range of motion impairing overall functional mobility, impaired balance or a need for rest to recover.
The Department of Social Services (DSS) contracted with the University of Connecticut, Center on Aging, to conduct a survey to better understand the recruitment and retention difficulties faced by home and community-based services providers. The survey asked questions about recruitment and retention, strategies utilized to retain direct care employees and recruit new direct care employees, and how providers used the American Rescue Plan Act stabilization funds. A total of 447 provider organizations participated in the survey from Feb. 10 to April 25, 2023.
If a patient loses his or her balance while a therapist is performing a therapeutic intervention meant to challenge balance, this would not be considered a fall under M1033 (Risk for hospitalization) response “1 – History of falls” CMS clarifies in response to a question in the October 2023 quarterly OASIS Q&As.
“Falls are not a result of an overwhelming external force (e.g., another person pushes the patient) or an anticipated loss of balance resulting from a supervised therapeutic intervention where the patient’s balance is being intentionally challenged during balance training,” CMS states.
This question was one of four questions included in this shorter batch of Q&As released on Oct. 17. Other questions pertain to GG0170R (Wheel 50 feet with two turns), M1033 (Risk for hospitalization) response “3 – Multiple hospitalizations" and whether or not a transfer OASIS is required when a patient is admitted to a hospital inpatient bed and is later changed to an observation stay.
In its response to the question about falls, CMS added that for response “1,” falls are defined as an unintentional change in position coming to rest on the ground, floor or onto the next lower surface (e.g., onto a bed, chair, or bedside mat).
CMS reminds that an intercepted fall would be considered a fall.
“An intercepted fall occurs when the patient would have fallen if they had not caught themself or had not been intercepted by another person,” CMS clarifies in their response.
Membership NewsWe invite you to serve on one of the Connecticut Association for Healthcare at Home's standing Committees. All Standing Committees report to and accept tasks from the Board of Directors and are expected to fulfill the mission of the Association.
Standing Committees are as follows: Business & Finance, Education, Government Relations, Hospice & Palliative Care and Quality Improvement. (See the Petition Form below for more information about each committee.)
If you have an interest in serving on one of our committees or continuing your service, please fill out the 2024 Association Committee Petition and return it to the Association no later than Wednesday, Nov. 8, 2023. The Association will make every effort to honor your committee preference while still achieving a balance of member representation.
Education
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Value Based Purchasing: Clinical Impact Webinar
