Latest News & Communications
As our members continue to provide high quality care to Ohio’s vulnerable populations, LeadingAge Ohio is urging everyone to review the following resources on control and prevention of Coronavirus (COVID-19).
If you have a question, concern, or want to share resources regarding COVID-19, we have a dedicated email account. Send a message to COVID19@leadingageohio.org, and we will get back to you quickly. As always, feel free to email or call any LeadingAge Ohio staff individually.
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- You Asked... We Answered Home Health & Hospice
- Provider Setting Specific
- You Asked... We Answered
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Recent Updates
Amended Health Orders
Adult Day Orders
Visitation Orders
- Director’s 7th Amended Order to Permit Access to Ohio’s Nursing Homes, with Exceptions
- Director’s 7th Amended Order to Permit Access to Ohio’s Residential Care Facilities, with Exceptions
Testing Orders
- Director’s Amended Order for the Testing of the Residents and Staff of all Residential Care Facilities
- Director’s Amended Order for the Testing of the Residents and Staff of all Nursing Homes
Vaccination Information/Resources
Communication around the vaccine with residents and staff is important. We've compiled several resources below to help in getting the word out and building confidence around the vaccine.
LeadingAge Ohio All Member Q & A: Vaccine Mandate (11/9/21)
LeadingAge Ohio All Member Q & A: Vaccine Participation (1/12/21)
- VIDEO: City of Columbus Dr. Roberts COVID Vaccine PSA
- FAQs and Resources on COVID-19 Vaccines and Issues Surrounding Vaccinations (Updated 1/8/21)
- LeadingAge Ohio All Member Q & A: Vaccines (12/16/20)
- LeadingAge Vaccine Resources
- CDC Vaccination Tracker- Long Term Care Facilities
Testing Resources
Lab Capacity Dashboard
The new dashboard provides self-reported information about labs that can run tests, including hours of operation, types of tests they accept, estimated turn-around time, and locations.
LeadingAge Resources
Visitation During COVID-19
As CMS updated visitation guidance for nursing homes, LeadingAge collaborated with Pathway Health on a Visitation During COVID-19 Toolkit for members. The 10 segment toolkit helps an organization navigate visitation guidance through a leader's guide, implementation checklists, competency tools for managers and all staff as well as a pre and post-test for all staff. The toolkit can be modified or edited to your organization’s needs. The elements of the toolkit also may be used by various providers and service lines in the continuum of care.
Pandemic Playbook
An interactive collection of insight, wisdom, and critical lessons LeadingAge members have learned about serving older adults during a catastrophic health crisis.
Coronavirus Resources
Visit this page regularly for current information, tools, and resources to help LeadingAge members plan for and respond to COVID-19.
06/30/2022
ODA Awareness for Preparedness Webinar
On June 29, the Ohio Department of Aging (ODA) hosted the Awareness for Preparedness Creating Health Environments webinar for Long-Term Care Facility Residents and Staff.
06/30/2022
Workforce Wins in House Appropriations bill for HHS
Today, the House Appropriations Committee released its reports accompanying the fiscal year 2023 Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) appropriations bill and its revised fiscal year 2023 subcommittee allocations.
06/30/2022
LeadingAge Ohio convenes adult day, AAA leaders to discuss rebuild
Statewide, numerous adult day centers have closed over the past two years, as a result of prolonged COVID-related closures and the challenges of rebuilding amidst lagging reimbursement, new infection control practices, and public fears about congregate settings.
06/30/2022
CMS releases Phase 3 Requirements of Participation
Yesterday, the Centers for Medicare & Medicaid Services (CMS) announced surveyor guidance for Phase 3 Requirements of Participation, as well as clarifications and technical corrections for Phase 2 guidance issued in 2017.
06/23/2022
LeadingAge Ohio responds to DeWine Administration survey on direct care workforce challenges
Last week, LeadingAge Ohio responded to a survey released by the DeWine Administration regarding ongoing direct care workforce challenges.
06/23/2022
More Phase 4 Payments being distributed
HRSA announced last week that it is sending out the latest batch of Phase 4 Provider Relief Fund (PRF) payments ($427M) to 1,400 providers nationwide.
06/23/2022
IRS increases standard mileage rate
To keep pace with the rising price of gas, the Internal Revenue Service (IRS) has increased the standard mileage reimbursement rate halfway through the year for the first time since 2011.
06/23/2022
Honoring Wishes hosts C-TAC June 29
C-TAC is the Coalition to Transform Advanced Care, a national advocacy group dedicated to improving the lives of Americans impacted by serious illness.
06/23/2022
New LeadingAge Ohio website launching, planned outage this Friday
This Friday, LeadingAge Ohio will launch a new website update and redesign. Anyone trying to access the website between the hours of 8:00-10:00AM may receive an error message.
06/20/2022
Cleveland PAC event a big success, Cincinnati (June 23) and Columbus (June 30) events coming up
06/16/2022
2022 LeadingAge Ohio Annual Conference and Trade Show - REGISTRATION NOW OPEN!
Join us August 30 - September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show!
06/09/2022
Ohio employers should weigh in on work-based learning
LeadingAge Ohio is part of the Complete to Compete (C2C) coalition, a statewide network of employers, education and higher education stakeholders working to improve post-secondary attainment and better align education / training with Ohio’s jobs.
06/09/2022
2022 LeadingAge Ohio Annual Conference and Trade Show: Hotel reservation, exhibitor booth registration NOW OPEN - Attendee registration opening next week!
Join LeadingAge Ohio August 30-September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show. This year’s theme is Momentum!
05/12/2022
Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
LeadingAge Ohio and HJ Sims invite you to join this webinar series with your board members, as HJ Sims provides a series of comprehensive virtual content geared directly toward the governance of senior living providers. The series will benefit all leaders within our field, especially board members, leadership teams, and individuals new to these roles.
03/22/2022
LeadingAge Ohio All-Member Call: Medication Aides as a workforce strategy - TODAY at 11:30AM
03/17/2022
CMS approves relief for nursing facilities, hospices
Yesterday afternoon, the Ohio Department of Medicaid (ODM) reached out to LeadingAge Ohio to notify providers that the Centers for Medicare & Medicaid Services (CMS) had approved the state plan amendment (SPA) which would allow distribution of HB169 funds to nursing facilities, intermediate care facilities, and hospice programs.
03/03/2022
ARPA Assisted Living Provider Relief Funding
The Ohio Department of Aging and Ohio Department of Medicaid conducted a call today for Ohio’s assisted living facilities on the process for applying for the American Rescue Plan Act of 2021 (ARPA) funding outlined in House Bill 169. Ohio has provided additional information on the funding on the Ohio Grants Partnership webpage.
You asked... We answered regarding Certification of Terminal Illness Content
You asked... We answered regarding Certification of Terminal Illness Content
You Asked:
Should the Certification of Terminal Illness (CTI) have both related and unrelated diagnoses in the narrative?
We Answered:
The CTI needs to have the reason the physician believes the individual has 6 months or less to live (the patient’s prognosis) and what clinical findings help substantiate that prognosis. The CTI may or may not have the actual diagnoses listed, oftentimes it does, but that is not a requirement of the content of the CTI. Please see the regulatory citation below from the CoP’s.
The CTI does not necessarily have to list the non-related diagnoses. However, to help substantiate the related and not related drugs, items, or services, it is good for the hospice physician to list what they believe are non-related diagnoses somewhere in the medical record. Often the non-related diagnoses might be listed on the plan of care or in a physician progress note.
418.22 Certification of terminal illness
(b) Content of certification. Certification will be based on the physician's or medical director's clinical judgment regarding the normal course of the individual's illness. The certification must conform to the following requirements:
(1) The certification must specify that the individual's prognosis is for a life expectancy of 6 months or less if the terminal illness runs its normal course.
(2) Clinical information and other documentation that support the medical prognosis must accompany the certification and must be filed in the medical record with the written certification as set forth in paragraph (d)(2) of this section. Initially, the clinical information may be provided verbally, and must be documented in the medical record and included as part of the hospice's eligibility assessment.
(3) The physician must include a brief narrative explanation of the clinical findings that supports a life expectancy of 6 months or less as part of the certification and recertification forms, or as an addendum to the certification and recertification forms.
(i) If the narrative is part of the certification or recertification form, then the narrative must be located immediately prior to the physician's signature.
(ii) If the narrative exists as an addendum to the certification or recertification form, in addition to the physician's signature on the certification or recertification form, the physician must also sign immediately following the narrative in the addendum.
(iii) The narrative shall include a statement directly above the physician signature attesting that by signing, the physician confirms that he/she composed the narrative based on his/her review of the patient's medical record or, if applicable, his/her examination of the patient.
(iv) The narrative must reflect the patient's individual clinical circumstances and cannot contain check boxes or standard language used for all patients.
(v) The narrative associated with the 3rd benefit period recertification and every subsequent recertification must include an explanation of why the clinical findings of the face-to-face encounter support a life expectancy of 6 months or less.
(4) The physician or nurse practitioner who performs the face-to-face encounter with the patient described in paragraph (a)(4) of this section must attest in writing that he or she had a face-to-face encounter with the patient, including the date of that visit. The attestation of the nurse practitioner or a non-certifying hospice physician shall state that the clinical findings of that visit were provided to the certifying physician for use in determining continued eligibility for hospice care.
(5) All certifications and recertifications must be signed and dated by the physician(s), and must include the benefit period dates to which the certification or recertification applies.
You asked... We answered June 28
You asked... We answered regarding Home Health therapy orders
You Asked:
If there is a home health patient who does not have an order for physical therapy (PT) on admission, but three weeks later has an event and needs a therapy evaluation, how long of a time-frame does the therapist have to get out to the home to evaluate the patient if the nurse gets an order for physical therapy to evaluate and treat with no specific date applied to the order? Is it a 5-day window to evaluate and treat the patient like the admission time-frame?
We Answered:
LeadingAge Ohio reached out to the Ohio Department of Health (ODH) regarding the timeframe for an evaluation and treatment from the therapist after the start of care. This was ODH’s response:
There is no specific time frame in the regulations; however, if the physician writes an order for PT to evaluate and treat, we would expect to see a PT visit to evaluate and treat. Some agencies have policies stipulating time frames and some have “expectations” that the visit would happen as soon as possible. ODH has seen these orders fall thru the cracks and it’s many weeks before therapy ever sees the patient or sometimes not at all. There is often no follow up with the physician to inform him/her of the delay or reason why therapy never provided service. Either of those scenarios would result in a citation.
Home Health and Hospice Newsletter: June 28, 2022
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features a Home Health CY 2023 Prospective Payment Rule summary.
Home Health, Hospice & DME Open Door Forum: Wednesday, June 29 at 2:00PM
Please call at least 15 minutes prior to the forum start time.
The next Home Health, Hospice & DME Open Door Forum is scheduled for June 29 from 2:00-3:00PM.
The agenda will include:
- Opening Remarks
- Chair – Brian Slater, Center for Medicare, CMS
- Co-Chair- Kelly Vontran, Center for Medicare, CMS
- Moderator – Jill Darling, Office of Communications, CMS
- Announcements & Updates
- CY 2023 HH PPS Proposed Rule Update
- June 2022 Hospice
- Public Reporting: May 2022 refresh reminder
- Addition of claims-based measures on Care Compare
- Provider reports – where to find
- Public Reporting: May 2022 refresh reminder
- Rulemaking: FY23 Proposed Rule public comment period closed 5/31/22 with brief overview
- Reminders: HQRP Updates and available resources
- June 2022 HHA
- Updates on OASIS manual, specs and QA’s
- Public Reporting: July 2022 refresh reminder
- Rulemaking: CY23 Proposed Rule has published and is now available for public comments
- Expanded Home Health Value-Based Purchasing (HHVBP) Model Update
- Website available by clicking here
- Help Desk email available here
- HHCAHPS Survey
- The website for the HHCAHPS Survey is available here
- Technical inquiries, or other questions may be emailed to HHCAHPS@RTI.ORG.
- Toll-free telephone number for the HHCAHPS Survey is 866-354-0985
III. Open Q&A
The call will be offered via conference call only. To participate by phone, dial 1-888-455-1397 and no passcode will be needed.
Vaccination expectations for surveyors
The Centers for Medicare & Medicaid Services (CMS) recently updated its vaccination expectations for surveyors. In January of this year CMS issued the following QSO-22-10-ALL memo requiring state agency surveyors and accrediting organization (AO) surveyors performing deemed status surveys to not participate in onsite surveys unless fully vaccinated (unless vaccination is medically contraindicated or the individual is legally entitled to a reasonable accommodation under federal civil rights laws because they have a disability or sincerely held religious beliefs, practices, or observances that conflict with the vaccination requirement).
That memo has been rescinded.
With QSO-22-18-ALL CMS encourages surveyors conducting federal surveys to be vaccinated but does not require it (or an acceptable exemption). It remains up to the survey entity to implement policies around COVID-19 vaccination (and exemptions).
Previous guidance for surveyors entering nursing homes was provided in QSO-20-39-NH and this guidance remains. While it is not directly applicable to home health and hospice providers, it may be applicable to some hospice inpatient facilities. Additionally, some state survey agencies and AOs have incorporated this guidance into their policies and procedures. It is expected that home health and hospice providers will not request vaccination status of surveyors or restrict surveyor access based on vaccination status.
ATTENTION hospices! CMS recruiting additional hospices for HOPE beta testing
As hospices should already be aware, the Centers for Medicare & Medicaid Services (CMS) and Abt Associates are currently beta testing a draft standardized hospice patient assessment instrument called Hospice Outcomes & Patient Evaluation (HOPE). Additional hospice providers are needed to complete the testing.
Hospices must be Medicare-certified and training for this round of hospices is anticipated to occur mid-July 2022 with data collection slated to begin in August 2022 and continue through early fall 2022.
CMS is specifically seeking hospice providers with sufficient registered nurse, social worker, and chaplain staffing to conduct at least 1 – 2 joint visits per week. Hospices currently participating in the beta test may be finding this difficult amidst the workforce shortage causing CMS to recruit more hospices.
It appears that CMS is still aiming for completion of the beta testing in early fall of this year. Should this occur, there may be time for CMS to analyze the results of the testing and formulate a proposal for use of the HOPE by all hospices in the FY2024 proposed rule. This proposed rule would be posted in Spring 2023 for public review.
Joint visits are typical in beta testing standardized assessment instruments such as the HOPE for inter-rater reliability, but it is not expected that joint visits will be required when a HOPE tool is implemented in hospice. CMS includes the following additional information about the 1-2 joint visits per week that would occur as part of the HOPE testing: For joint visits, two registered nurses visit one patient at the same time to complete the HOPE nurse assessment. Two social workers visit the patient at the same time to complete the HOPE social work assessment, and two chaplains visit the patient at the same time to complete the HOPE chaplain assessment. One of the two registered nurses, social workers and chaplains may attend their joint visit via video call, such as Zoom. HOPE assessments are completed at hospice admission, for symptom reassessment and at live discharge.
Recruitment will continue until CMS reaches the desired number of participants (number not specified). Those interested in participating should email HOPETesting@abtassoc.com by June 30.
You’re Invited: Honoring Wishes hosts Coalition to Transform Advanced Care - TOMORROW morning at 8:00AM
C-TAC is the Coalition to Transform Advanced Care, a national advocacy group dedicated to improving the lives of Americans impacted by serious illness. There are 12 million individuals, families and caregivers who struggle in a healthcare system that does not align with their values or needs.
Please join the Honoring Wishes Task Force on its monthly call as Jennifer Blemur, Esq. Director of Policy & Advocacy for C-TAC as she describes the work of C-TAC, as well as the role that state-level advanced illness coalitions can play in improving care in their state. The Honoring Wishes Task Force is Ohio’s coalition of clinicians, health systems, post-acute providers, emergency responders, and other stakeholders focused on improving healthcare decisionmaking and communication.
To register for the call tomorrow at 8:00AM, please click here.
2022 LeadingAge Ohio Annual Conference and Trade Show - REGISTRATION NOW OPEN!
Join us August 30 - September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show! Our theme this year is MOMENTUM.
LeadingAge Ohio is excited to announce that registration is officially open! Register yourself or sign up your group today to take advantage of 57 excellent breakout sessions, continuing education credits, an inspiring keynote speaker, networking opportunities, and much, much more. Join us at the can’t-miss in-person event of the summer for members and partners!
To register for the LeadingAge Ohio Annual Conference & Trade Show, please click here.
To download the full brochure, please click here.
To make your hotel reservation, please click here.
Final PAC fundraising brewery stop in Columbus/Dublin on June 30
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
Join LeadingAge Ohio staff, legislators, and members in the central Ohio region this Thursday, June 30, from 5:00-7:00PM, at North High Brewing/Dublin Brewpub for the final stop in the LeadingAge Ohio PAC fundraising receptions. Representative Tracy Richardson and others are planning to attend and enjoy some time with our members.
What the Media Said about end of life care this week – June 28, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
[Duplicate] Home Health and Hospice Newsletter: June 28, 2022
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features an article on PHE likely to continue beyond July 16.
NAHC request - PCHETA support sign-on opportunity
Last Thursday, the Palliative Care and Hospice Education and Training Act (PCHETA (S. 4260) was re-introduced in the US Senate by Senators Tammy Baldwin (D-WI) and Shelley Moore-Capito (R-WV). The Bill text is available here and the one pager is available here. PCHETA is a bill that would make major investments to increase and bolster the hospice and palliative care interdisciplinary workforce. LeadingAge Ohio will keep members informed on the bill’s progress.
Additional free at-home, rapid COVID-19 tests
Last week, the Biden Administration announced that COVIDTests.gov is now open for a third round of ordering. People who have difficulty accessing the internet or need additional support placing an order can call 1-800-232-0233 (TTY 1-888-720-7489) to get help in English, Spanish, and more than 150 other languages, 8:00AM - midnight, 7 days a week. For more information, people can visit COVID.gov/tests/faq.
OIG looking at home health falls reporting
In April 2022, a new OASIS-based measure for falls with major injuries for home health agencies was publicly released on Care Compare; Percent of Residents Experiencing One or More Falls with Major Injury. This month OIG added a study to their work plan to assess accuracy of home health agency reporting on falls in OASIS. The report will use Medicare claims to identify hospitalizations due to falls with major injury and the analysis will look the extent to which falls were reported on OASIS. The report will include a description of the beneficiary characteristics who did not have falls reported as well as characteristics of home health agencies that have low falls reporting rates. The report will be issued in 2023.
Study finds hospice comfort medications have great variation
A new study from the University of Michigan looked at two types of medication often used to support individuals with anxiety, agitation, delirium and other symptoms while on hospice. The two categories of drugs reviewed were benzodiazepines and antipsychotics. There has been concerted effort to reduce the use of these drugs in older adult populations, but little research has focused on their use in hospice. The study reviewed 400,000 Medicare beneficiaries who had not been prescribed these types of medications in the prior 6 months. The research found 54% of patients in the 4,300 hospices studied filled a prescription for a benzodiazepine and 31% filled an antipsychotic while on hospice. The greatest predictor of whether a patient was prescribed one of these medications was if they received care from a high prescribing hospice agency, not a patient’s clinical characteristics. The study also revealed differences between non-profit and for-profit hospice prescribing trends and racial and ethnic variations by patients.
Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
LeadingAge Ohio and HJ Sims invite you to join this webinar series with your board members, as HJ Sims provides a series of comprehensive virtual content geared directly toward the governance of senior living providers. The series will benefit all leaders within our field, especially board members, leadership teams, and individuals new to these roles. Participants will walk away with a clear understanding of the role and responsibilities of boards, how to think through affiliations, acquisitions and other partnerships, and other challenges in this volatile, post-COVID era.
Each session will tap the intellectual capital of industry experts from governance, law, finance, development, and strategic planning. Invite your board members and plan to attend the entire series for maximum impact. Webinars will be held every Tuesday in June.
Life Safety Code: Current Hot Topics and Updates webinar - June 22
Join LeadingAge Ohio and Representatives from the Ohio Department of Health (ODH) on June 22 at 1:00PM, for the most up-to-date information on top Life Safety Code deficiencies and remedies, as well as other hot topics related to Life Safety. CMS Blanket waivers that are expiring will be covered along with common Emergency Preparedness plan trends. Updates and changes to the Preventative Maintenance Manual will also be discussed.
Who will benefit from this webinar?
- Nursing and Hospice Facility Maintenance Staff
- Managers
- Administrators
- Compliance Officers
To register for this event, please click here.
LeadingAge Ohio PAC Brew Tour: Thursdays in June
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
The LeadingAge Ohio PAC will host fundraising events at three of Ohio’s premier breweries for its first-ever Summer PAC Brew Tour! These fundraising receptions will take place on Thursdays in June with three options to choose from - Cleveland at Great Lakes Brewing Company (June 16), Cincinnati at Sonder Brewing (June 23), and Columbus at North High Brewing Company (June 30). Legislators will be invited to attend as guests. Enjoy some great beer, great food, and support the PAC while networking with your colleagues!
Organizations interested in sponsorship should contact Corey Markham at cmarkham@leadingageohio.org.
Cleveland - Great Lakes Brewing Company
Thursday, June 16, 2022
2516 Market Ave
Cleveland, OH 44113
5:00-7:00PM
Register online here
Cincinnati - Sonder Brewing
Thursday, June 23, 2022
8584 Duke Blvd
Mason, OH
5:00-7:00PM
Register online here
Columbus - North High Brewing Company
Thursday, June 30, 2022
56 N High St
Dublin, OH 43017
5:00-7:00PM
Register online here
Goals of care with individuals with cognitive impairment: Wednesday, May 25
Join the Honoring Wishes Task Force next Wednesday for a conversation with Leigh Ann Kingsbury of InLeadS Consulting, who will offer her insights on goals of care conversations with individuals with cognitive impairment. A nationally-recognized expert in person-centered practices and healthcare decision making, Leigh Ann is a frequent presenter and facilitator on advance care planning, advocacy for individuals with disabilities, and legal aspects like guardianship and alternatives to guardianship. Recently she served as facilitator for Ohio’s Alzheimer’s and Related Dementias Task Force convened by the Department of Aging.
There is no cost for the webinar, but advance registration is required by clicking here. The presentation is part of a monthly series that LeadingAge Ohio hosts on behalf of the Honoring Wishes Task Force, a statewide coalition of post-acute providers, health systems, hospice & palliative care experts, elder law attorneys and other stakeholders. These webinars are open to all professionals interested in engaging with older adults and individuals with disabilities in healthcare planning discussions.
Public Health Emergency likely to continue beyond July 16
The current extension of the Public Health Emergency (PHE) is due to end on July 16. When it does end there are implications for Medicare, Medicaid and the CHIP program – for states, providers, and beneficiaries. However, the Department of Health and Human Services (HHS) Secretary Xavier Becerra committed to giving states and others 60 days’ notice if the PHE is not going to be renewed. Since May 16 passed with no notice, it is reasonable to expect that it will be renewed once again.
What the Media Said about end of life care this week – May 24, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: June 21, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding telehealth visits
- 2022 LeadingAge Ohio Annual Conference and Trade Show - REGISTRATION NOW OPEN!
- ICD-10-CM Diagnosis Codes: Fiscal Year 2023
- Honoring Wishes hosts C-TAC June 29
- The biggest barriers to hospice recruiting by Jim Parker, hospice news
- Free webinar on future CMS pilot to test transmission of hospice election data to Part D plans
- Surveys for compliance with Omnibus COVID-19 Health Care Staff Vaccination Requirements
- CMS revises instructions to claim edit for hospice transfers
- Version 3.3 of the HHS Security Risk Assessment Tool now available
- CMS proposed rule risks stability of home health care
- Cleveland PAC event a big success, Cincinnati (June 23) and Columbus (June 30) events coming up
- What the Media Said about end of life care this week – June 21, 2022
2022 LeadingAge Ohio Annual Conference and Trade Show - REGISTRATION NOW OPEN!
Join us August 30 - September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show! Our theme this year is MOMENTUM.
LeadingAge Ohio is excited to announce that registration is officially open! Register yourself or sign up your group today to take advantage of 57 excellent breakout sessions, continuing education credits, an inspiring keynote speaker, networking opportunities, and much, much more. Join us at the can’t-miss in person event of the summer for members and partners!
To register for the LeadingAge Ohio Annual Conference & Trade Show, please click here. For complete details on this year's conference, please click here to be directed to the LeadingAge Ohio dedicated Annual Conference & Trade Show webpage.
ICD-10-CM Diagnosis Codes: Fiscal Year 2023
Fiscal year 2023 ICD-10-CM diagnosis code files and guidelines are available on the 2023 ICD-10-CM webpage. These codes are effective for discharges and patient encounters on or after October 1, 2022.
Honoring Wishes hosts C-TAC June 29
C-TAC is the Coalition to Transform Advanced Care, a national advocacy group dedicated to improving the lives of Americans impacted by serious illness. There are 12 million individuals, families and caregivers who struggle in a healthcare system that does not align with their values or needs. Please join Honoring Wishes Task Force monthly call as Jennifer Blemur, Esq. Director of Policy & Advocacy for C-TAC as she describes the work of C-TAC, as well as the role that state-level advanced illness coalitions can play in improving care in their state. To register for the call on Wednesday, June 29 at 8:00AM, click here.
The biggest barriers to hospice recruiting by Jim Parker, hospice news
Please see the following story which ran in Hospice News on June 13, 2022.
As hospices sweat over recruitment and retention, many say that competition on wages and benefits is the leading barrier, as well as widespread misperceptions of their services.
Their employees, however, also cite burnout and the lack of flexibility of a career path as reasons they may leave the field.
A majority of hospices who responded to a survey by senior citizen advocacy group LeadingAge and consulting firm BerryDunn indicated that compensation, benefits and misperceptions were their biggest hiring challenges, according to a recent report. The survey was designed to identify best practices related to home health and hospice providers’ most pressing problems.
For several years running, staffing has been at the top of that list.
“Many of the most successful hospice organizations managed to accommodate for these [staffing] deficits without sacrificing quality,” the report indicated. “Strategies revealed in the study include increasing the amount of social workers and re-allocating non-clinical responsibilities, such as scheduling, to other areas of the organization.”
The long-standing hospice and palliative care workforce shortage has worsened substantially during the pandemic, threatening not only profit margins but access to care for patients and families. A number of hospices have shut down or sold their businesses because they could not hire enough workers.
Providers have also had to compete for new hires with better capitalized organizations like health systems or travel nurse companies. Generally speaking, these have been able to offer nurses higher wages and more flexible scheduling as demand for their services increased during COVID.
Nearly every hospice surveyed by LeadingAge and BerryDunn (98%) said that the workforce shortage has had a negative or “extremely negative” impact on their organization, according to the report. Close to 8-10% claimed that at least 20% of their registered nurse positions are currently unfilled.
While most health care organizations have seen a rise in turnover during the pandemic, hospices seem to be having a rougher go, the survey found.
Most reported turnover rates of 16% to 20% during the past 12 months. But more home health agencies than hospice agencies had turnover rates of less than 10%, while more hospice agencies had turnover rates of 30% or higher.
Agencies to some extent have helped mitigate the risk of turnover by bolstering their cadre of social workers, who can take on more of the conversations and other support that in their absence would fall on nurses.
Shifting other nonclinical responsibilities for nurses to other employees also appeared to slow nurse turnover, with scheduling as one of the main tasks identified.
But the biggest determinant was compensation.
Even though hospices have been gradually increasing clinicians’ pay during the pandemic — with some also offering signing or retention bonuses — larger providers such as health systems have been able to offer more.
Hospice worker wage and salary increases ranged from 3% to 6% during the last two years. Admission liaisons, nurses, aides and IT staff saw the largest increase, according to the National Association of Home Care & Hospice (NAHC).
“Right now caregivers that have left the home care space, specifically private duty, have left for more wages,” Aveanna Healthcare Holdings (NASDAQ: AVAH) CEO Tony Strange recently said at the RBC Capital Markets Global Healthcare Conference. “We need to make sure that we continue to press [reimbursement] rates in order to pass those wages down to caregivers to entice them back into the home care space.”
LeadingAge and BerryDunn surveyed more than 1,000 home health and hospice sites to compile these data, which was collected over a 12-week period between September and December 2021. Organizations responded via online survey software, online polling, verbal interviews, and submitted paper survey responses.
The survey was field tested twice and refined using input from hospice agency leaders, according to LeadingAge.
Free webinar on future CMS pilot to test transmission of hospice election data to Part D plans
Numerous industry stakeholder groups have been working with the National Council of Prescription Drug Plans (NCPDP) to improve coordination between hospice providers and Part D plans to ensure appropriate coverage for prescription drugs while patients are on hospice service.
A key issue believed to play a significant role in poor coordination is the length of time it takes for information about a patient’s hospice election to filter through the Centers for Medicare & Medicaid Services’ (CMS’) systems to the Part D prescription drug plans.
CMS is now set to launch a pilot study under which hospice EMR vendors, clearinghouses, and Part D plans will test whether hospice election information can be transmitted more timely from hospice EMR vendors/clearinghouses via an intermediary (called the Part D Transaction Facilitator) directly to the patient’s Part D plan.
In an effort to educate hospice providers, Part D plans, hospice EMR vendors/clearinghouses, and other interested parties, NCPDP is hosting a FREE WEBINAR on June 29 to describe the how the pilot will work. The pilot will utilize the Notice of Election (NOE) 837I Transaction Standard to provide information for the Part D Transaction Facilitator, who will create the NCPDP Telecommunication Standard Nx real-time Hospice enrollment transactions for submission to the Medicare Part D plans. The intent of this new process is to allow for timely Hospice election notification to Medicare Part D Plans.
ABOUT THE WEBINAR
- Background: Join this webinar to learn about a pilot initiative to solve for Hospice enrollment notification delays sent to the Medicare Part D plans that may result in inappropriate payments made by the Medicare Part D plans during a Hospice election period
- Date/Time: June 20 at 1:00PM
- Learning Objectives:
After this educational session, attendees will be able to:- Understand the journey from delayed information to real-time information.
- Describe the Hospice Election Status Nx Transactions and all they do.
- Learn about becoming an NCPDP/CMS Hospice Election Status pilot participant.
- Registration: To register, please click here. Scroll down to Upcoming Webinars and click on Hospice Election Status NCPDP/CMS Pilot. Please note that while most NCPDP webinars require payment, this webinar is complimentary.
Surveys for compliance with Omnibus COVID-19 Health Care Staff Vaccination Requirements
The Centers for Medicare & Medicaid Services (CMS) posted memo QSO-22-17-ALL containing new instructions for surveys for compliance with Omnibus COVID-19 Health Care Staff Vaccination Requirements. CMS previously issued guidance and survey procedures to survey entities for assessing and maintaining compliance with the regulatory requirements for vaccination.
Under the previous guidance, federal, state and Accreditation Organization (AO) surveyors were to assess for compliance with the vaccination requirements at surveys for initial certification, standard recertification or reaccreditation, and complaint surveys.
Effective immediately, surveyors will continue to survey for compliance with the vaccination requirements during initial and recertification surveys, but will now only survey for compliance in response to complaints alleging non-compliance with this requirement (not all complaint surveys). Since the vaccination requirements became effective earlier this year, 95% of the nearly 12,000 providers that have been surveyed by states are in compliance with the requirements.
This most recent memo also instructs state survey agencies to reach out to their CMS Location if they are considering citing vaccine requirements at immediate jeopardy, Condition or actual harm levels. CMS is reviewing its previous interpretive guidance describing Immediate Jeopardy, Condition-level and actual harm determinations to ensure that deficiency citations recognize good faith efforts by providers/suppliers and to more fully evaluate harm or potential harm to patients/residents by considering trends in COVID-19 rates in the community.
CMS revises instructions to claim edit for hospice transfers
The Centers for Medicare & Medicaid Services (CMS) recently updated Change Request (CR) 12619 Gap Billing Between Hospice Transfers which provides instructions to the Medicare Administrative Contractors (MACs) to implement the edit and updates Chapter 11 of the Medicare Claims Processing Manual to reflect that there must not be a gap in billing for hospice transfer situations, a hospice transfer will be rejected if the transfer does not occur immediately. The Manual instructions indicate that transfers are not allowed from the same provider.
Hospices must not submit an 8XC if the CMS Certification Number (CCN) is the same. In this scenario the beneficiary is not transferred to another hospice, they are transferred to another location of the same hospice. It is the term “another location” that is new in this revised CR.
Originally, the term “subunit” was used which is a specified term associated with home health agencies. The use of the term could be confusing to hospices as they do not have “subunits” so it was replaced with “another location.”
Version 3.3 of the HHS Security Risk Assessment Tool now available
The Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) have released version 3.3 of the popular HHS Security Risk Assessment (SRA) Tool. This tool is designed to aid small and medium sized health care organizations in their efforts to assess security risks.
The latest version of the SRA Tool contains a variety of feature enhancements based on user feedback and public input. New features include the incorporation of Health Industry Cybersecurity Practices (HICP) references, file association in Windows, improved reports, and other bug fixes and stability improvements.
Also new this year is the SRA Tool Excel Workbook. This alternative version of the SRA Tool takes the same content from the Windows desktop application and presents it in a familiar spreadsheet format. The Excel Workbook contains conditional formatting and formulas to calculate and help identify risk in a similar fashion to the SRA Tool application.
This version of the SRA Tool is intended to replace the legacy “Paper Version” and may be a good option for users who do not have access to Microsoft Windows.
CMS proposed rule risks stability of home health care
The Centers for Medicare and Medicaid Services (CMS) issued its annual proposed rule regarding Medicare home health services payment rates for CY 2023. As usual, the rule also includes a hodgepodge of non-rate related proposals as well. This article provides a summary of the proposed rule.
Overall, the rule presents serious concerns for the home health community as it includes significant proposed rate reductions to account for the change in the payment model in 2020. Medicare law requires CMS to make permanent and temporary adjustments intended to ensure that the transition to the PDGM payment model is budget neutral in comparison to expected Medicare spending on the 2019 payment model. The outcome of the CMS analysis of the impact of the new payment model is a proposed 7.69% permanent rate adjustment based on the conclusion that HHAs were overpaid in 2020 and 2021 due to provider behavior changes in coding.
To read a compete write up by NAHC, please click here.
Cleveland PAC event a big success, Cincinnati (June 23) and Columbus (June 30) events coming up
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
Cleveland event a big success! Last Thursday, members from Northeast Ohio joined LeadingAge Ohio partners and associate firms to raise money for the LeadingAge Ohio PAC at Great Lakes Brewing Company in Cleveland as the first stop on the summer PAC Brew Tour. In addition to some great beer and food, a number of state legislators stopped in to spend some time with our members.
Cincinnati Brew Tour stop this week. If you missed out in Cleveland, fear not. Join LeadingAge Ohio staff, legislators, and members in the southwest region on Thursday, June 23, from 5:00-7:00PM at Sonder Brewing in Mason. Representative Bill Seitz, Representative Jessica Miranda, Representative Sara Carruthers, Senator Steve Huffman, Senator George Lang, Senator Bill Blessing, and others are planning to attend and enjoy some time with our members.
The final stop of the tour will be Thursday, June 30 at North High Brewing in downtown Dublin for all of our central Ohio friends. We hope to see you at these next two PAC events! If you have any questions, please contact Patrick Schwartz at pschwartz@leadingageohio.org.
Check out the LeadingAge Ohio Education Calendar!
LeadingAge Ohio holds valuable education webinars and in-person events all throughout the year. To see the complete schedule of events, please click here!
What the Media Said about end of life care this week – June 21, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: June 14, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding eye protection and Hospice respite days
- You asked... We answered regarding CAP reporting for Hospice
- 2022 LeadingAge Ohio Annual Conference and Trade Show: Hotel reservation, exhibitor booth registration NOW OPEN. Attendee registration opening this week!
- LeadingAge home health and hospice recap
- CMS issues addition guidance on emergency preparedness testing
- IRS increases mileage rate for remainder of 2022
- Home Health News reports on ease in staffing issues
- CMS revises home health manual removing allowed practitioner section
- State inter-agency task force seeks input from stakeholders about direct care workers
- HHS extends American Rescue Plan HCBS spending deadline
- No updates to CDC healthcare recommendations at this time
- Living with COVID: New variants on the rise
- Free Active Shooter: Home Care and Hospice webinar - June 23
- Check out the LeadingAge Ohio Education Calendar!
- What the Media Said about end of life care this week – June 14, 2022
You asked... We answered regarding eye protection in hospice inpatient units
You Asked:
In follow up to the You Asked, We Answered in last week’s newsletter, a member asked: Does the need to wear eye protection also apply in a patient homes?
We Answered:
Ohio Department of Health (ODH) clarified that eye protection (i.e., goggles or a face shield that covers the front and sides of the face) should be worn during all patient care encounters, including care provided in the home setting.
You asked... We answered regarding CAP reporting for Hospice
You Asked:
Are respite days included in the 20% annual CAP reporting for hospice?
We Answered:
Yes, respite days are included in the 20% reporting for short-term inpatient days. Please see the conditions of participation below:
418.108 Condition of participation: Short-term inpatient care.
Inpatient care must be available for pain control, symptom management, and respite purposes, and must be provided in a participating Medicare or Medicaid facility.
(d) Standard: Inpatient care limitation. The total number of inpatient days used by Medicare beneficiaries who elected hospice coverage in a 12-month period in a particular hospice may not exceed 20 percent of the total number of hospice days consumed in total by this group of beneficiaries.
2022 LeadingAge Ohio Annual Conference and Trade Show: Hotel reservation, exhibitor booth registration NOW OPEN. Attendee registration opening this week!
Join LeadingAge Ohio August 30-September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show. This year’s theme is Momentum!
Hotel registration for this year's conference is now open through the LeadingAge Ohio 2022 Annual Conference and Trade Show website, or you can click here and automatically be taken to the Hilton registration system.
Business firms interested in exhibiting at this year’s conference may find all the details, including how to register, by clicking here. All details, including booth sizes and availability are located in one convenient location on the LeadingAge Ohio website.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features Hospice Preview Reports and the CDC heat and health tracker launch.
CMS issues addition guidance on emergency preparedness testing
The Quality, Safety & Oversight (QSO) Group at the Centers for Medicare & Medicaid Services (CMS) has issued a revised QSO -20-41-All memo to provide additional guidance and clarifications on the emergency preparedness standard for testing requirements due to the ongoing COVID-19 public health emergency (PHE).
If a provider experiences an actual natural or man-made emergency that requires activation of their emergency plan, inpatient and outpatient providers will be exempt from their next required full-scale community-based exercise or individual, facility-based functional exercise following the onset of the actual event. In light of the PHE, CMS is clarifying the testing exercise requirements to ensure that surveyors, providers, and suppliers are aware of the exemption available based on the activation of their emergency plans.
The updated guidance only applies if a facility is still currently operating under its activated emergency plan or reactivated its emergency plan for COVID-19 in 2021 or 2022. Facilities which have resumed normal operating status (not under their activated emergency plans) are required to conduct their testing exercises based on the regulatory requirements for their specific provider or supplier type. The guidance provides clarifications on testing exemptions for those providers/suppliers who continue to operate under their activated emergency plan and those which may have reactivated their emergency plans for COVID-19. The guidance will also apply for any subsequent 12-month cycles in the future, in the event facilities continue to operate under their activated emergency plans for COVID-19 response activities.
For outpatient providers, which include home health and hospice agencies, if the facility claimed the full-scale exercise exemption in 2020 based on its activated emergency plan for COVID-19 response and has since resumed normal operating status, the outpatient provider/supplier is expected to complete its required full-scale exercise in 2022, unless it has reactivated its emergency plan for an actual emergency during its 12-month cycle for 2022. If the facility claimed the full-scale exercise exemption in 2021 based on its activated emergency plan for COVID-19 response and has since resumed normal operating status, the outpatient provider/supplier is expected to complete its required full-scale exercise in 2024.
In the memo, CMS provides an additional scenario where an exemption for a full scale or facility-based functional exercise applies:
Facility Z conducted a table-top exercise in June 2019 (based on its annual cycle). It is scheduled to conduct a full-scale exercise in June 2020. In March 2020, Facility Z activates its emergency preparedness program due to the COVID-19 PHE. The facility conducts its required exercise of choice in June 2021. As of March 2022, the facility continued to operate under an activated emergency plan. When must the facility conduct its next required full-scale exercise? What is the exemption based on the requirements?
Answer: The facility is exempt from the June 2020 scheduled full-scale exercise for that “annual year” and is required to complete an exercise of choice in June 2021, and a following full-scale exercise in June 2022. It is exempt from its next required full-scale or individual facility-based exercise which would have been in June 2020. However, since the facility is continuing to operate under its activated emergency plan in early 2022, the facility is exempt from the fullscale exercise in June 2022.
IRS increases mileage rate for remainder of 2022
The Internal Revenue Service announced yesterday an increase in the optional standard mileage rate for the final six months of 2022. Taxpayers may use the optional standard mileage rates to calculate the deductible costs of operating an automobile for business and certain other purposes.
For the final six months of 2022, the standard mileage rate for business travel will be 62.5 cents per mile, up four cents from the rate effective at the start of the year. The new rate for deductible medical or moving expenses (available for active-duty members of the military) will be 22 cents for the remainder of 2022, up 4 cents from the rate effective at the start of 2022. These new rates become effective July 1, 2022. The IRS provided legal guidance on the new rates in Announcement 2022-13, issued last week.
In recognition of recent gasoline price increases, the IRS made this special adjustment for the final months of 2022. The IRS normally updates the mileage rates once a year in the fall for the next calendar year. For travel from Jan. 1 through June 30, 2022, taxpayers should use the rates set forth in Notice 2022-03.
While fuel costs are a significant factor in the mileage figure, other items enter into the calculation of mileage rates, such as depreciation and insurance and other fixed and variable costs.
The optional business standard mileage rate is used to compute the deductible costs of operating an automobile for business use in lieu of tracking actual costs. This rate is also used as a benchmark by the federal government and many businesses to reimburse their employees for mileage.
Taxpayers always have the option of calculating the actual costs of using their vehicle rather than using the standard mileage rates.
The 14 cents per mile rate for charitable organizations remains unchanged as it is set by statute.
Midyear increases in the optional mileage rates are rare, the last time the IRS made such an increase was in 2011.
Home Health News reports on ease in staffing issues
Home Health Care News reported last week that staffing issues have eased somewhat in home based care settings. The article interviewed a number of providers, including LeadingAge member Dorothy Davis of VNHS in Atlanta, about why the past 90 days have seemed a little bit better on the staffing front. They’ve heard from employees that inflation has had an impact on people’s decisions regarding their jobs. Additionally, the contract work of traveling is becoming tiresome and people are reverting to wanting full time positions. Finally, the end of COVID relief funds of various stripes has meant that hospitals and others have had less money to pay for travel nurses. One other major factor is the retailers that were the main competition for aides – Amazon and Walmart for example – overhired during the winter Omicron surge and now are laying people off or at least stopping hiring. While all of these trends are anecdotal, we will continue to monitor them and would love to hear from members if hiring has picked up at all.
CMS revises home health manual removing allowed practitioner section
The Centers for Medicare & Medicaid Services (CMS) issued a Change Request 12615 and new MLN article removing previous sections of the NOA requirements regarding allowed practitioners. Since March, advocacy efforts from LeadingAge in collaboration with the home health and advanced practice nurse community, pushed to revise the initial Benefits Policy Manual and an accompanying MLN article when it inaccurately summarized regulations for advanced nurse practitioners to certify eligibility and order services for home health. The passage of the CARES Act in 2021 permanently allowed nurse practitioners, clinical nurse specialists, and physician assistants to order home health. However, each state’s practice laws and regulations need to be amended in order to comply with the new federal scope of practice change. The underlying issue in the original Change Request and MLN article were statements made about “collaboration” between advanced practice nurses, physicians assistants, and physicians in states which did not have laws governing collaboration. Many states have proactively removed requirements for written collaborative agreements. CMS has stated to advocates that their intent was not to add additional “collaboration” requirements despite confusion in the article. LeadingAge will continue to work with advocacy partners to ensure that this critical change to home health policy is appropriately enacted allowing for greater access to home health services.
State inter-agency task force seeks input from stakeholders about direct care workers
Last week, several key departments within the DeWine Administration issued announcements of the formation of an inter-agency task force on direct care workers. The release included a request for comments on five facets of workforce challenges:
- Rules, Regulations and Laws
- Education and Training Support
- Scope of Practice
- Employee Wellness and Social Supports
- Leverage Technology and Innovations
LeadingAge Ohio is drafting comments for the Administration which will include recommendations for targeted, time-limited campaigns to boost the number of certified STNAs and home health aides, as well as regulatory changes like modifying adult day ratios, and creating payment streams for technology investments that can offset workforce. Members are encouraged to submit comments separately or send them to Susan Wallace at swallace@leadingageohio.org for inclusion with LeadingAge Ohio’s comments.
The task force will include representatives from the following state agencies:
- Ohio Department of Medicaid
- Ohio Department of Aging
- Ohio Department of Health
- Ohio Department of Developmental Disabilities
- Ohio Department of Administrative Services
- Ohio Department of Mental Health and Addiction Services
- Ohio Department of Veterans Services
- Ohio Department of Job and Family Services
- Ohio Department of Higher Education
- Ohio Department of Education
- Governor’s Office of Workforce Transformation
HHS extends American Rescue Plan HCBS spending deadline
Last week, the Department of Health & Human Services notified states that they now have an additional year — through March 31, 2025 — to use funding made available by the American Rescue Plan (ARPA) to enhance, expand, and strengthen HCBS for people with Medicaid who need long-term services and supports. In Ohio, these are the dollars that were used to fund some of the HB169 provider relief. Additionally, Ohio’s plan includes numerous workforce initiatives, as well as system enhancements like adult day development grants and $50 million to fund PACE expansion. The extended deadline takes some pressure off the state, which may have struggled to administer so many new programs and services in time. However, it also slows the pace of investments for providers whose needs are acute and urgent.
Additional information on states’ spending plans — including a recently updated infographic summarizing planned activities and key investments — can be found here. This LeadingAge article also describes how this is a very important opportunity for LeadingAge member advocacy with state Medicaid agencies.
No updates to CDC healthcare recommendations at this time
LeadingAge has been expecting updates to the Centers for Disease Control and Prevention (CDC) recommendations for healthcare settings and personnel, impacting nursing homes, assisted living, hospice, and home health providers. LeadingAge is aware that some states may have received detailed information about these updates from their state public health authority. The CDC said last Friday that these updates are on hold at this time. Updates may not be released for a month or more and may look different at the time of release than what may have been previewed. With this in mind, providers are reminded of the following:
- CDC recommends that healthcare settings, including nursing homes and assisted living, and healthcare personnel including hospice and home health, follow Interim Infection Prevention and Control Recommendations for Healthcare Personnel.
- Nursing homes can also refer to CDC’s Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes for more specific information.
- The definition of “up to date” has changed with CDC’s strengthened recommendation that individuals aged 50 and older should receive a second booster. More information on what “up to date” looks like can be found on CDC’s Stay Up to Date page.
Nursing homes should continue to refer to CDC’s Community Transmission Rates for determining frequency of routine screening testing of asymptomatic staff and other mitigation measures.
Living with COVID: New variants on the rise
Last week LeadingAge learned about the rising prevalence of a new variant that combines the transmissibility of omicron with the immunity-dodging ability of delta. You can read the transcript of the “Living with COVID” series here.
Free Active Shooter: Home Care and Hospice webinar - June 23
Please join RBC Limited's Webinar on Active Shooters: Home Care & Hospice (Let's Talk). This session will include:
- Preparing staff and actions to take when confronted with an active shooter;
- Develop procedures to take to prevent and prepare for potential active shooter incidents;
- Describe how to manage the consequences of an active shooter incident both in the field and office.
As we all know, violence in the Workplace continues to escalate for health care workers. This includes home care and hospice settings as well. A few weeks ago, while RBC Limited conducted a webinar on violence in the workplace, an active shooter event was occurring at the same exact time.
After the presentation, attendees will be able to join the discussion during live Q & A.
Capacity is limited, so please register here to guarantee your spot.
Check out the LeadingAge Ohio Education Calendar!
LeadingAge Ohio holds valuable education webinars and in-person events all throughout the year. To see the complete schedule of events, please click here!
What the Media Said about end of life care this week – June 14, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: June 7, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding eye protection in hospice inpatient units
- LeadingAge home health and hospice recap
- LeadingAge Ohio All-Member Call: Today at 11:30AM
- Hospice care compare May refresh will not include new measures
- CMS sending letters to physicians referring to hospice
- OIG workplan to include OASIS falls reporting and post-acute transfer policy
- CMS transitions administrative functions for HHA enrollments and CHOWs
- ODH Health Alert: Monkeypox virus update
- LeadingAge Ohio Board of Directors: nominations due July 1
- Ohio employers should weigh in on work-based learning
- Life Safety Code: Current Hot Topics and Updates webinar - June 22
- Advanced Principles of Hospice Management - September 21
- Hospice Clinical Bootcamp - October 12
- Have you met Elliott Ness? Support the PAC at Great Lakes Brewing!
- Check out the LeadingAge Ohio Education Calendar!
You asked... We answered regarding eye protection in hospice inpatient units
You Asked:
Our hospice has an inpatient unit. Do we need to wear eye protection in all patient rooms when the community transmission rate is substantial or high, or just in PUI (person under investigation)/COVID positive patient rooms?
We Answered:
LeadingAge Ohio reached out to the Ohio Department of Health (ODH) to see what they recommended for eye protection for staff working in hospice inpatient units when the community transmission rate is substantial or high. The Survey Administrator Bureau of Survey and Certification, ODH gave the following guidance:
Our surveyors are enforcing the most current CDC guidance related to PPE including the bolded and underlined area below as it relates to eye protection.
Implement Universal Use of Personal Protective Equipment for HCP
If SARS-CoV-2 infection is not suspected in a patient presenting for care (based on symptom and exposure history), HCP should follow Standard Precautions (and Transmission-Based Precautions if required based on the suspected diagnosis). Additionally, HCP working in facilities located in counties with substantial or high transmission should also use PPE as described below:
- NIOSH-approved N95 or equivalent or higher-level respirators should be used for:
- All aerosol-generating procedures (refer to Which procedures are considered aerosol generating procedures in healthcare settings?)
- All surgical procedures that might pose higher risk for transmission if the patient has SARS-CoV-2 infection (e.g., that generate potentially infectious aerosols or involving anatomic regions where viral loads might be higher, such as the nose and throat, oropharynx, respiratory tract).
- NIOSH-approved N95 or equivalent or higher-level respirators can also be used by HCP working in other situations where additional risk factors for transmission are present such as the patient is not up to date with all recommended COVID-19 vaccine doses, unable to use source control, and the area is poorly ventilated. They may also be considered if healthcare-associated SARS-CoV-2 transmission is identified and universal respirator use by HCP working in affected areas is not already in place.
- To simplify implementation, facilities in counties with substantial or high transmission may consider implementing universal use of NIOSH-approved N95 or equivalent or higher-level respirators for HCP during all patient care encounters or in specific units or areas of the facility at higher risk for SARS-CoV-2 transmission.
- Eye protection (i.e., goggles or a face shield that covers the front and sides of the face) should be worn during all patient care encounters.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features information on the CDC issuing no updates to the healthcare recommendations at this time and LeadingAge staff meeting with home health and hospice subject matter experts at CMS.
LeadingAge Ohio All-Member Call: Today at 11:30AM
The next LeadingAge Ohio All-Member Call will take place today at 11:30AM. Please plan to join the LeadingAge Ohio advocacy team to discuss the “new lame duck”, as Ohio policymakers sprint from one deadline to the next. An infusion of ARPA investment, coupled with a chaotic redistricting process has created intense periods of policymaking, and aging services continue to be in focus as providers struggle to emerge from the pandemic. Find out what initiatives the legislature advanced and which it delayed, including when to expect HCBS ARPA funding, the latest on PACE expansion, work to offset workforce expenses of nursing facilities, and a new solution for hospice transportation. Members will also hear the latest on Ohio’s nurse aide training rules and Ohio’s new home care license, as well as how they can use campaign season to connect with legislators.
The call is free to members but registration in advance is required. To have your question answered on the call, email it to COVID19@leadingageohio.org.
Hospice care compare May refresh will not include new measures
Last week, the Centers for Medicare & Medicaid Services (CMS) had originally planned to publicly display data for two new quality measures (Hospice Visits in the Last Days of Life (HVLDL) and the Hospice Care Index (HCI) claims-based measures), however these measures have been suppressed by CMS for all hospices and CMS is targeting the August 2022 refresh for the inaugural public display of these two new quality measures. The May 2022 quarterly refresh for the Hospice Quality Reporting Program will now only include the Hospice Item Set (HIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey, and Claims-based measure scores exclude Quarter 1 and Quarter 2 of calendar year 2020. In addition, state averages will now be displayed for each measure.
CMS sending letters to physicians referring to hospice
The Centers for Medicare & Medicaid Services' (CMS) Center for Program Integrity recently started mailing letters inviting physicians starting in Florida to one-on-one training sessions about the Medicare hospice benefit. These letters are being sent to physicians who are ordering and referring Medicare beneficiaries to hospice services. Purpose of this three-hour, in-person trainings is to help physicians understand Medicare hospice benefit, referral process, and regulations. Husch Blackwell produced a product discussing what these training sessions involve, why CMS is conducting them, and how physicians and hospices can respond.
OIG workplan to include OASIS falls reporting and post-acute transfer policy
The Department of Health & Human Services Office of the Inspector General (OIG) reported the addition of a new study and a new audit that should be of interest to the home health and hospice communities. These alerts to the public via daily updates of new audits and reports is part of the OIG Work Plan. The OIG Descriptions of the new work items are provided below:
Accuracy of Falls Reporting in Home Health OASIS Assessments
In April 2022, the Centers for Medicare & Medicaid Services (CMS) began publicly reporting on the Care Compare website the percentage of patients in home health care who fell and endured major injuries for each home health agency (HHA). HHAs report falls in patient assessments using the standardized Outcome and Assessment Information Set (OASIS), and CMS reports the agency fall rates calculated from these assessments.
In this study, OIG will assess the accuracy of HHAs’ reporting of falls in OASIS. Specifically, OIG will use Medicare claims to identify hospitalizations due to falls with major injuries among Medicare beneficiaries in home health care and will then assess the extent to which those falls were reported in OASIS assessments. OIG plans to describe the characteristics of beneficiaries who did not have their falls reported, as well as the characteristics of HHAs that have particularly low reporting rates. This study will be conducted by the Office of Evaluation and Inspections, and the OIG expects to release findings from this study during FY2023.
Follow-up Review of Inpatient Claims Under the Post-Acute-Care Transfer Policy (PACT)
Medicare makes the full Medicare Severity Diagnosis-Related Group (MS-DRG) payment to a hospital that discharges an inpatient beneficiary “to home.” However, if a patient is on hospital service for a shorter period of time than expected and is subsequently discharged to home with home health care, hospice, or other post-acute care, Medicare pays hospitals a per diem rate. As a result, the hospital receives less payment than would be the case if it were paid the full amount for the MS-DRG.
OIG has conducted a number of studies to determine whether the post-acute transfer policy is being implemented properly, including one related to post-acute transfers to home health care.
One prior OIG review found that the CMS Common Working File (CWF) edits that detected inpatient claims under the post-acute care transfer policy were working appropriately. However, some Medicare contractors did not receive automatic notifications of improperly billed claims or did not act to adjust those claims. As a result, OIG recommended that CMS recover the identified overpayments in line with its policies and procedures and ensure that the Medicare contractors are receiving the notifications and are acting to recover the overpayments. CMS concurred with all OIG recommendations and detailed how they were addressed.
This follow–up audit, being conducted by the OIG Office of Audit Services, will determine whether CMS’s CWF edits are working properly in detecting inpatient claims under the post-acute-care transfer policy and are automatically recovering overpayments, and whether Medicare contractors are receiving the automatic notifications and acting to recover overpayments. The audit report is scheduled for completion in FY2023.
CMS transitions administrative functions for HHA enrollments and CHOWs
The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 12749 that describes the transitioning of certain certification enrollment functions performed by the CMS Survey and Operations Group (SOG) Locations (formerly CMS Regional Offices) to CMS’ Center for Program Integrity (CPI) Provider Enrollment Oversight Group (PEOG) and the Medicare Administrative Contractors (MACs).
To date, CMS has transitioned several transactions that include voluntary termination applications and federally qualified health center initial enrollment applications, changes of ownership, and changes of information. Effective May 27, 2022, the following enrollment transactions will “transition”, which includes home health agency (HHA) initial enrollment applications and changes of ownership.
- Ambulatory surgical center (ASC) initial enrollment applications, changes of ownership, and changes of information.
- Community mental health center (CMHC) initial enrollment applications, changes of ownership, and changes of information.
- Comprehensive outpatient rehabilitation facility (CORF) initial enrollment applications, changes of ownership, and changes of information.
- Home health agency (HHA) initial enrollment applications, changes of ownership under 42 CFR § 489.18 (as distinguished from changes in majority ownership under
42 CFR § 424.550(b)), and changes of information
- Outpatient physical therapy/outpatient speech pathology (OPT/OSP) provider initial enrollment applications, changes of ownership, and changes of information.
- Portable x-ray supplier (PXRS) initial enrollment applications, changes of ownership, and changes of information.
CMS has revised the Program Integrity Manual, Chapter 10, section 10.2.1.6 to reflect the changes along with detailed instructions for initial enrollment and CHOWs for HHAs.
ODH Health Alert: Monkeypox virus update
Yesterday afternoon, the Ohio Department of Health (ODH) shared the attached Monkeypox Virus Update outlining resources available through ODH for the diagnosis of monkeypox and other important information. Healthcare providers who suspect monkeypox due to clinical presentation and patient history should report suspected cases to the appropriate local health department based on the patient’s address.
LeadingAge Ohio encourages members to evaluate their emergency preparedness response protocols specific to monkeypox. They should consider monkeypox’s impact on the facility’s hazardous vulnerability risk, training, communication, their nursing staff’s competency in assessment, response, and contact tracing. LeadingAge Ohio encourages members to reach out to local health departments’ to understand their plans for response to a suspicion of monkeypox at a facility and discuss the process for obtaining lab results.
LeadingAge Ohio Board of Directors: nominations due July 1
Last week, LeadingAge Ohio released a call for nominations to serve on the LeadingAge Ohio Board of Directors and individuals in all stages and capacities of leadership positions are encouraged to apply. Individuals with expertise and interests aligned with the 2022+ LeadingAge Ohio Strategic Plan, which centers on advocacy and workforce development, will be strong candidates for Board positions. The Nominating Committee will meet to evaluate candidates for board service in mid July.
To review the nomination packet, click here. LeadingAge Ohio encourages any who are interested in serving on the board to contact Susan Wallace at swallace@leadingageohio.org to express interest. Nominations are due no later than Friday, July 1.
Ohio employers should weigh in on work-based learning
LeadingAge Ohio is part of the Complete to Compete (C2C) coalition, a statewide network of employers, education and higher education stakeholders working toimprove post-secondary attainment and better align education / training with Ohio’s jobs. C2C launched a survey to gauge understanding in what businesses, organizations, and agencies know about work-based learning programs in Ohio. The information gained from the survey will be utilized to reinforce existing work-based learning resources and identify areas of growth in strengthening the framework to grow the program.
LeadingAge Ohio members are encouraged to participate in the survey, regardless of how involved your organization has been in work-based learning in the past. Opportunities for students to become involved with aging services and providers can forge pathways into aging careers in light of current workforce needs.
Please use this link to access the survey. The survey should take no more than 20 minutes to complete. Please submit your responses to the survey by June 15, 2022.
Please email Workforce Director, Randi Hamill, at rhamill@leadingageohio.org if you have any questions or need assistance.
Life Safety Code: Current Hot Topics and Updates webinar - June 22
Join LeadingAge Ohio and representatives from the Ohio Department of Health (ODH) on June 22 at 1:00PM for the most up-to-date information on top Life Safety Code deficiencies and remedies, as well as other hot topics related to Life Safety. CMS Blanket waivers that are expiring will be covered along with common Emergency Preparedness plan trends. Updates and changes to the Preventative Maintenance Manual will also be discussed.
Who will benefit from this webinar?
- Nursing and Hospice Facility Maintenance Staff
- Managers
- Administrators
- Compliance Officers
To register for this event, please click here.
Advanced Principles of Hospice Management - September 21
This program will provide an overview of hospice management principles for new hospice clinical and administrative managers or hospice managers who want to get an update on the latest technical and regulatory topics. Topics covered will include best practices in sustaining a successful program that meets the end-of-life needs of patients, families and the wider community. Day-to-day management issues and practical resolutions will also be addressed.
Topics discussed will include:
- Overview of the regulatory bodies that govern hospice operation and a detailed discussion of the CMS survey process
- Details of the Hospice Medicare Benefit and Conditions of Participation that pertain specifically to the management of hospice
- Local Coverage Determinations and adequate non-cancer documentation
- Hospice Quality Reporting Guidelines
- Assessments, Plan of Care and IDG processes
- Operational issues such as staffing ratios, physician orders and visit frequencies, Hospice ABN’s, etc.
- Importance of good nursing facility communication
For additional information and/or to register, please click here.
Hospice Clinical Bootcamp - October 12
Join LeadingAge Ohio's Director of Home Health/Hospice Regulatory Relations Anne Shelley for this day-long offering will include what direct care staff need to know related to the Medicare Hospice Benefit, the Hospice Conditions of Participation, Advance Care Planning, Hospice-Nursing Facility Collaboration, Non-Cancer documentation, symptom management and professional barriers and communication in hospice. This education will greatly benefit all new hospice nurses, social workers, chaplains and volunteer and bereavement coordinators, not to mention being a good refresher for all seasoned front-line staff.
Objectives:
- Explain the philosophy of hospice care.
- Define unique hospice characteristics.
- Explain components of the Hospice Medicare Benefit.
- Discuss the importance of Advance Care Planning.
- Discuss components and importance of hospice symptom management.
- Identify basic components of hospice Conditions of Participation.
- Discuss major components of Hospice COP’s, Sub-Part C.
- Discuss the major components of Hospice COP's, Sub-Part D.
- Describe information needed in non-cancer documentation.
- Discuss the importance of hospice collaboration with nursing facilities.
For additional information and/or to register, please click here.
Have you met Elliott Ness? Support the PAC at Great Lakes Brewing!
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
Join LeadingAge Ohio staff, legislators, and members in the northeast region on Thursday, June 16, from 5:00-7:00PM, at Great Lakes Brewing Company in downtown Cleveland for the first of three LeadingAge Ohio PAC fundraising receptions.
LeadingAge Ohio will be hosting two additional gatherings on June 23 in Cincinnati (Sonder Brewing) and on June 30 in Columbus (North High Brewing). Complete details can be viewed by clicking here.
Check out the LeadingAge Ohio Education Calendar!
LeadingAge Ohio holds valuable education webinars and in-person events all throughout the year. To see the complete schedule of events, please click here!
Home Health and Hospice Newsletter: May 31, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding CMS flexibilities
- LeadingAge home health and hospice recap
- End of COVID-19 emergency declaration blanket waivers and HCIC program
- LeadingAge Ohio Board of Directors: Call for nominations
- COVID-19 rebound after Paxlovid treatment
- PHE will be extended past July 15; CMS offers guidance on Medicaid post-PHE
- Second boosters and nursing homes
- COVID hospitalizations are up; parts of the nation are in fifth wave
- Life Safety Code: Current Hot Topics and Updates webinar - June 22
- Check out the LeadingAge Ohio Education Calendar!
- LeadingAge Ohio PAC Brew Tour: Thursdays in June
You asked... We answered regarding CMS flexibilities
You Asked:
At one-point hospices were allowed to extend the comprehensive assessment update visit from 15 days to 21 days. Has this waiver been lifted and returned to an every 15 day visit for a comprehensive assessment update?
We Answered:
The only waivers that have been lifted for hospices are related to the Life Safety Code and facility and medical equipment, which would affect hospice inpatient units. Those waiver cancellations can be found here.
All other waivers listed in this document will be lifted at the end of the Public Health Emergency (PHE). Once a date has been set to end the PHE, CMS will provide specific timeframes for the ending of the waivers. Initially, many of the waivers were to be lifted 60 days after the end of the PHE.
So, hospices are still working with the 21-day timeframe for the update of the comprehensive assessment, but please remember, even though the comprehensive assessment update is every 21 days, the update of the plan of care is still and always has been every 15 days.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features information on the LeadingAge Coronavirus Update Call taking place on Wednesday and COVID-19 Funding Action Alert.
End of COVID-19 emergency declaration blanket waivers and HCIC program
The Ohio Department of Health (ODH) and Ohio Department of Medicaid (ODM) issued this memo ending the Health Care Isolation Centers (HCIC) and in-house surge facilities on June 7, 2022. All SNFs that were approved to be a HCIC and utilize certified space outside of the SNF (i.e. in a licensed residential care facility or in a building separate from the SNF), as well as any SNF that surged its certified capacity beyond its existing license and certified capacity, will need to terminate providing care within its HCIC or in-house surge facility effective June 7.
Also effective June 7, approved HCIC providers must cease billing for enhanced reimbursement for HCIC isolation and quarantine services and will resume billing using usual and customary Medicaid NF service codes. Any claims inappropriately billed for HCIC services after this service date will be denied or payments recouped.
LeadingAge Ohio Board of Directors: Call for nominations
The Nominating Committee of the LeadingAge Ohio Board of Directors is commencing its preparation of the annual slate of nominees to replace those whose terms will soon be expiring. The LeadingAge Ohio membership will vote on this slate at its annual meeting this autumn.
The LeadingAge Ohio Board sets the strategic direction for the association and brings together leaders throughout the state to influence state workforce and reimbursement policy, and a variety of programs and services for older adults in Ohio. “LeadingAge Ohio Board service offers members a behind-the-scenes view of state-level decisionmaking and the opportunity to grow our collective impact,” said Cynthia Bougher, Immediate Past Chair of the LeadingAge Ohio Board of Directors and Chair of the Nominations Committee. “It has also expanded my network of colleagues I can reach out to and rely on.”
Board members are nominated to represent the diversity of the LeadingAge Ohio membership, as well as the breadth of the continuum served by members. To review the nominations form, click here. LeadingAge Ohio encourages any who are interested in serving on the board to contact Cynthia Bougher at Cynthia.bougher@valleyhospice.org to express interest. Individuals with expertise and interests aligned with the 2022+ LeadingAge Ohio Strategic Plan will be strong candidates for the Board positions.
COVID-19 rebound after Paxlovid treatment
The Centers for Disease Control and Prevention (CDC) issued the following Health Alert Network (HAN) Health Advisory to update healthcare providers, public health departments, and the public on the potential for recurrence of COVID-19 or “COVID-19 rebound.” Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease. Paxlovid treatment helps prevent hospitalization and death due to COVID-19. COVID-19 rebound has been reported to occur between 2 and 8 days after initial recovery and is characterized by a recurrence of COVID-19 symptoms or a new positive viral test after having tested negative. A brief return of symptoms may be part of the natural history of SARS-CoV-2 (the virus that causes COVID-19) infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status. Limited information currently available from case reports suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease. There is currently no evidence that additional treatment is needed with Paxlovid or other anti-SARS-CoV-2 therapies in cases where COVID-19 rebound is suspected.
PHE will be extended past July 15; CMS offers guidance on Medicaid post-PHE
The federal public health emergency will likely be extended at least through September after federal health officials did not announce an expiration date last week. The Department of Health and Human Services (HHS) Secretary Becerra and the Centers for Medicare & Medicaid Services (CMS) Administrator Brooks-LaSure sent a letter to governors on May 17 stating they were unsure when the emergency would end, but urged states to take the necessary steps to prepare for the coming wave of Medicaid redeterminations. CMS also released a slide deck that lays out enrollment flexibilities states can apply for and reminded states to consider how to distribute renewals throughout the year since they will be unable to redistribute renewals in future years. For the letter, click here, and click here for the CMS slide deck.
Second boosters and nursing homes
The Centers for Disease Control and Prevention (CDC) strengthened recommendations for second boosters last week. Individuals over age 50 are now required to have a second booster to be considered “up to date” if their first booster was more than four months ago. Find out what this means for nursing homes by clicking here.
COVID hospitalizations are up; parts of the nation are in fifth wave
Federal data showed the U.S. seven-day average of hospital admissions from COVID rose about 20 percent over the previous week, causing officials to advise Americans in high risk zones to consider wearing masks indoors again. For the data click here, for more from the New York Times, click here. Americans can now order up to eight free COVID tests from the government online; the test kits can be ordered at COVID.gov, which then directs to the USPS website, or call (800) 232-0233.
Life Safety Code: Current Hot Topics and Updates webinar - June 22
Join LeadingAge Ohio and Representatives from the Ohio Department of Health (ODH) on June 22 at 1:00PM, for the most up-to-date information on top Life Safety Code deficiencies and remedies, as well as other hot topics related to Life Safety. CMS Blanket waivers that are expiring will be covered along with common Emergency Preparedness plan trends. Updates and changes to the Preventative Maintenance Manual will also be discussed.
Who will benefit from this webinar?
- Nursing and Hospice Facility Maintenance Staff
- Managers
- Administrators
- Compliance Officers
To register for this event, please click here.
LeadingAge Ohio PAC Brew Tour: Thursdays in June
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
The LeadingAge Ohio PAC will host fundraising events at three of Ohio’s premier breweries for its first-ever Summer PAC Brew Tour! These fundraising receptions will take place on Thursdays in June with three options to choose from - Cleveland at Great Lakes Brewing Company (June 16), Cincinnati at Sonder Brewing (June 23), and Columbus at North High Brewing Company (June 30). Legislators will be invited to attend as guests. Enjoy some great beer, great food, and support the PAC while networking with your colleagues!
Organizations interested in sponsorship should contact Corey Markham at cmarkham@leadingageohio.org.
Cleveland - Great Lakes Brewing Company
Thursday, June 16, 2022
2516 Market Ave
Cleveland, OH 44113
5:00-7:00PM
Register online here
Cincinnati - Sonder Brewing
Thursday, June 23, 2022
8584 Duke Blvd
Mason, OH
5:00-7:00PM
Register online here
Columbus - North High Brewing Company
Thursday, June 30, 2022
56 N High St
Dublin, OH 43017
5:00-7:00PM
Register online here
Check out the LeadingAge Ohio Education Calendar!
LeadingAge Ohio holds valuable education webinars and in-person events all throughout the year. To see the complete schedule of events, please click here!
Home Health and Hospice Newsletter: May 24, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding Home Health therapy orders
- LeadingAge home health and hospice recap
- NAHC request - PCHETA support sign-on opportunity
- Additional free at-home, rapid COVID-19 tests
- OIG looking at home health falls reporting
- Study finds hospice comfort medications have great variation
- Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
- Life Safety Code: Current Hot Topics and Updates webinar - June 22
- LeadingAge Ohio PAC Brew Tour: Thursdays in June
- Goals of care with individuals with cognitive impairment: Wednesday, May 25
- Public Health Emergency likely to continue beyond July 16
- What the Media Said about end of life care this week – May 24, 2022
You asked... We answered regarding Home Health therapy orders
You Asked:
If there is a home health patient who does not have an order for physical therapy (PT) on admission, but three weeks later has an event and needs a therapy evaluation, how long of a time-frame does the therapist have to get out to the home to evaluate the patient if the nurse gets an order for physical therapy to evaluate and treat with no specific date applied to the order? Is it a 5-day window to evaluate and treat the patient like the admission time-frame?
We Answered:
LeadingAge Ohio reached out to the Ohio Department of Health (ODH) regarding the timeframe for an evaluation and treatment from the therapist after the start of care. This was ODH’s response:
There is no specific time frame in the regulations; however, if the physician writes an order for PT to evaluate and treat, we would expect to see a PT visit to evaluate and treat. Some agencies have policies stipulating time frames and some have “expectations” that the visit would happen as soon as possible. ODH has seen these orders fall thru the cracks and it’s many weeks before therapy ever sees the patient or sometimes not at all. There is often no follow up with the physician to inform him/her of the delay or reason why therapy never provided service. Either of those scenarios would result in a citation.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features an article on PHE likely to continue beyond July 16.
NAHC request - PCHETA support sign-on opportunity
Last Thursday, the Palliative Care and Hospice Education and Training Act (PCHETA (S. 4260) was re-introduced in the US Senate by Senators Tammy Baldwin (D-WI) and Shelley Moore-Capito (R-WV). The Bill text is available here and the one pager is available here. PCHETA is a bill that would make major investments to increase and bolster the hospice and palliative care interdisciplinary workforce. LeadingAge Ohio will keep members informed on the bill’s progress.
Additional free at-home, rapid COVID-19 tests
Last week, the Biden Administration announced that COVIDTests.gov is now open for a third round of ordering. People who have difficulty accessing the internet or need additional support placing an order can call 1-800-232-0233 (TTY 1-888-720-7489) to get help in English, Spanish, and more than 150 other languages, 8:00AM - midnight, 7 days a week. For more information, people can visit COVID.gov/tests/faq.
OIG looking at home health falls reporting
In April 2022, a new OASIS-based measure for falls with major injuries for home health agencies was publicly released on Care Compare; Percent of Residents Experiencing One or More Falls with Major Injury. This month OIG added a study to their work plan to assess accuracy of home health agency reporting on falls in OASIS. The report will use Medicare claims to identify hospitalizations due to falls with major injury and the analysis will look the extent to which falls were reported on OASIS. The report will include a description of the beneficiary characteristics who did not have falls reported as well as characteristics of home health agencies that have low falls reporting rates. The report will be issued in 2023.
Study finds hospice comfort medications have great variation
A new study from the University of Michigan looked at two types of medication often used to support individuals with anxiety, agitation, delirium and other symptoms while on hospice. The two categories of drugs reviewed were benzodiazepines and antipsychotics. There has been concerted effort to reduce the use of these drugs in older adult populations, but little research has focused on their use in hospice. The study reviewed 400,000 Medicare beneficiaries who had not been prescribed these types of medications in the prior 6 months. The research found 54% of patients in the 4,300 hospices studied filled a prescription for a benzodiazepine and 31% filled an antipsychotic while on hospice. The greatest predictor of whether a patient was prescribed one of these medications was if they received care from a high prescribing hospice agency, not a patient’s clinical characteristics. The study also revealed differences between non-profit and for-profit hospice prescribing trends and racial and ethnic variations by patients.
Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
LeadingAge Ohio and HJ Sims invite you to join this webinar series with your board members, as HJ Sims provides a series of comprehensive virtual content geared directly toward the governance of senior living providers. The series will benefit all leaders within our field, especially board members, leadership teams, and individuals new to these roles. Participants will walk away with a clear understanding of the role and responsibilities of boards, how to think through affiliations, acquisitions and other partnerships, and other challenges in this volatile, post-COVID era.
Each session will tap the intellectual capital of industry experts from governance, law, finance, development, and strategic planning. Invite your board members and plan to attend the entire series for maximum impact. Webinars will be held every Tuesday in June.
Life Safety Code: Current Hot Topics and Updates webinar - June 22
Join LeadingAge Ohio and Representatives from the Ohio Department of Health (ODH) on June 22 at 1:00PM, for the most up-to-date information on top Life Safety Code deficiencies and remedies, as well as other hot topics related to Life Safety. CMS Blanket waivers that are expiring will be covered along with common Emergency Preparedness plan trends. Updates and changes to the Preventative Maintenance Manual will also be discussed.
Who will benefit from this webinar?
- Nursing and Hospice Facility Maintenance Staff
- Managers
- Administrators
- Compliance Officers
To register for this event, please click here.
LeadingAge Ohio PAC Brew Tour: Thursdays in June
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
The LeadingAge Ohio PAC will host fundraising events at three of Ohio’s premier breweries for its first-ever Summer PAC Brew Tour! These fundraising receptions will take place on Thursdays in June with three options to choose from - Cleveland at Great Lakes Brewing Company (June 16), Cincinnati at Sonder Brewing (June 23), and Columbus at North High Brewing Company (June 30). Legislators will be invited to attend as guests. Enjoy some great beer, great food, and support the PAC while networking with your colleagues!
Organizations interested in sponsorship should contact Corey Markham at cmarkham@leadingageohio.org.
Cleveland - Great Lakes Brewing Company
Thursday, June 16, 2022
2516 Market Ave
Cleveland, OH 44113
5:00-7:00PM
Register online here
Cincinnati - Sonder Brewing
Thursday, June 23, 2022
8584 Duke Blvd
Mason, OH
5:00-7:00PM
Register online here
Columbus - North High Brewing Company
Thursday, June 30, 2022
56 N High St
Dublin, OH 43017
5:00-7:00PM
Register online here
Goals of care with individuals with cognitive impairment: Wednesday, May 25
Join the Honoring Wishes Task Force next Wednesday for a conversation with Leigh Ann Kingsbury of InLeadS Consulting, who will offer her insights on goals of care conversations with individuals with cognitive impairment. A nationally-recognized expert in person-centered practices and healthcare decision making, Leigh Ann is a frequent presenter and facilitator on advance care planning, advocacy for individuals with disabilities, and legal aspects like guardianship and alternatives to guardianship. Recently she served as facilitator for Ohio’s Alzheimer’s and Related Dementias Task Force convened by the Department of Aging.
There is no cost for the webinar, but advance registration is required by clicking here. The presentation is part of a monthly series that LeadingAge Ohio hosts on behalf of the Honoring Wishes Task Force, a statewide coalition of post-acute providers, health systems, hospice & palliative care experts, elder law attorneys and other stakeholders. These webinars are open to all professionals interested in engaging with older adults and individuals with disabilities in healthcare planning discussions.
Public Health Emergency likely to continue beyond July 16
The current extension of the Public Health Emergency (PHE) is due to end on July 16. When it does end there are implications for Medicare, Medicaid and the CHIP program – for states, providers, and beneficiaries. However, the Department of Health and Human Services (HHS) Secretary Xavier Becerra committed to giving states and others 60 days’ notice if the PHE is not going to be renewed. Since May 16 passed with no notice, it is reasonable to expect that it will be renewed once again.
What the Media Said about end of life care this week – May 24, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: May 17, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding Medicare and Medicaid Election Statement
- LeadingAge home health and hospice recap
- Expanded HHVBP Model – Achievement thresholds and benchmarks now available on IQIES
- Home Health allies in Congress tell CMS to ensure PDGM fairness
- Draft OASIS-E Guidance Manual now available
- More ARP Rural Payments distributed last week
- FY 2023 Hospice Wage Index proposed rule advocacy
- Study finds hospice policy changes reduced dementia patient usage
- New guide helps hospices address mental health needs
- Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
- LeadingAge Ohio PAC Brew Tour: Thursdays in June
- Ohio ends HCIC program
- ODM shares Patient Liability Fact Sheet
- Key deadline approaches for Medicaid unwinding
- Check out the LeadingAge Ohio Education Calendar!
- What the Media Said about end of life care this week – May 17, 2022
You asked... We answered regarding Medicare and Medicaid Election Statement
You Asked:
During LeadingAge Ohio’s recent hospice billing workshop, the need to specify on the Hospice Consent which coverage the consent was for - Medicare or Medicaid - was discussed. Our consent lists Medicare/Medicaid, but does not actually have a place to specify which coverage the consent applies to. Is this part of the Medicare billing manual, or just a best practice?
We Answered:
Medicare and Medicaid both have Election Statements that are required to be signed when an individual elects their payer coverage. When the Ohio Department of Medicaid (ODM) updated the hospice rules 5 years ago, LeadingAge Ohio worked to have ODM include the same criteria on their Election Statement as the Medicare Election Statement so a hospice provider could have a combined Election Statement for both Medicare and Medicaid. ODM reached out to Medicare, and Medicare approved hospice providers using a combined Election Statement as long as all the CMS criteria was on the Election Statement and the patient specified which payer source they were electing, Medicare, Medicaid or both. Please see the ODM hospice rule 5160-56-02 Hospice services: Eligibility and Election Requirements, section (C)(1). A hospice provider can either put a check box by the payer source or circle which payers the patient is selecting on the Election Statement so there is some indication the patient knows what benefit(s) they will be using while on hospice services.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features an article on proposed legislation on EVV possibly eliminating GPS requirements.
Expanded HHVBP Model – Achievement thresholds and benchmarks now available on IQIES
The achievement thresholds and benchmarks for each quality measure in the expanded HHVBP Model are now available on the Internet Quality Improvement and Evaluation System (iQIES) portal. The achievement thresholds and benchmarks were calculated by cohort using quality measure data for the Model baseline year, which is calendar year (CY) 2019 for the CY 2023 performance year/CY 2025 payment year.
Information on how to access the achievement thresholds and benchmarks, as well as an FAQ, are available by clicking here.
Should you experience difficulty locating the HHVBP file, please contact the iQIES Help desk staff by email at iQIES@cms.hhs.gov or by phone at (800) 339-9313.
For questions about the achievement thresholds, benchmarks, and cohorts, and use in the expanded HHVBP Model, please contact the HHVBP Help Desk staff by email at HHVBPquestions@lewin.com.
*Please include your name, agency name, and the CCN when contacting the help desks.
Home Health allies in Congress tell CMS to ensure PDGM fairness
Two U.S. Senators and two Representatives have written a bipartisan letter to the Centers for Medicare & Medicaid Services (CMS), urging the government agency to craft a CY2023 home health payment proposed rule that ensures “payments under the Patient Driven Groupings Model (PDGM) are fair to providers and ensure patient access to high-quality care.”
“A key part of the upcoming rule is the evaluation as to whether PDGM was budget neutral in 2020,” wrote Senators Debbie Stabenow (D-MI), Todd Young (R-IN), Reps. Terri Sewell (D-AL) and Vern Buchanan (R-FL). “We are concerned that CMS may not be able to reliably determine whether any change in aggregate payments in 2020 was caused by provider behavior, the impacts of COVID-19, or other aspects of the new payment system. To the extent such a determination is possible, we believe CMS should consider applying pre-PDGM provider behaviors to establish the estimated spending that would have occurred in the absence of PDGM.”
In addition, the members urge CMS to carefully consider data and comments submitted by stakeholders to last year’s rule where CMS offered a proposed methodology for the required budget neutrality calculations. Stakeholders raised concerns that the CMS methodology does not reflect an appropriate comparison resulting in unwarranted projected payment cuts. CMS noted that most commenters disagreed with the methodology and committed to considering alternative approaches to refine it.
With the costs of providing quality services continuing to rise, payment stability is needed to ensure access to vital home health care services. An inaccurate or premature budget neutrality adjustment would only compound the risks brought on by higher service costs. Home health has been on the front lines of the COVID-19 response, reaching patients in need throughout the pandemic. Supporting home health requires fair and appropriate Medicare payment policies.
Draft OASIS-E Guidance Manual now available
The draft Guidance Manual for the OASIS-E version of the Outcome and Assessment Information Set (OASIS) data set, effective January 1, 2023, is available in the Downloads section on the OASIS Users Manuals page. The updated draft OASIS-E All Items Instrument is now available in the Downloads section of the OASIS Data Sets webpage. A log of changes since last posting is also available.
More ARP Rural Payments distributed last week
The Health Resources and Services Administration (HRSA) sent out $450 million in American Rescue Plan (ARP) Rural payments to 2200 providers. It has now distributed $7.9B of the $8.5 billion appropriated by Congress to provide relief to rural providers. With this latest distribution, 99% of applications have completed review. Providers who have not yet received a communication about their ARP rural application will receive a notification of its status as soon as HRSA has completed its review and processing. LeadingAge has heard from a handful of members who had received notices months ago indicating that they qualified for the payments but have been waiting ever since. Members should check their bank accounts to see if they’ve received a payment even if they aren’t physically located in a rural area as the payments were distributed to providers based upon where the Medicare or Medicaid beneficiaries served by the provider reside.
FY 2023 Hospice Wage Index proposed rule advocacy
The Hospice Network held its May monthly call last week and discussed the FY2023 Hospice Wage Index proposed rule and draft comment letter. LeadingAge shared a VoterVoice action alert page for hospice members to submit comments on the Centers for Medicare & Medicaid Services' (CMS) request for information on health equity.
Study finds hospice policy changes reduced dementia patient usage
A study from the George Washington University Milken Institute School of Public Health found that use of hospice by individuals with Alzheimer disease and related dementias (ADRD) immediately declined after the passage and implementation of the 2014 Improving Medicare Post-Acute Care Transformation (IMPACT) Act. This patient population also saw slower growth in hospice use after the implementation of IMPACT and the 2-tier payment system compared to earlier years of claims data. Study authors believe the results may reflect unintended reduced access for hospice-appropriate patients with ADRD as hospices attempt to minimize risk of long stays. The study calls for additional research on the impact of these policy changes including their impact on the quality of care.
New guide helps hospices address mental health needs
National Partnership for Healthcare and Hospice Innovation (NPHI) recently released its Community Counseling Guide to help member providers structure bereavement services, including best practices for billing.
Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
LeadingAge Ohio and HJ Sims invite you to join this webinar series with your board members, as HJ Sims provides a series of comprehensive virtual content geared directly toward the governance of senior living providers. The series will benefit all leaders within our field, especially board members, leadership teams, and individuals new to these roles. Participants will walk away with a clear understanding of the role and responsibilities of boards, how to think through affiliations, acquisitions and other partnerships, and other challenges in this volatile, post-COVID era.
Each session will tap the intellectual capital of industry experts from governance, law, finance, development, and strategic planning. Invite your board members and plan to attend the entire series for maximum impact. Webinars will be held every Tuesday in June.
LeadingAge Ohio PAC Brew Tour: Thursdays in June
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
The LeadingAge Ohio PAC will host fundraising events at three of Ohio’s premier breweries for its first-ever Summer PAC Brew Tour! These fundraising receptions will take place on Thursdays in June with three options to choose from - Cleveland at Great Lakes Brewing Company (June 16), Cincinnati at Sonder Brewing (June 23), and Columbus at North High Brewing Company (June 30). Legislators will be invited to attend as guests. Enjoy some great beer, great food, and support the PAC while networking with your colleagues!
Organizations interested in sponsorship should contact Corey Markham at cmarkham@leadingageohio.org.
Cleveland - Great Lakes Brewing Company
Thursday, June 16, 2022
2516 Market Ave
Cleveland, OH 44113
5:00-7:00PM
Register online here
Cincinnati - Sonder Brewing
Thursday, June 23, 2022
8584 Duke Blvd
Mason, OH
5:00-7:00PM
Register online here
Columbus - North High Brewing Company
Thursday, June 30, 2022
56 N High St
Dublin, OH 43017
5:00-7:00PM
Register online here
Ohio ends HCIC program
The Ohio Department of Medicaid (ODM), in collaboration with the Ohio Department of Health (ODH), is providing the attached notice regarding the unwinding of certain emergency flexibilities implemented during the COVID-19 public health emergency, including the elimination of the healthcare isolation center (HCIC) program, which were specially designated nursing facilities that offered isolation and/or quarantine capability in the event of a surge in COVID-19 cases. The notice also includes the end date for these programs. Please direct any surge questions to ODH at bill.robbins@odh.ohio.gov and any program or billing questions to ODM at julie.davis@medicaid.ohio.gov.
ODM shares Patient Liability Fact Sheet
Last Wednesday, the Ohio Department of Medicaid (ODM) released the final version of the long-awaited Application of Share of Cost/Patient Liability for Nursing Facilities fact sheet, which highlights challenging areas for providers helping to manage patient liability. The purpose of this fact sheet is to provide nursing facilities with an overview of Share of Cost (SOC)/Patient Liability (PL), an explanation of and application of SOC/PL in various scenarios and answers to frequently asked questions.
The LeadingAge Ohio Billing & Eligibility Subcommittee had the opportunity to preview the document, which has been under development for several years. LeadingAge Ohio strongly encourages members to share this document with their billing staff. To learn more about committee service with LeadingAge Ohio, contact Susan Wallace at swallace@leadingageohio.org.
Key deadline approaches for Medicaid unwinding
The Public Health Emergency (PHE) has most recently been extended to mid-July 2022. The Biden Administration has previously promised states that it will give states a 60-day notice before the PHE expires. This means that if states are not notified by mid-May, the PHE will likely be extended further.
As this new Kaiser Family Foundation (KFF) analysis shows, millions of people could lose coverage, but most older adults will remain eligible. States will largely be responsible for managing the unwinding of the continuous enrollment requirement, and their efforts to conduct outreach, education and provide enrollment assistance can help ensure that older adults who remain eligible for Medicaid are able to retain coverage. When states resume redeterminations, it is likely that there could be a lot of enrollment churn as individuals who are eligible lose coverage and then re-enroll in a short period of time. This of course will impact providers, who will be assisting residents in managing any accumulated assets and re-applying for Medicaid.
LeadingAge Ohio’s Billing & Eligibility Subcommittee has been diligently tracking this issue, discussing strategies for streamlining work with county JFS offices once the PHE comes to an end. If you are interested in committee service, contact Susan Wallace at swallace@leadingageohio.org.
Check out the LeadingAge Ohio Education Calendar!
LeadingAge Ohio holds valuable education webinars and in-person events all throughout the year. To see the complete schedule of events, please click here!
What the Media Said about end of life care this week – May 17, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: May 10, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding Physician Assistants (PA) in hospice
- You asked... We answered regarding universal source control, relaxing of restrictions and testing
- LeadingAge home health and hospice recap
- CMS stakeholder call: Wednesday, May 11 at 11:00AM
- Medicare Quality Improvement Organization Appeals Overview for Healthcare Provider Webinar: May 25
- CMS updates home health medicare billing manual
- 2 new HHVBP resources focused on Quality Measures & Improvement
- MLN updates VBID Hospice Benefit Component billing information
- Home health U537F NOA error solved
- Palmetto question report
- Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
- ODM shares MITS “dark” days
- LeadingAge Ohio PAC Brew Tour: Thursdays in June
- What the Media Said about end of life care this week – May 10, 2022
You asked... We answered regarding Physician Assistants (PA) in hospice
You Asked:
I have three questions about physician assistants (PAs) working in hospice:
- Can a PA complete Face to Face (F2F) encounter visits to document assessment of eligibility?
- Can a PA work for a hospice?
- Can we bill for PA visits when the visit is made for symptom management (or must they also be the attending physician to bill for their visit)?
We Answered:
According to the Hospice Medicare Benefit Policy Manual Chapter 9, a Physician Assistant unfortunately cannot complete a F2F visit to determines a hospice patient’s eligibility. It is in federal statute that only a physician or nurse practitioner can perform F2F encounters at this time. A physician assistant can be employed by a hospice, but for a hospice to be able to bill for their services, the PA must be the hospice patient’s attending physician. Please see the citation below that refers to physician assistants as attending physicians for hospice.
Hospice Medicare Benefit Policy Manual Chapter 9 - Coverage of Hospice Services Under Hospital Insurance
40.1.3.3 – Physician Assistants as Attending Physicians (Rev. 246, Issued: 09-14-18, Effective: 12-17- 18, Implementation: 12-17-18)
Effective January 1, 2019, Medicare will pay for medically reasonable and necessary services provided by physician assistants (PAs) to Medicare beneficiaries who have elected the hospice benefit and who have selected a PA as their attending physician. PAs are paid 85 percent of the fee schedule amount for their services as designated attending physicians.
A physician assistant is defined as a professional who has graduated from an accredited physician assistant educational program who performs such services as he or she is legally authorized to perform (in the State in which the services are performed) in accordance with State law (or State regulatory mechanism provided by State law) and who meets the training, education, and experience requirements as the Secretary may prescribe. The physician assistant qualifications for eligibility for furnishing services under the Medicare program can be found in the regulations at 42 CFR 410.74 (c).
If a beneficiary does not have an attending physician, a nurse practitioner, or physician assistant who has provided primary care prior to or at the time of the terminal illness, the beneficiary may choose to be served by either a physician or a nurse practitioner who is employed by the hospice. The beneficiary must be provided with a choice of a physician or a nurse practitioner.
Medicare pays for attending physician services provided by physician assistants to Medicare beneficiaries who have elected the hospice benefit and who have selected a physician assistant as their attending physician. This applies to physician assistants without regard to whether they are hospice employees.
Effective January 1, 2019, Medicare will pay for medically reasonable and necessary services provided by PAs to Medicare beneficiaries who have elected the hospice benefit and who have selected a PA as their attending physician. PAs are paid 85 percent of the fee schedule amount for their services as designated attending physicians.
Attending physician services provided by PAs may be separately billed to Medicare only if:
- The PA is the beneficiary's designated attending physician; and
- Services are medically reasonable and necessary; and
- Services would normally be performed by a physician in the absence of the PA, whether or not the PA is directly employed by the hospice; and
- Services are not related to the certification of terminal illness.
If the physician assistant is employed by the hospice, the hospice can bill Part A for physician services meeting the above criteria on a hospice claim. If the physician assistant is not employed by the hospice, the physician assistant can bill Part B for physician services meeting the above criteria. PAs are authorized to furnish physician services under their State scope of practice, under the general supervision of a physician; therefore the regulations at 42 CFR 410.150(a)(15) require that payment for PA services may be made to the employer or contractor of a PA.
Payment for physician assistant services is made at 85 percent of the physician fee schedule amount. Services that are duplicative of what the hospice nurse would provide are not separately billable.
Since PAs are not physicians, as defined in 1861(r)(1) of the Act, they may not act as medical directors or physicians of the hospice or certify the beneficiary’s terminal illness and hospices may not contract with a PA for their attending physician services as described in section 1861(dd)(2)(B)(i)(III) of the Act, which outlines the requirements of the interdisciplinary group as including at least one physician, employed by or under contract with the agency or organization. All of these provisions apply to PAs without regard to whether they are hospice employees.
Physician assistants cannot certify or re-certify an individual as terminally ill, meaning that the individual has a medical prognosis that his or her life expectancy is 6 months or less if the illness runs its normal course. In the event that a beneficiary’s attending physician is a nurse practitioner or a physician assistant, the hospice medical director or the physician member of the hospice IDG certifies the individual as terminally ill.
The hospice face-to-face encounter must be performed by a hospice physician or hospice nurse practitioner. PAs may not perform the face-to-face encounter.
You asked... We answered regarding universal source control, relaxing of restrictions and testing
You Asked:
The Centers for Disease Control and Prevention (CDC) webpage has information on both the COVID-19 county level and community transmission level. Which one should I be following to determine universal source control, relaxing of restrictions, and testing?
We Answered:
The CDC recommends use of COVID-19 Community Levels to determine the impact of COVID-19 on communities and take action. Community Transmission levels are provided for healthcare facility use only. Healthcare facilities need to monitor the community transmission levels on the CDC COVID Data Tracker webpage. The webpage begins with the COVID-19 Integrated County View. Healthcare facilities need to scroll further down on the webpage then select Ohio in the drop down. The data-type drop down should be set to community transmission.
Healthcare settings should use the CDC’s Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic guidance for relaxing of restrictions of distancing and masking when the community transmission levels are moderate to low. When the community transmission level increases to substantial to high, healthcare facilities should implement universal source control of eye protection in addition to masking. Facility policies should define the frequency of how often they will monitor this webpage and adjust source control measures and operational practices accordingly. Nursing homes are to conduct routine staff testing according to the community transmission levels outlined in the CMS QSO-20-38-NH memo.
LeadingAge Ohio encourages members to explain to stakeholders the difference between the community guidance and the guidance for healthcare settings. A best practice is to have a routine update for staff to keep them abreast of the changing community transmission levels and reminders of how universal source control changes as the community level changes to high and substantial levels. We encourage members to continue to submit questions to COVID19@leadingageohio.org.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features Hospice CAHPS survey data submission deadline.
CMS stakeholder call: Wednesday, May 11 at 11:00AM
On April 7, the Centers for Medicare & Medicaid Services (CMS) released a national policy for coverage of aducanumab (brand name Aduhelm™) and any future monoclonal antibodies directed against amyloid approved by the FDA with an indication for use in treating Alzheimer’s disease. From the onset, CMS ran a transparent, evidence-based process that incorporated more than 10,000 stakeholder comments and more than 250 peer-reviewed documents into the determination.
As a part of CMS’ continued commitment to engage stakeholders on an ongoing basis, CMS will hold a national stakeholder call on May 11 at 11:00AM to review the recent finalized coverage decision on monoclonal antibodies directed against amyloid for the treatment of Alzheimer’s Disease. CMS will review the overall coverage process, the finalized decision, and address questions as time allows.
To RSVP for this call, please click here. After registering, you will receive a confirmation email containing information about joining the webinar.
Medicare Quality Improvement Organization Appeals Overview for Healthcare Provider Webinar: May 25
Medicare patients and their caregivers have the legal right to challenge a Hospice, home health or skilled nursing facility discharge notice or other notice that Medicare-covered services are being terminated. As a Medicare Beneficiary and Family Centered Care - Quality Improvement Organization (BFCC-QIO), Livanta receives thousands of appeals each year from patients or their caregivers when they are faced with a transition to a lower level of care that they believe is not appropriate or when they believe their medical condition is not stable enough to be discharged.
Presenters discuss appeal rights in detail and describe what patients, families and providers can expect when they call Livanta and begin the case review process.
Who will benefit from this webinar:
- Home Health and Hospice providers,
- SNF administrators,
- Directors
- Clinical Managers
- QAPI professionals
For additional information and/or to register, please click here.
CMS updates home health medicare billing manual
Last month, the Centers for Medicare & Medicaid Services (CMS) updated the home health billing manual to reflect changes to eliminate the Request for Anticipated Payment and add the Notice of Admissions process. In the original MLN article noting the changes and transition, concerns were raised regarding the Definition of Allowed Practitioner, particularly paraphrasing regulations for advance practice nurse collaboration with physicians. CMS released an updated MLN and edits to the home health billing manual to clarify the definition of allowed practitioners.
2 new HHVBP resources focused on Quality Measures & Improvement
To support home health agencies (HHAs) participating in the expanded Home Health Value Vased Purchasing (HHVBP) Model, the HHVBP TA Team produced two expanded Model resources focused on quality measures and quality improvement. The on-demand video, Quality Measures Used in the Expanded HHVBP Model, provides measure-specific information on each of the quality measures included in the expanded Model.
The accompanying written resource, How to use Existing Quality Assurance and Performance Improvement (QAPI) Processes to Support Improvement in Expanded Home Health Value-Based Purchasing (HHVBP) Model, provides a practical and visual guide to the quality improvement cycle as it relates to the expanded HHVBP Model and overall quality improvement efforts. This resource also highlights data and reports currently available to HHAs in iQIES and on the Care Compare website.
Both resources are designed to support HHAs as they prepare for the first performance year, calendar year 2023, of the expanded HHVBP Model. These resources, and others, are now available on the Expanded HHVBP Model webpage.
For questions, please email the HHVBP Model Help Desk at HHVBPquestions@lewin.com.
MLN updates VBID Hospice Benefit Component billing information
MLN released an article for hospices and others billing Medicare Administrative Contractors (MACs) for services they provide to Medicare hospice patients enrolled in Medicare Advantage (MA) plans participating in the voluntary Value-Based Insurance Design (VBID) Model’s Hospice Benefit Component. The article links to several updated manuals which clarify billing for the VBID hospice model in preparation for CY 2023. As a reminder, Medicare will deny payment for claims with dates of service during a hospice election (with a hospice election start date on or after January 1, 2021 through December 31, 2024) for services provided to a patient enrolled in an participating VBID Model’s Hospice Benefit Component MA plan. Regardless of plan participation dates, hospices must still submit claims for these services to Medicare through their MAC. If a beneficiary is not enrolled in a participating VBID Hospice MA plan, Medicare fee-for-service will become financially responsible for most services, with the MA plan supporting any supplemental benefits.
Home health U537F NOA error solved
LeadingAge has shared before that Medicare Administrative Contractors (MACs) have identified an issue where U537F is assigning incorrectly on some notices of admission (NOAs), due to the Common Working File (CWF) not correctly recognizing discharges (patient status other than 30 on the last HH period). The CWF maintainer has developed a fix for this issue. Effective April 25, providers can resubmit any home health NOAs (32A) that have returned to provider incorrectly and are advised to bill the KX modifier on the final HH period of care claim(s) affected by the late NOA. The claim(s) should also include Remarks to request an exception to the late-filing penalty. These remarks can be similar to ‘Late NOA due to System Problem 34567.’
Palmetto question report
The Hospice Coalition will be meeting via telecommunications with Palmetto representatives on June 9. Please route this request for questions to the individuals in your hospice agencies who deal with Palmetto routinely to see if they have any questions they would like us to raise during the meeting. Please submit questions by Friday, May 13.
You may submit questions any time they occur to you by emailing Jeff Lycan at jlycan@nhcooperative.org and they will be added to the list for the next quarterly meeting.
Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
LeadingAge Ohio and HJ Sims invite you to join this webinar series with your board members as HJ Sims provides a series of comprehensive virtual content geared directly toward the governance of senior living providers. The series will benefit all leaders within our field, especially board members, leadership teams and those new to these roles. Participants will walk away with a clear understanding of the role and responsibilities of boards, how to think through affiliations, acquisitions and other partnerships, and other challenges in this volatile, post-COVID era.
Each session will tap the intellectual capital of industry experts from governance, law, finance, development, and strategic planning. Invite your board members and plan to attend the entire series for maximum impact.
Webinars will be held every Tuesday in June and can be registered for individually by clicking on the date below, or select the full series option available in the June 7 date:
- June 7- Session 1 - Role of the Board
- June 14 - Session 2 - Legal Responsibilities of Boards
- June 21 - Session 3 - A Board's Role in Mergers and Acquisitions, Strategic Affiliations and Sponsorship Transitions
- June 28 - Session 4 - Governing During Challenging Times
Who Should Attend:
- Board Members
- Leadership
- Leadership Team Members
ODM shares MITS “dark” days
The Ohio Department of Medicaid (ODM) announced that its Medicaid Information Technology Sytem (MITS) will experience "dark days" beginning June 23 through July 1. All claims submitted by a billing/trading partner during this time period will be held and processed after July 1 and will be processed in the new OMES system. Facilities should be aware that if claims are billed during that time period, reimbursement will be delayed. Facilities that also use a trading partner to complete their billing will need to make sure the trading partner is ready for this transition.
At this point, ODM is uncertain whether a facility can manually enter a claim in the MITS system during the time window. ODM continues to work with its partners, but wanted to notify providers well in advance of the dates, so that they can plan for the delays. More information will be forthcoming from ODM as we near the transition window.
LeadingAge Ohio PAC Brew Tour: Thursdays in June
*Non-profit organizations should not forward this email as it deals with political action committee (PAC) business.
The LeadingAge Ohio PAC will host fundraising events at three of Ohio’s premier breweries for its first-ever Summer PAC Brew Tour! These fundraising receptions will take place on Thursdays in June with three options to choose from - Cleveland at Great Lakes Brewing Company (June 16), Cincinnati at Sonder Brewing (June 23), and Columbus at North High Brewing Company (June 30). Legislators will be invited to attend as guests. Enjoy some great beer, great food, and support the PAC while networking with your colleagues!
Organizations interested in sponsorship should contact Corey Markham at cmarkham@leadingageohio.org.
Cleveland - Great Lakes Brewing Company
Thursday, June 16, 2022
2516 Market Ave
Cleveland, OH 44113
5:00-7:00PM
Register online here
Cincinnati - Sonder Brewing
Thursday, June 23, 2022
8584 Duke Blvd
Mason, OH
5:00-7:00PM
Register online here
Columbus - North High Brewing Company
Thursday, June 30, 2022
56 N High St
Dublin, OH 43017
5:00-7:00PM
Register online here
What the Media Said about end of life care this week – May 10, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: May 3, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding Physician Assistants as hospice attending physicians
- LeadingAge home health and hospice recap
- Hospice Billing Workshop: May 10
- Medicaid shares timeline for “Next Generation” credentialing, fiscal intermediary
- DeWine signs bill allowing nursing home visits in future pandemics
- Ohio legislation proposes rebasing direct care
- Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
- Department of Labor announces listening sessions on revisions to overtime regs
- What the Media Said about end of life care this week – May 3, 2022
You asked... We answered regarding Physician Assistants as hospice attending physicians
You Asked:
Now that Physician Assistants (PAs) can be a hospice patient’s attending physician, can they also sign the Certification of Terminal Illness (CTI)?
We Answered:
No, PAs cannot sign the Certification of Terminal Illness even if they are the hospice patient’s attending physician. Neither can Nurse Practioners. The only health care personnel that can sign a CTI are a Doctor of Medicine or Osteopathy. Please see the citation below from the Hospice Medicare Benefit Manual Chapter 9.
20.1 - Timing and Content of Certification (Rev. 246, Issued: 09-14-18, Effective: 12-17- 18, Implementation: 12-17-18)
No one other than a medical doctor or doctor of osteopathy can certify or re-certify an individual as terminally ill, meaning that the individual has a medical prognosis that his or her life expectancy is 6 months or less if the illness runs its normal course. Nurse practitioners and physician assistants cannot certify or re-certify an individual as terminally ill. In the event that a beneficiary’s attending physician is a nurse practitioner or a physician assistant, the hospice medical director or the physician member of the hospice IDG certifies the individual as terminally ill.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features CMMI releasing fifth annual report on HHVBP.
Hospice Billing Workshop: May 10
Billing for hospice services has become more complex with the additional regulatory requirements. Join veteran hospice biller Shonda Wood-Paul, Director of Revenue Cycle with Hospice of the Western Reserve, and Anne Shelley, Director of Home Health and Hospice Regulatory Relations, with LeadingAge Ohio on May 10 from 10:00AM - 2:00PM, as they walk through all the necessary components of hospice billing. Shonda and Anne will also focus on current hospice billing issues and concerns.
Who Should Attend?
- Hospice Billers
- Financial Managers
- Administrators
- Managers
For additional information and/or to register, please click here. The Hospice Billing Workshop will take place at the LeadingAge Ohio offices in Columbus.
Medicaid shares timeline for “Next Generation” credentialing, fiscal intermediary
The Ohio Department of Medicaid (ODM) will begin to launch its Next Generation Medicaid program beginning July 1, 2022, with the implementation of OhioRISE, a coordinated care program for children with complex behavioral health needs. Other Medicaid programs will be implemented in the following months on a staggered basis to keep the focus on the individual and honor member choice to allow for a smooth transition.
This staggered start ensures continuity of care, limits confusion, and reduces complexities surrounding the anticipated end of the federal public health emergency (PHE) and provides the necessary time for provider testing and training.
The phased implementation will occur in three stages:
Stage 1: On July 1, OhioRISE will begin to provide coordination and specialized services to help children and youth with behavioral health needs who receive care across multiple systems. This builds on the work already underway including the selection and launch of a statewide network of community-based care management entities, the design and build of a centralized technology for the Child and Adolescent Needs and Strengths assessment tool, transition grant funding to Care Management Entities (CMEs) and MRSS providers (Mobile Response and Stabilization Services) to launch new OhioRISE services and support provider and workforce development; and the completion of extensive community and provider training sessions for more than 1,650 participants.
Stage 2: In October 2022, Centralized Provider Credentialing will begin through the Ohio Medicaid Enterprise System (OMES) Provider Network Management (PNM) module, which will reduce administrative burden on providers. Also, the Single Pharmacy Benefit Manager (SPBM) will begin providing pharmacy services across all managed care plans and members.
Stage 3: During the last three months of 2022, ODM will finish implementing the Next Generation program with all seven Next Generation managed care plans beginning to provide healthcare coverage under the new program. ODM will also complete the OMES implementation including the Fiscal Intermediary (FI) which will simplify and streamline the provider process for submitting claims and prior authorizations.
Ohio Medicaid is committed to launching the Next Generation Medicaid correctly. The phased timeline assures no disruption to members’ care or provider support. Eligible members will continue to receive the full complement of Medicaid benefits available today, and providers will continue serving the 3.34 million Ohioans covered by Medicaid, working with current MCOs using processes and procedures practiced today.
Additional details will be available soon to guide consumers, providers, and stakeholders. To keep up to date with the Next Generation of Ohio Medicaid, please click here. Questions can be sent to ODMNextGen@medicaid.ohio.gov.
DeWine signs bill allowing nursing home visits in future pandemics
Two weeks ago, Governor DeWine signed HB120 (Richardson) into law, which would place certain requirements for compassionate visitation nursing homes in the event of future public health emergencies. The bill is a response to early-pandemic challenges experienced by families and caregivers. LeadingAge Ohio worked with the bill’s sponsor to ensure it would not conflict with federal guidance and would not impede appropriate infection control measures. To read LeadingAge Ohio’s testimony on the bill, please click here.
Ohio legislation proposes rebasing direct care
Two weeks ago, Representatives Susan Manchester and Jim Hoops, as well as Senator Mark Romanchuk, introduced companion bills HB 625 and SB 325, respectively. The identical bills would seek to rebase the direct care portion of the Medicaid nursing facility formula, using 2021 costs. The rebasing would take effect for the July 1 ratesetting process and is intended to account for the rapid escalation in wages and agency usage that occurred during 2020 and 2021.
LeadingAge Ohio supported the development of the bill as one strategy to ameliorate the current workforce and wage pressures being felt by aging services providers.
Help Your Board Hit the Governance Bullseye, webinar series: Starts June 7
LeadingAge Ohio and HJ Sims invite you to join this webinar series with your board members as HJ Sims provides a series of comprehensive virtual content geared directly toward the governance of senior living providers. The series will benefit all leaders within our field, especially board members, leadership teams and those new to these roles. Participants will walk away with a clear understanding of the role and responsibilities of boards, how to think through affiliations, acquisitions and other partnerships, and other challenges in this volatile, post-COVID era.
Each session will tap the intellectual capital of industry experts from governance, law, finance, development, and strategic planning. Invite your board members and plan to attend the entire series for maximum impact. Webinars will be held every Tuesday in June.
Department of Labor announces listening sessions on revisions to overtime regs
The Department of Labor (DOL) announced a series of listening sessions with workers, employers and workplace stakeholders on potential revisions to regulations used to enforce the Fair Labor Standards Act’s (FLSA) minimum wage and overtime exemptions for executive, administrative and professional employees.
The FLSA requires employers to pay most U.S. employees at least the federal minimum wage for all hours worked, and overtime pay at not less than time and one-half the regular rate of pay for hours worked over 40 in a workweek.
The law, however, provides an exemption from minimum wage and overtime pay for workers employed as “bona fide” executive, administrative or professional employees. To be exempt, employees must generally meet certain tests regarding their job duties and be paid on a salary basis at not less than $684 per week.
In fiscal year 2021, the department’s Wage and Hour Division recovered more than $138 million in overtime back wages for more than 145,000 workers. In its FLSA investigations, the division found overtime back wages represented 80 percent of all back wages found due.
The division announced that it will hold a listening session for workers, employee stakeholders and union representatives on May 5 from 6:00-7:00PM. You can register by clicking here.
What the Media Said about end of life care this week – May 3, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: April 26, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding hospice CAHPS quality scores
- LeadingAge Ohio all-member call: Today at 11:30AM
- LeadingAge home health and hospice recap
- National stakeholder call with CMS administrator: Today at 3:30PM
- CMS Open Door Forum recap
- Preview reports and star rating preview reports for the July 2022 refresh now available in iQIES
- OTC COVID-19 at-home testing billing guidance
- Medicare Cost Report E-Filing system: Interim rate and settlement documentation webinar
- LeadingAge Ohio PAC events announced
- Ready to connect with your peers at the 2022 Annual Conference?
- Workforce Director begins full-time work this week
- What the Media Said about end of life care this week – April 26, 2022
You asked... We answered regarding hospice CAHPS quality scores
You Asked:
Our hospice manager reached out to our Strategic Healthcare Programs (SHP) rep who holds the caregiver satisfaction surveys for our hospice to see if there was anything we could do to help improve our Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores. The hospice team suggested leaving a note in the admit packet stating the possibility of a survey coming their way and the why’s behind it. The SHP representative’s reply to this proposed strategy was, “You cannot discuss any of the questions on the survey or encourage them to fill out the survey in any capacity”. Can you provide guidance on navigating this if we want to improve our quality scores?
We Answered:
There are guidelines regarding hospice CAHPS surveys detailing what hospices can and cannot communicate with their patients and those guidelines can be found in the CAHPS Hospice Survey Quality Assurance Guidelines. Letting families know they may be receiving a survey is allowed. Please see an excerpt from the guidelines below.
Communicating with Patients and/or Their Caregivers about the CAHPS Hospice Survey CAHPS Hospice Survey guidelines allow hospices to communicate about the CAHPS Hospice Survey with patients and/or their caregivers prior to administration of the survey. For example, hospices may inform caregivers during the hospice admission process that they may receive the CAHPS Hospice Survey. If a hospice wants to let caregivers know that they may receive a survey and encourage them to complete it, the hospice must inform all caregivers.
Certain types of communications are not permitted because they may introduce bias in the survey results. For instance, hospices/survey vendors are not allowed to:
- Ask any CAHPS Hospice Survey or CAHPS Hospice Survey-like questions of caregivers prior to administration of the survey
- Attempt to influence or encourage caregivers to answer CAHPS Hospice Survey questions in a particular way
- Imply that the hospice, its personnel, or agents will be rewarded or gain benefits for positive feedback from caregivers by asking caregivers to choose certain responses, or indicate that the hospice is hoping for a given response, such as a “10,” “Definitely yes” or an “Always”
- Indicate that the hospice’s goal is for all caregivers to rate them as a “10,” “Definitely yes,” or an “Always”
- Offer incentives of any kind for participation in the survey
- Invite or ask the caregiver if they want to participate in a survey or suggest they can “opt out” of the survey
- Show or provide the CAHPS Hospice Survey or cover letters to caregivers while they are in the hospice or at any time prior to the administration of the survey
- Mail or distribute any pre-notification letters or postcards after patient death to inform caregivers about the CAHPS Hospice Survey Note:
- Hospices may not contact caregivers directly regarding survey responses.
LeadingAge Ohio all-member call: Today at 11:30AM
Join LeadingAge Ohio staff, along with Dana Ullom-Vucelich and Kristen Collins from Ohio Living, today at 11:30AM for the next all-member call, which will feature a robust discussion of retention strategies. Workforce continues to be the top concern among LeadingAge Ohio members, and has fostered other challenges like lagging census and survey citations across provider types. The Centers for Medicare & Medicaid Services (CMS) have signaled their concern, with turnover measures being added to the Care Compare measures beginning in July.
Dana and Kristen will discuss how Ohio Living has maintained a low turnover rate percentage across their organization, whether on their campuses or in home health and hospice operations, offering strategies that other members may employ in their own practices.
The call is free to members but registration in advance is required. To have your question answered on the call, email it to COVID19@leadingageohio.org.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features information on the upcoming CMS HCBS webinar.
National stakeholder call with CMS administrator: Today at 3:30PM
Please join the Administrator of the Centers for Medicare & Medicaid Services (CMS), Chiquita Brooks-LaSure, and her leadership team, who will provide updates on the CMS Strategic Vision and key accomplishments during the first quarter of 2022 today at 3:30PM. The Administrator’s vision is for CMS to serve the public as a trusted partner and steward dedicated to advancing health equity, expanding coverage, and improving health outcomes as we engage the communities we serve throughout the policymaking and implementation process. Members are invite to join for this third national stakeholder call to learn more!
Speakers:
- CMS Administrator, Chiquita Brooks-LaSure
- Principal Deputy Administrator and Chief Operating Officer, Jon Blum
- CMS Leadership Team
To RSVP for today's call, please click here.
After registering, you will receive a confirmation email containing information about joining the call. Please note that when you click the link to join the call later today, you will see a message stating that the host will allow you to join the event momentarily. Please continue to wait at that screen until the CMS team begins the call.
CMS Open Door Forum recap
On the April 20 Centers for Medicare & Medicaid Services (CMS) Home Health, Hospice, and DME (Durable Medicare Equipment) Open Door Forum (ODF), the following information and updates were provided:
HOSPICE
FY2023 Hospice Proposed Rule
CMS provided a brief update of the proposed payment rate update (2.7%), wage index changes, and other aspects of the recently released FY2023 hospice proposed rule.
Hospice Quality Reporting Program
CMS reminded hospices that the FY2024 annual payment update is based on the CY2022 data submissions. Hospices must comply with the following HIS and Hospice CAHPS Survey participation requirements to avoid the APU penalty which increases to 4% in FY2024.
- Submit at least 90% of HIS records within the 30 days of the event date (patient’s admission or discharge) for patient admissions/discharges occurring 1/1/22 – 12/31/22
- Ongoing monthly participation in the CAHPS Hospice Survey 1/1/22 – 12/31/22
- Hospice Care Index (HCI), and
- Hospice Visits in Last Days of Life (HVLDL)
Public reporting of the new claims-based measures will occur with the May 2022 refresh of Care Compare. The Provider Preview Reports for this refresh were made available to hospices in their CASPER folders in March. Hospices should note that the Preview Reports drop off their CASPER folder after 60 days; therefore, hospices are encouraged to download and save or print these reports for future reference. CAHPS Hospice Survey Star Rating will be reported in August 2022. It will NOT be reported with the May Care Compare refresh.
HOME HEALTH
OASIS Updates
The quarterly OASIS Q&As are now available here.
The draft OASIS-E guidance manual and OASIS-E data specifications are expected to be posted early summer.
Public Reporting
Preview Reports and Star Rating Preview Reports for the July 2022 Care Compare refresh are available in iQIES. Instructions for accessing the reports can be found under the March 25, 2022 update here, and any questions about access should be directed to the iQIES Help Desk by phone at (800) 339-9313 or by email at iQIES@cms.hhs.gov.
CMS also reminded home health agencies that it had previously identified an issue in the iQIES system that may have affected HHA’s Services Provided values that are displayed on the HHA Provider Preview reports that were distributed in iQIES on 02/23/2022. CMS asked HHAs to review the Services Provided Information on the HHA Provider Preview Reports for the April 2022 refresh and contact their OASIS Education Coordinator (OEC) or OASIS Automation Coordinator, should inaccuracies be identified. The process to collect and maintain the Services Provided information recently migrated into iQIES and CMS is addressing the issues identified. To allow time to complete the identified changes, CMS decided for the April 2022 refresh, to publish the same Services Provided data for each Home Health Agency that was posted on Care Compare for the January 2022 refresh. CMS is still urging HHA providers to carefully review the Services Provided data within the Preview Reports release on 2/23/2022. If the values are incorrect for your agency, please contact your State Automation or State OEC and request an update of your Services Provided data in iQIES. Should you have questions, please contact the iQIES Help Desk by phone at (800) 339-9313 or by email at iQIES@cms.hhs.gov. CMS continues to work to refine and rectify the update process moving forward.
Home Health CAHPS
CMS shared that the recording of the CAHPS Update Training conducted at the end of January 2022 is available. The agenda for the training and the slides are available for download here, and the full recording of the training can be obtained by sending an email requesting it to hhcahps@rti.org.
The CY2024 annual payment update (APU) period began on April 1, 2022. Home health agencies are required to provide data for April 2022 through March 2023 to meet compliance requirements and avoid the APU penalty. Those providers that believe they are exempt from CAHPS because they are a small agency, specifically having had 59 or fewer patients from the period of April 2021 through March 2022, need to complete the Participation Exemption Request Form for the annual payment update for calendar year 2024.
The HHCAHPS Coordination Team Quarterly Review newsletter is now available.
Home Health Value Based Purchasing Expansion Update
The April 2022 Expanded Home Health Value Based Purchasing Model newsletter is now available. Education materials will be located on the expanded model webpage and some items will be located in iQIES. Benchmark and achievement thresholds are expected to be posted in iQIES in mid-May. Providers should expect a Guide to be posted and updated materials for two composite measures and podcasts and videos related to home health in general to be posted. A sample interim performance report and final report will be available in iQIES with a webinar to be held in August to discuss the reports. CMS encouraged providers to sign up for newsletters via the Model’s webpage to know when these materials are available. Questions can be submitted to the Help Desk at HHVBPquestions@lewin.com.
Preview reports and star rating preview reports for the July 2022 refresh now available in iQIES
For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will be based on the standard number of quarters. This refresh resumes the reporting of all claims-based measures for the Home Health Quality Reporting Program (QRP). Due to the COVID-19 reporting exceptions, the claims-based measures have been calculated excluding Q1 and Q2 2020 data from measure calculations. For additional information, please see the Home Health QRP COVID-19 Public Reporting Tip Sheet in the downloads section of the Home Health Quality Reporting Training webpage and the Home Health Data Submission Deadlines webpage.
For additional information, please see the HH QRP COVID-19 Public Reporting Tip Sheet in the downloads section of the HH Quality Reporting Training webpage and the Home Health Data Submission Deadlines webpage.
OTC COVID-19 at-home testing billing guidance
Effective January 15, 2022, CareSource, in alignment with Centers for Medicare & Medicaid Services (CMS) guidance, began covering FDA-authorized over-the-counter (OTC) at-home COVID-19 diagnostic tests without a prescription and with no member cost sharing. As a measure to eliminate barriers to COVID-19 testing, the FDA-authorized OTC at-home COVID19 diagnostic tests are now covered without a prescription and no member cost share, with a limit of 8 individual tests per 30 days, in accordance with federal guidance.
Medicare Cost Report E-Filing system: Interim rate and settlement documentation webinar
If you’re a Medicare Part A provider or organization that files cost reports, you can attend this CMS webinar today at 1:00PM to learn about new functionality in the Medicare Cost Report E-Filing (MCReF) system:
- View and download interim rate review, tentative settlement, and final or reopening settlement documentation completed by your Medicare Administrative Contractor
- Submit individual or bulk (chain providers) Medicare Part A cost reports for fiscal years ending on or after December 31, 2017
- Track the status of Medicare Part A cost reports with fiscal years ending after December 31, 2009
Send questions in advance to OFMDPAOQuestions@cms.hhs.gov with “MCReF Webinar” in the subject line. We’ll answer your questions during the webinar or use them to develop educational materials.
More Information is available in this MLN article or you can visit the MCRef webpage by clicking here.
LeadingAge Ohio PAC events announced
The LeadingAge Ohio PAC once again broke its previous year’s fundraising record in 2021 by raising over $32,000 thanks to the generous support of our committed members. This year, the PAC will once again focus on reaching new heights and building momentum with exciting events throughout the year, including its first ever Brew Tour and the return of the Golf Outing. To learn more about the PAC, visit the PAC webpage here. All proceeds for the events below support the LeadingAge Ohio PAC, so make sure to pay via personal, partnership, or LLC funds (no corporate payments).
2022 Summer Brew Tour:
The LeadingAge Ohio PAC will host events at three of Ohio’s premier breweries for its first-ever Summer PAC Brew Tour! These fundraising receptions will take place on Thursdays in June with three options to choose from across the state. Legislators will be invited to attend as guests.
Cleveland - Great Lakes Brewing Company
Thursday, June 16, 2022
2516 Market Ave
Cleveland, OH 44113
5:00-7:00PM
Register online here
Cincinnati - Sonder Brewing
Thursday, June 23, 2022
8584 Duke Blvd
Mason, OH
5:00-7:00PM
Register online here
Columbus - North High Brewing Company
Thursday, June 30, 2022
56 N High St
Dublin, OH 43017
5:00-7:00PM
Register online here
2022 PAC Golf Outing
The LeadingAge Ohio PAC Golf Outing will also return in 2022. Join LeadingAge Ohio members, partners, and guests at the Golf Club of Dublin on Monday, October 3 to enjoy a day of golf at a beautiful club, support the PAC, and win some prizes! The outing will be a scramble with a shotgun start at 10:00AM. Sponsorships are available. Learn more and register online here.
Ready to connect with your peers at the 2022 Annual Conference?
Join LeadingAge Ohio August 30-September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show! We are excited to announce this year’s theme: Momentum! Momentum is what propels our field forward. When harnessed, it can spread quickly. Our world has changed. Our field has changed. Now we need to build on what we have accomplished to prepare for what lies ahead.
Hotel registration for this year's conference is now open through the LeadingAge Ohio 2022 Annual Conference and Trade Show website.
Interested in sponsoring this event and supporting Ohio’s voice for aging services, LeadingAge Ohio? Please contact Corey Markham at 614-545-9015 or cmarkham@leadingageohio.org for information on becoming a Sponsor!
Workforce Director begins full-time work this week
As you may have seen in The Source a few weeks ago, LeadingAge Ohio welcomed Randi Hamill as Workforce Director. Randi began full-time work for LeadingAge Ohio yesterday. She comes to LeadingAge Ohio having worked several years in adult protective services in North Carolina, where she supported clients across the continuum including in facility settings. Here in Ohio she’s worked with the Age Friendly Innovation Center at the Ohio State University while earning her Master’s in Social Work, supporting the development and evaluation of their Age Friendly Scholars program. At LeadingAge Ohio, Randi will focus on developing and implementing programs that help LeadingAge Ohio members address the breadth of their workforce needs. You can welcome Randi or reach out to discuss the workforce issues most pressing to your organization by emailing her at rhamill@leadingageohio.org.
What the Media Said about end of life care this week – April 26, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: April 19, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding timely filing of a NOE
- LeadingAge home health and hospice recap
- In-person Advanced Principles of Hospice Management program: Thursday, April 28
- CMS limits MA plan cost sharing for Home Health Services
- Next Home Health, Hospice & DME Open Door Forum taking place tomorrow
- HHS issues clarity on the application of the No Surprise Billing requirements
- Hospice Visits in the Last Days of Life
- Ready to connect with your peers at the 2022 Annual Conference?
- LeadingAge Ohio Advocacy in Action call covers hot legislative topics and a grassroots advocacy Q&A
- LeadingAge Ohio Awards nomination extended deadline is today
- What the Media Said about end of life care this week – April 19, 2022
You asked... We answered regarding timely filing of a NOE
You Asked:
We understand the billing process for the submission of a late hospice Notice of Election (NOE), but wanted to see if there was anything from the certification process or clinical documentation that should also occur. For instance, does the medical director and attending need to sign a new hospice certification or do new consents need to be signed?
We Answered:
If the NOE is filed late, you are still responsible for the hospice patient’s care and cannot bill for the days leading up to the NOE being accepted. All signed consents, statement of election and certifications are all good, (you don’t have to change anything), your biller just needs to bill the 77 code for the days the NOE was not filed timely and accepted.
Please see the citation from the Hospice Claims Processing Manual Chapter 11 below:
20.1.1 - Notice of Election (NOE) (Rev. 4152, Issued: 10-26-2018, Effective: 01-01-18, Implementation: 04-01-19) When a Medicare beneficiary elects hospice services, hospices must complete the data elements identified below for the Uniform (Institutional Provider) Bill (Form CMS-1450) or its electronic equivalent, which is a Notice of Election (NOE).
Timely-filed hospice NOEs shall be filed within 5 calendar days after the hospice admission date. A timely-filed NOE is a NOE that is submitted to the A/B MAC (HHH) and accepted by the A/B MAC (HHH) within 5 calendar days after the hospice admission date. While a timely-filed NOE is one that is submitted to and accepted by the Medicare contractor A/B MAC (HHH) within 5 calendar days after the hospice election, posting to the CWF may not occur within that same time frame. The date of posting to the CWF is not a reflection of whether the NOE is considered timely-filed. In instances where a NOE is not timely-filed, Medicare shall not cover and pay for the days of hospice care from the hospice admission date to the date the NOE is submitted to, and accepted by, the A/B MAC (HHH). These days shall be a provider liability, and the provider shall not bill the beneficiary for them. The hospice shall report these non-covered days on the claim with an occurrence span code 77, and charges for all claim lines reporting these days shall be reported as non-covered, or the claim will be returned to the provider.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features information on PHE extension and an MACPAC update.
In-person Advanced Principles of Hospice Management program: Thursday, April 28
Join LeadingAge Ohio Director of Home Health/Hospice Regulatory Relations Anne Shelley for a program that will provide an overview of hospice management principles for new hospice clinical and administrative managers or hospice managers who want to get an update on the latest technical and regulatory topics. Topics covered will include best practices in sustaining a successful program that meets the end-of-life needs of patients, families and the wider community. Day-to-day management issues and practical resolutions will also be addressed.
For more information and/or to register, please click here.
CMS limits MA plan cost sharing for Home Health Services
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule with comment period that finalizes two remaining proposals from the proposed rule titled “Medicare and Medicaid Programs; Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly”.
One provision that CMS finalized in this rule is a policy change related to service category cost sharing limits for Medicare Parts A and B services. Under this provision, CMS has adopted a requirement that Medicare Advantage (MA) plans must use cost sharing that does not exceed cost sharing in original Medicare for home health services for plans with a mandatory maximum out of pocket (MOOP) amount. The highest allowable MA plan cost sharing limit for home health is 20 percent or an actuarially equivalent copayment which is limited to MA plans with a lower MOOP amount. MA plans that establish a mandatory or intermediate MOOP amount must establish $0 cost sharing for home health services. The provision is effective January 1, 2023.
CMS believes imposing limits on cost sharing for covered services is an important way to ensure that the cost sharing aspect of an MA plan design does not discriminate against or discourage enrollment of beneficiaries who have high health care needs and who need specific services.
Home health agencies have had patients refuse needed home health services due to high co-pays that the beneficiary would not have been subject to under Fee-For-Service Medicare.
Next Home Health, Hospice & DME Open Door Forum taking place tomorrow
The next Home Health, Hospice & DME Open Door Forum is scheduled for tomorrow from 2:00-3:00PM.
The agenda will include:
- Announcements & Updates
- Rulemaking: Updates on the FY 2023 Hospice Proposed Rule
- New Resources available for the HQRP
- Public Reporting: (May 2022 refresh updates)
- OASIS
- Public Reporting (updates on the Interim QAO Performance Reports and the April and July refresh)
- http://homehealthcahps.org and email for questions about HHCAHPS to hhcahps@rti.org
- FY 2023 Hospice Proposed Rule
- Hospice
- Home Health
- Home Health Services information on Care Compare
- Home Health CAHPS Survey Update
- Open Q&A
The call will be offered via conference call only. To participate by phone, dial 1-888-455-1397 and use passcode 5109694.
HHS issues clarity on the application of the No Surprise Billing requirements
On April 6, the Department of Health and Human Services (HHS) issued an FAQs document providing some clarity on which health care providers are subject to the “No Surprise Billing” requirements. Since most discussions and regulatory actions have been around the balance billing provisions of the No Surprise Billing Act, there has been a great deal of confusion for providers that are not inpatient hospitals, emergency rooms, or air ambulances.
In the FAQs, HHS does not specifically state which providers must comply with the varying provisions of the Act, the application of the requirements seems to be defined by provider actions.
Per the FAQs:
- What types of providers do the No Surprises requirements apply to? When assessing whether a No Surprises requirement applies to a particular provider, it is important to look at how the provider practices, rather than the provider’s specialty type, license, or certification. The rules apply broadly to any physician or other health care provider who is acting within the scope of practice of that provider’s license or certification under applicable state law. However, some providers may not practice in a setting or manner that triggers certain requirements. For example, a provider who never furnishes services in connection with a visit to a health care facility or emergency facility wouldn’t furnish items or services that fall within the balance billing protections. However, that same provider would, for example, need to provide a good faith estimate of expected charges to uninsured or self-pay individuals, when applicable, and comply with the continuity of care and provider directory requirements.
Therefore, based on the new FAQs, it is recommended that home health and hospice agencies comply with three provisions of the No Surprise Billing Act:
- The Good Faith Estimate provision for uninsured or self- pay patients
- Continuity of care provision
- Provider Directory provision
HHS has yet to issue conforming regulations for the continuity of care and the provider directory provisions but has issued regulations to implement the good faith estimate provision.
The good faith estimate provision requires that health care providers and facilities give uninsured (or self-pay) individuals an estimate for the cost of their health care before the individual agrees to get the item or service. If the uninsured (or self-pay) individual is billed for an amount at least $400 above the estimate, the individual may be eligible to start a Patient-Provider Dispute Resolution (PPDR) process by submitting a request to HHS and paying a small administrative fee. The PPDR process is handled by a third-party company certified by the HHS. This company will decide if the estimated amount, or billed amount.
There are specific time frames, formats, and contents for the good faith estimate, as well as requirements around providing cost estimates for items and services of other providers that provide items and services in conjunction with the primary provider.
HHS has a dedicated webpage to the No Surprise Billing requirements that included several resources for healthcare providers, health plans, and the general public.
For a more detailed explanation on the good faith estimate requirements, along with a form template click here.
Under the continuity of care provision, the health plan must notify each individual enrolled who is a continuing care patient of the termination of the provider and their right to elect continued transitional care from the provider or facility. The transitional care period permits the continuing care patient to elect to continue to have the same benefits provided, under the same terms and conditions as would have applied under the plan or coverage had the termination not occurred, with respect to the course of treatment.
If the patient elects to continue with the healthcare provider, the provider must accept payment from the plan or issuer and cost sharing from the individual) for items and services as payment in full, and continue to adhere to all policies, procedures, and quality standards imposed by the plan or issuer for an individual as if the termination hadn’t occurred. The transition period is the earlier of 90 days or when the patients is no longer in need of continued care.
The provider directory provisions require that healthcare providers provide the names, addresses, specialty, telephone numbers, and digital contact information of individual health care providers to the health plan or issuer when:
- The provider or health care facility begins a network agreement with a plan or issuer
- The provider or health care facility terminates a network agreement with a plan or issuer
- There are material changes to the content of provider directory information of the provider or health care facility;
- At any other time (including upon the request of plan or issuer) determined appropriate by the provider, health care facility, or the Secretary of Health and Human Services (HHS).
Since HHS has not initiated rulemaking for the implementation of the continuity of care and provider directory requirements, providers are expected to work with health plans or issuers to make good faith efforts for compliance.
Hospice Visits in the Last Days of Life
In February 2022, the National Quality Forum (NQF) endorsed the claims-based measure, Hospice Visits in the Last Days of Life (HVLDL) as NQF #3645. NQF is a not-for-profit, nonpartisan, membership-based organization that facilitates an evidence- and consensus-based approach to endorsing quality measures. HVLDL reflects the proportion of hospice patients who received in-person visits from a registered nurse or a medical social worker on at least 2 of the final 3 days of life. HVLDL is the re-specified measure replacing the HIS-based Hospice Visits When Death is Imminent (HVWDII). Public reporting for HVLDL will begin in May 2022 and will replace public reporting of HVWDII.
More information, including a link to the NQF website, can be found on the HQRP Quality Measure Development webpage.
Ready to connect with your peers at the 2022 Annual Conference?
Join LeadingAge Ohio August 30-September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show! We are excited to announce this year’s theme: Momentum! Momentum is what propels our field forward. When harnessed, it can spread quickly. Our world has changed. Our field has changed. Now we need to build on what we have accomplished to prepare for what lies ahead.
Hotel registration for this year's conference is now open through the LeadingAge Ohio 2022 Annual Conference and Trade Show website.
Interested in sponsoring this event and supporting Ohio’s voice for aging services, LeadingAge Ohio? Please contact Corey Markham at 614-545-9015 or cmarkham@leadingageohio.org for information on becoming a Sponsor!
LeadingAge Ohio Advocacy in Action call covers hot legislative topics and a grassroots advocacy Q&A
Advocacy in Action calls are held on the second Monday of each month at 10:00AM and are dedicated to keeping members “in the know” on advocacy and statehouse issues.
This month’s Advocacy in Action call provided a legislative update from the LeadingAge Ohio policy team on House Bill 138 (DNR Fix), House Bill 169 (Provider Relief), House Bill 120 (Pandemic Visitation), House Bill 466 (Staffing Agencies), and more. The call also featured a Q&A with Julie Abiecunas, CEO at JRC Adult Day in Canton, who recapped her recent visit with House Finance Chairman Scott Oelslager and discussed grassroots advocacy strategy.
The Zoom recording for this month’s Advocacy in Action call can be viewed by members here.
LeadingAge Ohio Awards nomination extended deadline is today
Did you miss the awards nomination deadline? Are you still interested in nominating a colleague for one of the 2022 award categories and honoring them at the LeadingAge Ohio Annual Conference & Trade Show this summer?
Fear not - the deadline was extended until TODAY!
The LeadingAge Ohio Awards Program celebrates exemplary work of the individuals and organizations within our membership on an annual basis. COVID’s relentless impact makes honoring innovations by staff and volunteers more important than ever. Check out the 2021 award tributes here.
Nominations for this year’s awards are open and include nine different categories. With many opportunities to recognize staff and volunteers, please spread the word about the Awards Program to get the nomination process started. The application period will now close on Wednesday, April 20.
Visit the Annual Awards webpage on the LeadingAge Ohio website under the About header within the Recognition & Awards section to access the award descriptions/nomination forms by category.
Questions regarding the annual Awards Program can be directed to Patrick Schwartz, Director of Strategic Communications, pschwartz@leadingageohio.org.
What the Media Said about end of life care this week – April 19, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: April 12, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding masking of staff in non-patient care areas
- LeadingAge home health and hospice recap
- LeadingAge Ohio Awards nomination deadline extended until Wednesday, April 20
- DNR “Fix” bill signed by the Governor
- ARPA HCBS Provider Relief Payments
- Next Home Health, Hospice & DME Open Door Forum: April 20
- Home health quality update
- Eligible patients can receive free second COVID booster
- Hospice PEPPER available for download
- Ready to connect with your peers at the 2022 Annual Conference?
- Wait, what? Email spoofing and how to protect yourself
- What the Media Said about end of life care this week – April 12, 2022
You asked... We answered regarding masking of staff in non-patient care areas
You Asked:
All our home health and hospice staff are either fully vaccinated or have an exemption. It was our understanding that if the staff were fully vaccinated, they were allowed to not mask in non-patient care areas of our office. It seems that the CDC has come out with some new terminology and guidance related to "up to date" vaccine status, which means not only being fully vaccinated, but also having one booster. The latest CDC guidance for health care professionals who are up to date with all recommended COVID-19 vaccine doses is, they can choose not to wear source control or physically distance when they are in well-defined areas that are restricted from patient access (e.g., staff meeting rooms, kitchens, etc.) What about staff who are fully vaccinated but don’t have any boosters?
We Answered:
LeadingAge Ohio reached out to the Ohio Department of Health (ODH) to ask when home health and hospice agencies are surveyed, what is the surveyor looking for related to source control/masking for fully vaccinated individuals in non-patient care areas of their office. ODH’s response was:
On survey, we are not looking at related masking of staff in non-patient care areas, we are only looking at source control/masking in patient care areas.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features information on Wednesday's LeadingAge Coronavirus call and inpatient hospice 1134 waivers ending.
LeadingAge Ohio Awards nomination deadline extended until Wednesday, April 20
Did you miss the awards nomination deadline? Are you still interested in nominating a colleague for one of the 2022 award categories and honoring them at the LeadingAge Ohio Annual Conference & Trade Show this summer?
Fear not - the deadline has been extended until Wednesday, April 20.
The LeadingAge Ohio Awards Program celebrates exemplary work of the individuals and organizations within our membership on an annual basis. COVID’s relentless impact makes honoring innovations by staff and volunteers more important than ever. Check out the 2021 award tributes here.
Nominations for this year’s awards are open and include nine different categories. With many opportunities to recognize staff and volunteers, please spread the word about the Awards Program to get the nomination process started. The application period will now close on Wednesday, April 20.
Visit the Annual Awards webpage on the LeadingAge Ohio website under the About header within the Recognition & Awards section to access the award descriptions/nomination forms by category.
Questions regarding the annual Awards Program can be directed to Patrick Schwartz, Director of Strategic Communications, pschwartz@leadingageohio.org.
DNR “Fix” bill signed by the Governor
Last Wednesday afternoon, Governor DeWine signed HB 138 into law. HB 138 included numerous changes to the laws governing emergency medical technicians (EMTs), including a long-awaited “fix” which would allow EMTs to follow Do Not Resuscitate (DNR) orders signed by nurse practitioners and physician assistants. The legislation will be effective 90 days following signing, or July 5. At this point, LeadingAge Ohio does not anticipate additional rule revisions will be required to further codify the change.
Questions regarding the change may be sent to Anne Shelley at ashelley@leadingageohio.org or Susan Wallace at swallace@leadingageohio.org.
ARPA HCBS Provider Relief Payments
The Ohio Department of Medicaid (ODM) announced that it has received approval from the Centers for Medicare and Medicaid Services (CMS) for the managed care portion of provider relief payments as appropriated by the Ohio General Assembly in H.B. 169. This latest approval impacts the following categories:
- MyCare
- Hospice
- Home Health
- Community behavioral health
- Non-institutional durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)
This portion of payments does not require an Executive Order or an emergency rule.
For reference: The distribution methodology for these payments is as follows:
- MyCare: Payment is equal to approximately 10% of paid claims, using claim period from November 1, 2020, through October 31, 2021, as the basis, and distributed to providers as a lump sum.
- Hospice: Payment is equal to approximately 10% of paid claims, using claim period from July 1, 2020, through June 30, 2021, as the basis, and distributed to providers as a lump sum.
- Home Health: Payment is equal to approximately 10% of paid claims, using claim period from July 1, 2020, through June 30, 2021, as the basis, and distributed to providers as a lump sum.
- Community Behavioral Health: Payment is equal to approximately 10% of paid claims, using claim period from July 1, 2020, through June 30, 2021, as the basis, and distributed to providers as a lump sum.
- Non-institutional DMEPOS: Payment is equal to approximately 10% of paid claims, using claim period from July 1, 2020, through June 30, 2021, as the basis, and distributed to providers as a lump sum.
Unlike previous payments, the Medicaid managed care plans will process these payments directly to providers. ODM is working with them to distribute these funds as quickly as possible.
Please Note: Providers will almost certainly receive multiple checks from multiple plans.
ODM also introduced a dashboard tool that allows providers to enter their Medicaid billing ID and view ALL payments that will be dispersed to them from FFS, Managed Care, and MyCare per H.B. 169. The dashboard details all categories of provider relief from H.B. 169 (ARPA HCBS and non-ARPA/GRF funds) EXCEPT for Assisted living (RCFs), PACE, and DODD waiver providers. Providers can access the tableau through the ARPA HCBS page of our website by clicking the LAUNCH button located in this link.
VERY IMPORTANT - PLEASE NOTE:
- The managed care preprint relief payment is calculated as 10% of claims, however the amount providers will receive with this first payment is 50% of the total.
- This was required by CMS in order to avoid a situation where a provider may be “overpaid”.
- At the end of calendar year (CY) 2022, ODM will reconcile a provider’s total claims to actual CY22 claims experience and a final relief payment will be calculated.
- There is no action required on the part of the provider during this reconciliation process.
- ODM will work with the plans at the end of the year on this final installment of relief.
- ODM will send out an announcement when the final installments are prepared, and post the final amount of payment to the dashboard.
ODM recognizes the complexity of the provider relief payment disbursement, and acknowledges that it has been a confusing process for providers. Community provider relief payments are contained in Ohio’s American Rescue Plan Act Home- and Community-Based Services (ARPA HCBS) plan, which can be found here.
For questions about any of these provider payments, please email ProviderReliefInquiries@medicaid.ohio.gov.
Next Home Health, Hospice & DME Open Door Forum: April 20
The next Home Health, Hospice & DME Open Door Forum is scheduled for April 20 from 2:00-3:00PM.
The agenda will include:
- Announcements & Updates
- Rulemaking: Updates on the FY 2023 Hospice Proposed Rule
- New Resources available for the HQRP
- Public Reporting: (May 2022 refresh updates)
- OASIS
- Public Reporting (updates on the Interim QAO Performance Reports and the April and July refresh)
- http://homehealthcahps.org and email for questions about HHCAHPS to hhcahps@rti.org
- FY 2023 Hospice Proposed Rule
- Hospice
- Home Health
- Home Health Services information on Care Compare
- Home Health CAHPS Survey Update
- Open Q&A
The call will be offered via conference call only. To participate by phone, dial 1-888-455-1397 and use passcode 5109694.
Home health quality update
Many health agencies have experienced problems in the iQIES system that affected how Services Provided values for their agencies were displayed on the HHA Provider Preview reports distributed in February and on Care Compare. The Center for Medicare & Medicaid Services (CMS) recently released a notice about the systems transition that may affect home health agency demographic data. Specifically, CMS indicated that while it is transitioning to the Provider Enrollment, Chain and Ownership System (PECOS) system as the source for agency demographic data, a final date when all demographic data will be obtained from PECOS has not been identified.
During this transition, all home health agencies are responsible to ensure their latest demographic data are updated and available in both iQIES and PECOS systems. A referencing document that outlines the steps home health agencies should follow can be accessed in the Downloads section of the How to Update Home Health Demographic Data page. Should you have questions regarding this updated process, please contact the iQIES help desk by email at iQIES@cms.hhs.gov or by phone at (800) 339-9313.
CMS also recently posted an announcement that the Preview Reports and Star Rating Preview Reports for the July 2022 Refresh are available. However, home health agencies are not seeing the reports in their iQIES folders. It appears that the announcement was made in error and the reports are not yet available. The reports are due out this month and LeadingAge Ohio will let members know when they are available.
Eligible patients can receive free second COVID booster
On April 6, the Center for Medicare & Medicaid Services (CMS) announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing, as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine, and there is no applicable copayment, coinsurance, or deductible. People with Medicaid coverage can also get COVID-19 vaccines, including boosters, at no cost.
The CDC recently updated its recommendations regarding COVID-19 vaccinations. Certain immunocompromised individuals and people ages 50 years and older who received an initial booster dose at least 4 months ago are eligible for another booster to increase their protection against severe disease from COVID-19. Additionally, the CDC recommends that adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least 4 months ago can receive a second booster dose of a Pfizer-BioNTech or Moderna COVID-19 vaccine.
The COVID-19 vaccine, including the booster doses, is the best defense against severe illness, hospitalization, and death from the virus. CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations. More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available by clicking here and through the CMS COVID-19 Provider Toolkit.
People can visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.
Hospice PEPPER available for download
The annual Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER) is now available for download. PEPPER is a data report that contains a single hospice’s claims data statistics (obtained from the UB-04 claims submitted to the Medicare Administrative Contractor (MAC)) for areas targeted by CMS as being at risk for improper Medicare payment.
Each hospice receives a PEPPER, which contains statistics for these target areas, regardless of whether the hospice’s data are of concern. The report shows how a hospice’s data compares to national, MAC jurisdiction and state statistics for the three most recent years.
Hospices can use the PEPPER to see how they compare to others in each of these target areas. The PEPPER also includes suggested interventions that hospices could consider when assessing their risk for each of the target areas.
The target areas for this year’s pepper are:
- Live Discharges No Longer Terminally Ill
- Live Discharges – Revocations
- Live Discharges LOS 61 – 179 Days
- Long Length of Stay
- Continuous Home Care Provided in an Assisted Living Facility
- Routine Home Care in Assisted Living Facility
- Routine Home Care in Nursing Facility
- Routine Home Care in Skilled Nursing Facility
- Claims with Single Diagnosis Coded
- No General Inpatient Care or Continuous Home Care
- Long General Inpatient Stay
NEW target areas this year:
- Average Number of Medicare Part D Claims for Beneficiaries Residing at Home
- Average Number of Medicare Part D Claims for Beneficiaries Residing in an Assisted Living Facility
- Average Number of Medicare Part D Claims for Beneficiaries Residing in a Nursing Facility
The PEPPER must be downloaded by each hospice. It will not be mailed. It is available electronically at the PEPPER Resources Portal. An updated PEPPER User’s Manual is available at www.PEPPERResources.org under the Hospices tab.
RELI Group, the PEPPER contractor for the Centers for Medicare & Medicaid Services (CMS), will hold a webinar on Tuesday, May 17 from 3:00-4:00PM that will include the history/background of PEPPER, a high-level review of the target areas, a walk-through of a sample PEPPER, and guidance for accessing the PEPPER. Registration is required.
Ready to connect with your peers at the 2022 Annual Conference?
Join LeadingAge Ohio August 30-September 1, 2022 at the Hilton Columbus at Easton for the LeadingAge Ohio Annual Conference and Trade Show! We are excited to announce this year’s theme: Momentum! Momentum is what propels our field forward. When harnessed, it can spread quickly. Our world has changed. Our field has changed. Now we need to build on what we have accomplished to prepare for what lies ahead.
Hotel registration for this year's conference is now open through the LeadingAge Ohio 2022 Annual Conference and Trade Show website.
Interested in sponsoring this event and supporting Ohio’s voice for aging services, LeadingAge Ohio? Please contact Corey Markham at 614-545-9015 or cmarkham@leadingageohio.org for information on becoming a Sponsor!
Wait, what? Email spoofing and how to protect yourself
With the increase of people becoming more reliant on working from home and using the internet, email spoofing is on the rise. Email spoofing is the act of sending emails with a forged sender address. It tricks the recipient into thinking that someone they know or trust sent them the email. Usually, it’s a tool of a phishing attack, designed to take over your online accounts, send malware, or steal funds.
Spoofed email messages are easy to make, but also easy to detect. Recently our own President and CEO, Susan Wallace had her email account spoofed. Those of us who receive emails from Susan on a regular basis noticed immediately that the writing style was not hers and the request was not one she traditionally makes, which raised a flag. A quick look at the sender information showed her name, but the email address attached to it was not a “LeadingAgeOhio.org” URL, thus easy to detect.
If you receive a suspicious email from an employee, agency or even a friend, do not respond or open any attachment, contact your IT group or whoever in your organization that handles your email system. More information on email spoofing is available in this October 2021 article from CyberNews.com.
What the Media Said about end of life care this week – April 12, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: April 5, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding attending physicians
- LeadingAge home health and hospice recap
- FY2023 Hospice Payment Rule proposes 2.7% update, mitigation policy for significant wage index losses
- Hospice Quality/Compliance Networking Forum Webinar: April 21
- Biden-Harris Administration announces new way for Medicare Beneficiaries to get free over-the-counter COVID-19 tests
- Important updates on the Hospice Quality Reporting Program (HQRP)
- Medicare Cost Report E-Filing System: Interim rate and settlement documentation webinar: April 26
- CMS Open Door Forum this Thursday, April 7
- What the Media Said about end of life care this week – April 5, 2022
You asked... We answered regarding attending physicians
You Asked:
Our hospice recently came across § 418.106, the condition of participation (CoP) that states Physician Assistants (PA) can now order medications for hospice patients if the PA is:
- The patient's attending physician; and
- Not an employee of or under arrangement with the hospice.
Does this CoP apply to the state of Ohio?
We Answered:
Yes, this CoP does pertain to the state of Ohio as the Ohio Department of Medicaid (ODM) revised the rule 3701-19-17 Medical Services to be consistent with the federal regulations. As of January 23, 2020, physician assistants in Ohio can be the attending physician for a hospice patient and order medications for their patients on their behalf.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features Home Health CAHPS Preview Reports.
FY2023 Hospice Payment Rule proposes 2.7% update, mitigation policy for significant wage index losses
Last Wednesday, March 30, the Centers for Medicare & Medicaid Services (CMS) issued Medicare Program; FY 2023 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements, a proposed rule governing hospice payment and other policies for fiscal year (FY) 2023.
The proposed rule was issued much earlier than is customary, and — likely due to the continuing Public Health Emergency (PHE) and the various other changes implemented over the last two years – is quite limited in scope. However, CMS has taken the opportunity presented by the rule to propose some useful policy changes, including a permanent mitigation policy to smooth the impact of year-to-year changes in hospice payments resulting from changes in the hospice wage index.
Another important advancement in the rule is that CMS indicates that it will initiate a hospice Technical Expert Panel (TEP) during CY 2022 to help provide input on the Hospice Special Focus Program (SFP) enacted as part of the hospice survey reforms included in the Consolidated Appropriations Act of 2021. CMS further indicates it will include a proposal implementing the Hospice SFP in the FY 2024 Hospice rulemaking proposed rule.
Read a summary produced by NAHC by clicking here.
Hospice Quality/Compliance Networking Forum Webinar: April 21
LeadingAge Ohio invites Hospice QAPI Managers, Compliance Professionals, Clinical Managers and Leadership to this semi-annual educational networking event, lead by LeadingAge Ohio's Director of Home Health/Hospice Regulatory Relations Anne Shelley. This is an open forum for these professionals to come together with peers and share the regulatory and compliance hurdles that keep them up at night.
With the release of the Hospice Wage Index Rule last week (see previous article), participants will spend time reviewing information contained in that release. Also, HQRP will be discussed including how programs are tracking the new claims-based measures, Hospice Visits in the Last Days of Life (HVLDL) and Hospice Care Index. Regulatory updates will be shared with the proposed FY 2023 Hospice Wage Index Rule slated to come out in early April. Hospice Surveys, TPE audits and other compliance concerns will be addressed.
Make plans to join your colleagues for this engaging forum opportunity on April 21 from 10:00AM-12:00PM. To register, please click here.
Biden-Harris Administration announces new way for Medicare Beneficiaries to get free over-the-counter COVID-19 tests
The Biden-Harris Administration announced yesterday that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.
This is the first time that Medicare has covered an over-the-counter self-administered test at no cost to beneficiaries. This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost, in addition to the two sets of four free at-home COVID-19 tests Americans can continue to order from covidtests.gov. National pharmacy chains are participating in this initiative, including: Albertsons Companies, Inc., Costco Pharmacy, CVS, Food Lion, Giant Food, The Giant Company, Hannaford Pharmacies, H-E-B Pharmacy, Hy-Vee Pharmacy, Kroger Family of Pharmacies, Rite Aid Corp., Shop & Stop, Walgreens and Walmart.
Providers and suppliers eligible to participate include certain types of pharmacies and other health care providers who are enrolled in Medicare and able to furnish ambulatory health care services such as preventive vaccines, COVID-19 testing and regular medical visits. To ensure that people with Medicare have access to these tests, Medicare is not requiring participating eligible pharmacies and health care providers go through any new Medicare enrollment processes. If a health care provider currently provides ambulatory health care services such as vaccines, lab tests or other clinic type visits to people with Medicare, then they are eligible to participate in this initiative.
A list of eligible pharmacies and other health care providers that have committed publicly to participate in this initiative can be found here. Because additional eligible pharmacies and health care providers may also participate, people with Medicare should check with their pharmacy or health care provider to find out whether they are participating.
This initiative adds to existing options for people with Medicare to access COVID-19 testing, including:
- Requesting free over-the-counter tests for home delivery at covidtests.gov. Every home in the U.S. is eligible to order two sets of four at-home COVID-19 tests.
- Access to no-cost COVID-19 tests through health care providers at over 20,000 testing sites nationwide. A list of community-based testing sites can be found here.
- Access to lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost through Medicare.
- In addition to accessing a COVID-19 laboratory test ordered by a health care professional, people with Medicare can also access one lab-performed test without an order and cost-sharing during the public health emergency.
For more information, please see this fact sheet.
People with Medicare can get additional information by contacting 1-800-MEDICARE and going to the Medicare.gov Coronavirus webpage. Medicare also maintains several resources to help ensure beneficiaries receive the correct benefits while also avoiding the potential for fraud or scams. More details—particularly on identifying scams due to COVID-19—can be found by clicking here.
Pharmacies and other health care providers interested in participating in this initiative can get more information by clicking here.
Important updates on the Hospice Quality Reporting Program (HQRP)
Swingtech sends informational messages to hospices related to the Quality Reporting Program (QRP) on a quarterly basis. Their latest outreach communication can be found on the HQRP Requirements and Best Practices webpage. If you want to receive Swingtech’s quarterly emails, then add or update the email addresses to which these messages are sent by sending an email to QRPHelp@swingtech.com. Be sure to include your facility name and CMS Certification Number (CCN) along with any requested updates.
Medicare Cost Report E-Filing System: Interim rate and settlement documentation webinar: April 26
If you’re a Medicare Part A provider or organization that files cost reports, register and attend this webinar hosted by the Centers for Medicare & Medicaid Services (CMS) on Tuesday, April 26 from 1:00-2:30PM to learn about new functionality in the Medicare Cost Report E-Filing (MCReF) system, including the ability to:
- View and download interim rate review, tentative settlement, and final or reopening settlement documentation completed by your Medicare Administrative Contractor
- Submit individual or bulk (chain providers) Medicare Part A cost reports for fiscal years ending on or after December 31, 2017
- Track the status of Medicare Part A cost reports with fiscal years ending after December 31, 2009
Send questions in advance to OFMDPAOQuestions@cms.hhs.gov with “MCReF Webinar” in the subject line. Questions sent in advance will be answered during the webinar or use them to develop educational materials.
CMS Open Door Forum this Thursday, April 7
The next Home Health, Hospice & DME Open Door Forum is scheduled for Thursday, April 7 from 2:00-3:00PM.
This week's agenda includes:
- Announcements & Updates
- Rulemaking: Updates on the FY 2023 Hospice Proposed Rule
- New Resources available for the HQRP
- Public Reporting: (May 2022 refresh updates)
- OASIS
- Public Reporting (updates on the Interim QAO Performance Reports and the April and July refresh)
- http://homehealthcahps.org and email for questions about HHCAHPS to hhcahps@rti.org
- FY 2023 Hospice Proposed Rule
- Hospice
- Home Health
- Home Health Services information on Care Compare
- Home Health CAHPS Survey Update
- Open Q&A
The call will be offered via conference call only. To participate by phone, dial 1-888-455-1397 and use passcode 5109694.
What the Media Said about end of life care this week – April 5, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: March 29, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- Brod passes the baton to Wallace
- You asked... We answered regarding transfer billing
- LeadingAge home health and hospice recap
- Preview Reports for the May 2022 refresh
- HB 169 Provider Relief Payments announced, includes funds to nursing homes and hospices
- Congress debates HCBS expansion, Improvement for Veterans
- Home Health CAHPS participation exemption request deadline
- CMS identifies issue with Provider Preview Reports
- MACPAC addresses HCBS workforce challenges
- COVID-19 Vaccine Boosters Communications Toolkit
- HCBS reduces costs for families and states
- CDC stretches vaccine intervals for males 12-39
- Leading Faithfully: Being present to the dying and those who love them
- What the Media Said about end of life care this week – March 29, 2022
Brod passes the baton to Wallace
Earlier this month, Susan Wallace assumed leadership of LeadingAge Ohio, succeeding Kathryn Brod who had served as the organization’s Chief Executive for nearly eight years. At a gathering of members and colleagues last week, each of LeadingAge Ohio’s previous board members shared words of gratitude for Brod, who came to LeadingAge Ohio after a long career serving non-profit aging services in various capacities.
In written remarks, Rev. Ken Daniel, President/CEO of United Church Homes noted, “Kathryn has been the consummate leader who was the right person at the right moment in LeadingAge Ohio’s history.” Current LeadingAge Ohio Board Chair Allison Salopeck, President/CEO of Jennings, noted Brod was “the most selfless person I know,” and colleagues shared stories and gratitudes for Brod’s service to the organization, which included preparing her successor.
Wallace now leads the organization, having served in association management for the past fifteen years, following a brief career as a hospice social worker. Wallace began at LeadingAge Ohio following eight years with the Midwest Care Alliance prior to its merger with LeadingAge Ohio in 2014 and has steered advocacy work for LeadingAge Ohio since 2019, serving as spokesperson and subject matter expert for Medicaid reimbursement and other policy issues. “I am so honored to be able to continue Kathryn’s legacy at LeadingAge Ohio,” remarked Wallace. “We have seen LeadingAge Ohio’s reputation and influence grow in recent years. Our members are known as collaborators and thought leaders in their communities. I look forward to helping our organization maintain that trajectory into the future, ensuring that Ohio continues to be a great place to age.”
You asked... We answered regarding transfer billing
You Asked:
Is it possible for a patient to transfer from one hospice to another over the course of two days if the patient is traveling several hours to the new hospice? For example, the patient is leaving hospice A on a Monday, but does not arrive at the new hospice B until Tuesday. Can hospice A bill for the transfer on Monday and hospice B bill the transfer on Tuesday? I believe this situation has occurred in the past.
We Answered:
Currently, transfers are being allowed to process through the Common Working File (CWF) where the “from date” from the receiving hospice does not make the “to date” from the transferring hospice, resulting in a gap following the date of transfer. In these cases, it is deemed to be a gap in care and therefore would not be considered a continuous hospice election. The Centers for Medicare & Medicaid Services (CMS) issued Change Request 12619 and effective July 1, 2022 a new CWF edit will no longer allow a gap of care to occur during a transfer. The CWF edit will reject the hospice transfer if the transfer does not occur immediately and there is a gap in the number of billing days between one hospice and the next. If the receiving hospice’s claim “from date” is not the same as the transferring hospice’s “through date” with “patient status” indicating a transfer (code 50 or 51), the hospice transfer will be rejected.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features provider relief funds (PRF) reporting deadlines.
Preview Reports for the May 2022 refresh
Providers can now access the latest Provider Preview Reports via the Certification and Survey Provider Enhanced Reports (CASPER) application. These reports preview data that will be displayed on the Care Compare website in May 2022. For this refresh, two new Claims-based measures will be added for public reporting:
- Hospice Care Index (HCI)
- Hospice Visits in the Last Days of Life (HVLDL)
Hospice Item Set (HIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey, and Claims-based measure scores exclude Quarter 1 and Quarter 2 of calendar year 2020. In addition, state averages will now be displayed for each measure.
Once released in CASPER, providers will have 30 days during which to review their quality measure results. Although the actual “preview period” is 30 days, the reports will continue to be available for another 30 days, or a total of 60 days. CMS encourages providers to download and save their Hospice Provider Preview Reports for future reference, as they will no longer be available in CASPER after this 60-day period.
Learn more about the Provider Preview Report (HIS and Claims-based measures) here and about the CAHPS Preview Report here. Hospice QRP Key Dates for Providers can be found here.
HB 169 Provider Relief Payments announced, includes funds to nursing homes and hospices
Last week, Governor DeWine signed an executive order for the Department of Medicaid (ODM) to issue provider relief funds approved by the Ohio General Assembly in H.B. 169 for home health, community behavioral health, and noninstitutional durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Also authorized were payments to nursing facilities, intermediate care facilities, and hospices. Hospices, along with other Medicaid providers, will receive a calculator 10% of their Medicaid service revenue (not including room & board payments) for the period from November 1, 2020 to October 31, 2021.
Centers for Medicaid & Medicaid Services (CMS) approval has been received and the emergency rules were filed March 23.
These provider payments were processed Thursday, March 24 through Medicaid Information Technology System (MITS). Providers will receive the EFT payments approximately this Wednesday, with paper checks mailed afterwards. Providers will receive a separate remittance advice that includes the code “HB169COVIDPMT” to help identify the payments. As a reminder, these payments are based on fee-for-service (FFS) payments only. The calculation of these payments is equal to approximately 10% of paid claims, using claim period from July 1, 2020, through June 30, 2021, as the basis, and distributed to providers as a lump sum.
CMS approvals that are still pending include services and equipment provided to individuals through managed care, including MyCare.
ODM has developed a tool to assist providers to know how much they are receiving and from which payor:
ODM is pleased to announce a new tool that will be available to providers beginning early next week. It is a tableau dashboard that will allow providers to enter their Medicaid billing ID and view payments that will be dispersed to them from FFS, Managed Care, and MyCare per HB 169. This includes all the categories of provider relief from HB 169, ARPA HCBS and non-ARPA/GRF funds, EXCEPT for Assisted living (RCFs) and DODD waiver providers. Providers can access this tableau through the ARPA HCBS page of our website linked here.
Ohio Medicaid appreciates the difficulty faced by providers and the individuals each serves. We continue to work closely with CMS and impress upon them the urgency in which to move these payments as quickly and efficiently as possible.
Community provider relief payments are contained in Ohio’s American Rescue Plan Act Home- and Community-Based Services (ARPA HCBS) plan. Additional information about the Ohio plan can be found here.
ODM declined to share with the associations the exact amounts each provider will receive, noting that since funds were based on their Medicaid revenue, doing so would reveal confidential information.
ODM has previously noted that, once emergency rules are filed, payments should be delivered to providers via the MITS system within seven days. LeadingAge Ohio encourages members to reach out to Susan Wallace with any questions related to provider relief at swallace@leadingageohio.org.
Congress debates HCBS expansion, Improvement for Veterans
The Elizabeth Dole HCBS for Veterans and Caregivers Act, H.R. 6823 introduced in the U.S. House of Representatives earlier this month and would work to improve home and community-based services (HCBS) services for patients, their families, and their caregivers.
Specifically, this legislation would:
- Expand access to HCBS services for veterans living in US territories and to Native veterans enrolled in IHS or tribal health program.
- Raise the cap on how much the VA can pay for the cost of home care from 65% of the cost of nursing home care to 100%.
- Coordinate expanded VA home care programs with other VA programs.
- Establish a pilot project to address home health aide shortages.
- Providing respite care to caregivers of veterans enrolled in home care programs.
- Establish a “one stop shop” webpage to centralize information for families and veterans on programs available.
- Require the VA to provide a coordinated handoff for veterans and caregivers denied or discharged from the Program of Comprehensive Assistance for Family Caregivers into any other home care program they may be eligible for.
Following the introduction of the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act, the House Committee on Veterans’ Affairs held a hearing on the bill, and several other pieces of legislation designed to improve the Veterans Administration (VA) and health care delivery for veterans.
In written testimony, Dr. Julianne Flynn, Acting Assistant Under Secretary for Health Care within the Veterans Health Administration offered support for numerous provisions included in H.R. 6823, in particular the increase of to 100% of what the VA can pay for home based on the cost of nursing home care. Likewise, the legislation received favorable comments from other members of the panel as well as testifying witnesses from the Elizabeth Dole Foundation and the Paralyzed Veterans of America.
Home Health CAHPS participation exemption request deadline
The deadline for home health agencies to submit a request for an exemption from participating in the Home Health CAHPS (HH CAHPS) Survey for the CY 2023 Annual Payment Update (APU) is March 31.
Medicare-certified home health agencies are eligible for an exemption if they served 59 or fewer survey eligible patients between April 1, 2020, and March 31, 2021. If your agency is exempt, you do not need to participate in the HHCAHPS data collection period, which runs from April 1, 2021 through March 31, 2022.
To be exempted from participating in the HH CAHPS Survey for the CY 2023 APU, HHAs must count the number of home health patients they served between April 1, 2020, and March 31, 2021, who meet HHCAHPS survey eligibility criteria and then report that count on the Participation Exemption Request Form. Please note, exemptions are active for one year only.
CMS identifies issue with Provider Preview Reports
The Centers for Medicare & Medicaid Services (CMS) had previously identified an issue in the iQIES system that may have affected your HHA’s Services Provided values that are displayed on the HHA Provider Preview reports that were distributed in iQIES on 02/23/2022. Moreover, CMS had previously asked HHAs to review the Services Provided Information on the HHA Provider Preview Reports for the April 2022 refresh and contact their OASIS Education Coordinator (OEC) or OASIS Automation Coordinator, should inaccuracies be identified. The process to collect and maintain the Services Provided information recently migrated into iQIES and we are addressing the issues identified.
To allow time to complete the identified changes, CMS has decided for the April 2022 refresh, to publish the same Services Provided data for each Home Health Agency that was posted on Care Compare for the January 2022 refresh. We believe that this will allow us to publish the most accurate Services Provided data at this time.
CMS is still urging HHA providers to carefully review the Services Provided data within the recently issued Preview Reports, however, would like to note that they are not attaching a deadline to this review. These reports were distributed in iQIES on 02/23/2022. If the values are incorrect for your agency, please contact your State Automation or State OEC and request an update of your Services Provided data in iQIES. Should you have questions, please contact the iQIES Help Desk by phone at (800) 339-9313 or by email at iQIES@cms.hhs.gov. CMS continues to work to refine and rectify the update process moving forward.
For those experiencing issues locating your agency’s HHA Provider Preview Report, follow the steps outlined below:
New Users
- Only active users with login credentials to iQIES as of the distribution date of the HHA Provider Preview reports for the April 2022 refresh will have the report in their HHA Provider Preview Report folder.
a. If you are a new user of iQIES and received your iQIES login credentials after the February 23, 2022 distribution of the HHA Provider Preview reports, please contact the iQIES Help Desk for assistance (see iQIES Help Desk contact information below).
b. Inform the help desk staff that you are a new user of iQIES since the HHA Provider Preview reports for the April 2022 refresh were made available. The iQIES help desk team will gather the necessary information from you including such things as your agency’s CMS Certification Number (CCN) and will then make the report for your agency available to you in the HHA Provider Preview Reports folder in iQIES.
c. Follow the steps below to locate your agency’s report in the HHA Provider Preview Report folder.
Existing Users
- If you were an active user prior to the February 23, 2022 distribution of the HHA Provider Preview Reports but you cannot locate your report, please follow the steps below:
a. Log into iQIES by clicking here
b. Select the My Reports option from the Reports menu
c. From the My Reports page, locate the HHA Provider Preview Reports folder.
i. NOTE: The folders and reports on the My Reports page are listed in alphabetic order so users may need to utilize the page forward functionality at the bottom of the webpage to advance to the page where the folder is located. Alternatively, users may change the default number of rows that display on the webpage from 10 to a larger number to view the larger list of items.
d. Select the HHA Provider Preview Reports link to open the folder.
e. To locate the latest HHA Provider Preview report, select the down arrow adjacent to the Created Date label at the top of the table. This will order the reports in the folder from newest to oldest.
f. Select the report file with the following label: Preview of Home Health Agency Quality Measure Scores To Be Posted on Care Compare (April 2022)_Updated [provider’s CCN will display after the word Updated].
g. Once the report is open, users will notice the Services Provided information displayed beneath their agency’s demographic information at the top of the report.
Should you have questions, please contact the iQIES Help Desk by phone at (800) 339-9313 or by email at iQIES@cms.hhs.gov.
MACPAC addresses HCBS workforce challenges
Last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) released an issue brief, “State Efforts to Address Medicaid Home and Community Based Services Workforce Shortages.” The brief looks at state Medicaid levers to address the HCBS workforce shortage, noting that low wages, high rates of turnover, and lack of advancement opportunities all contribute to the shortage. In turn the shortage of workers limits the ability of state Medicaid programs to provide adequate services to beneficiaries in the community. Among other things, the issue brief provides examples of state actions using funds provided under the American Rescue Plan Act to support the HCBS workforce. Nearly all states who have applied for ARPA funds include some type of HCBS workforce efforts in their plans.
COVID-19 Vaccine Boosters Communications Toolkit
While COVID-19 cases, hospitalizations and deaths continue to decline in Ohio and nationally, new variants in the future remain likely. It is important that time is taken to encourage all eligible Ohioans in all age groups who haven’t already gotten a COVID-19 vaccine booster shot to get one, especially Ohioans age 50 and over who are at greatest risk of severe illness, hospitalization, and death.
Providers can offer invaluable assistance in increasing COVID-19 vaccinations and saving lives.
People are more likely to get a booster shot if someone they personally know and trust encourages them to do so, answers any questions they may have, and tells them where to get a shot. We are asking you to engage your members/stakeholders in this effort by urging them to use the attached communications toolkit to encourage their patients/clients/stakeholders to get a COVID-19 booster shot.
Attached is a toolkit to promote the importance of booster doses using social media channels with sample text and graphics, or on websites or in publications.
HCBS reduces costs for families and states
A new policy brief from the Brandeis Community Living Policy Center looks at how increased access to and investments in home- and community-based services have positive economic impacts on families, the HCBS workforce, and states.
CDC stretches vaccine intervals for males 12-39
The Centers for Disease Control & Management (CDC) has updated the interval between dose for the mRNA vaccines to include an 8-week interval for some people ages 12 years and older, especially for males ages 12-39 years due to the small risk of myocarditis. The Interim Clinical Considerations for Use of COVID-19 Vaccines webpage states:
mRNA COVID-19 vaccines are FDA-approved or authorized for a 3-week (Pfizer-BioNTech vaccine) or 4-week (Moderna vaccine) interval between the first and second dose. A 3- or 4-week interval continues to be the recommended interval for people who are moderately to severely immunocompromised, adults ages 65 years and older, and others who need rapid protection due to increased concern about community transmission or risk of severe disease. mRNA COVID-19 vaccines are safe and effective at the FDA-approved or FDA-authorized intervals, but a longer interval may be considered for some populations. While absolute risk remains small, the relative risk for myocarditis is higher for males ages 12-39 years, and this risk might be reduced by extending the interval between the first and second dose. Some studies in adolescents (ages 12-17 years) and adults have shown the small risk of myocarditis associated with mRNA COVID-19 vaccines might be reduced and peak antibody responses and vaccine effectiveness may be increased with an interval longer than 4 weeks. Extending the interval beyond 8 weeks has not been shown to provide additional benefit. There are currently no data available for children ages 11 years and younger. Therefore, an 8-week interval may be optimal for some people ages 12 years and older, especially for males ages 12–39 years.
LeadingAge Ohio encourages providers to keep their policies updated with current CDC guidance and ensure any education material provided to staff, residents, and clients contains the most current recommendations. The facility medical director could also assist a provider in updating their policies accordingly. For providers subject to the vaccine mandate, employers should discuss these recommendations with newly vaccinated individuals, document the interval recommendation for that specific individual, and then ensure they are vaccinated accordingly.
Leading Faithfully: Being present to the dying and those who love them
Join Reverend Becky King, MDiv, BCC and Kim Vesey, RN, CHPN, MS on Wednesday, May 18 for this training, which is specifically designed to better equip participants in the support of end of life care. Clergy, chaplains and care ministry teams for aging services organizations should plan to join this event. Discussion among peers throughout the day will build networking opportunities. Attendees can expect to implement information learned and build resources on a wide range of topics.
For program information and to register, click here.
What the Media Said about end of life care this week – March 29, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: March 22, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding patient referrals from hospitals
- CMS approves relief for nursing facilities, hospices
- LeadingAge Ohio All-Member Call: Medication Aides as a workforce strategy - TOMORROW at 11:30AM
- LeadingAge home health and hospice recap
- Post-Acute Care Quality Reporting Programs
- OSHA to lead focused inspection and enforcement of facilities treating COVID-19 patients
- Preventative Maintenance Manual
- HB 138 passes Senate
- Honoring Wishes Task Force networking call: Tomorrow at 8:30AM
- REMINDER: LeadingAge Ohio Awards Program open for nominations, application period to close April 8
- Clark R. Law Executive Management Scholarship announced, application portal now open
- CDC’s Project Firstline offers IC resources
- LeadingAge Ohio welcomes Workforce Director Randi Hamill
- ODH shifts to weekly COVID-19 data reporting
- ODH Life Safety Code meeting
- What the Media Said about end of life care this week – March 22, 2022
You asked... We answered regarding patient referrals from hospitals
You Asked:
Our hospice functions as a department of a larger healthcare system. We oftentimes receive patient referrals from the hospital. In some cases, the patient’s family is not quite ready to take the patient home once the referral is made to hospice, so we admit them to our Inpatient unit for respite care for 5 days then have them return home with family caring for the patient. Is that an appropriate way to use the respite benefit or should we try to get the patient home for a period of time before they can use that respite?
We Answered:
It is possible to admit a patient into the respite level of care, but you need to document the need for respite care very clearly in the medical record. The Hospice Medicare Benefit Manual Chapter 9 defines "respite care" as:
Short-term inpatient care provided to the individual only when necessary to relieve the family members or other persons caring for the individual at home.
There would be limited circumstances that a patient could be admitted into a respite level of care from a hospital setting. For example, if the patient was in a hospital setting and needed hospice and the family/caregiver was ill and not able to bring the patient into their home for fear of the hospice patient acquiring an infectious disease, that might constitute the need for a few days of respite care while the family/caregiver recovers from their illness. Again, the need for respite care would need to be identified and documented in detail in the patient’s medical record.
The Hospice Claims Processing Manual Chapter 11 goes on to say:
Payment for respite care may be made for a maximum of 5 continuous days at a time including the date of admission but not counting the date of discharge. Payment for the sixth and any subsequent days is to be made at the routine home care rate and the patient would be liable for room and board. Payment at the respite rate is made when respite care is provided at a Medicare or Medicaid certified hospital, SNF, hospice facility, or NF.
CMS approves relief for nursing facilities, hospices
Last Wednesday afternoon, the Ohio Department of Medicaid (ODM) reached out to LeadingAge Ohio to notify providers that the Centers for Medicare & Medicaid Services (CMS) had approved the state plan amendment (SPA) which would allow distribution of HB169 funds to nursing facilities, intermediate care facilities, and hospice programs. Funds have already been approved for distribution to DoDD waiver providers, PASSPORT and Ohio Home Care Waiver providers, as well as assisted living communities.
The funds will be distributed to nursing facilities and hospices as follows:
- $225 million will be distributed to nursing facilities based on their Medicaid-certified bed count. $75 million will be distributed based on the quality incentive payment (QIP) methodology, on a “per point, per Medicaid day” basis. Previously, ODM had implied they would distribute the QIP funds based on a per-point, per-bed basis, but this is not the case.
- Hospices will receive $3.7 million distributed based on an estimated 10 percent of total Medicaid payments between November 1, 2020 and October 31, 2021. CMS did not approve an alternative methodology for the remaining $19 million that were appropriated for hospices in HB169, since they were based on room and board payments for hospice patients residing in nursing facilities.
Before ODM can distribute the funds, it must promulgate an emergency rule to be approved by the Governor. It estimates that next week, it will be able to initiate the disbursement in the MITS system, and funds should be distributed the week of March 28. Any questions related to HB169 relief payments may be sent to Susan Wallace at swallace@leadingageohio.org.
LeadingAge Ohio All-Member Call: Medication Aides as a workforce strategy - TOMORROW at 11:30AM
Join LeadingAge Ohio President/CEO Susan Wallace in a conversation with Good Shepherd Home Executive Director Chris Widman about using medication aides to boost retention, reduce errors and skill-up their existing workforce tomorrow, Wednesday March 23 at 11:30AM.
With no signs of workforce challenges abating, medication aides are just one strategy that can be used to stretch nursing hours while investing in nurse aides. The all-member call will also include the latest in regulatory guidance from LeadingAge Ohio Quality and Regulatory Specialist Stephanie DeWees, LeadingAge Ohio’s forecast on when to anticipate licensure rules for home care agencies, and the latest on HB169 relief funds for nursing facilities and hospices.
To register for tomorrow’s webinar, click here. To pose questions ahead of the webinar, email Susan Wallace at swallace@leadingageohio.org.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features Senate "Economic Package" hearing news.
Post-Acute Care Quality Reporting Programs
The Centers for Medicare & Medicaid Services (CMS) identified an Internet Quality Improvement and Evaluation System (iQIES) nuance that may affect Home Health Aide's (HHA) Services Provided values that are displayed on the HHA Provider Preview reports for the April 2022 refresh. These reports were distributed in iQIES on 02/23/2022. CMS is asking each HHA to carefully review the Services Provided values that display on these reports. If the values are incorrect for your agency, please contact your State Automation or State OASIS Education Coordinator (OEC) and request an update of your Services Provided data in iQIES. Should you have questions, please contact the iQIES Help Desk by phone at (800) 339-9313 or by email at iQIES@cms.hhs.gov.
OSHA to lead focused inspection and enforcement of facilities treating COVID-19 patients
The Occupational Safety and Health Administration (OSHA) announced this month that until June 9, 2022, it will devote 15 percent of its workplace inspections per region to nursing homes, hospitals, and assisted living communities that treat people with COVID-19.
Through this focused enforcement initiative, the agency will verify and assess employers’ compliance actions taken, including their readiness to address any ongoing or future COVID-19 surges.
This action was foreshadowed by comments made by President Joe Biden about reforming quality and safety in nursing homes during his State of the Union address.
OSHA’s goal is to expand its presence to ensure continued mitigation to control the spread of COVID-19 and future variants of the SARS-CoV-2 virus, and protect the health and safety of health care workers at heightened risk for contracting the virus.
The agency will be initiating focused inspections to emphasize monitoring for current and future readiness to protect workers from COVID-19. Follow-up inspections will be conducted at sites that were previously issued citations, as well as where complaints were received but the agency did not conduct in-person inspections.
This initiative supplements OSHA’s targeted enforcement under the Revised COVID-19 National Emphasis Program by conducting focused follow-up and monitoring inspections of previously inspected or investigated hospitals and skilled nursing care facilities within four North American Industry Classification System codes listed in the memorandum where COVID-19 citations or Hazard Alert Letters were issued, including remote-only inspections where COVID-19-related citations were issued.
This initiative and the revised COVID-19 National Emphasis Program would comprise 15 percent of OSHA’s enforcement activity.
On December 27, 2021, OSHA announced its decision to withdraw the non-recordkeeping portions of the Healthcare Emergency Temporary Standard. The agency will accept continued compliance with the Healthcare ETS as satisfying employers’ related obligations under the General Duty Clause, Personal Protective Equipment and Respiratory Protection standards.
OSHA has continually conducted outreach at the national, regional, and area office levels throughout the duration of the pandemic outbreak. Visit the agency’s Coronavirus Disease webpage for more information and resources on keeping workers safe from COVID-19.
Preventative Maintenance Manual
The Preventive Maintenance Manual was updated to reflect Centers for Medicare and Medicaid Services (CMS) adoption of the 2012 edition of the National Fire Protection Association 101 Life Safety Code. The Ohio Department of Health (ODH) believes the contents of this document to be compliant with the 2012 edition of the National Fire Protection Association 101 Life Safety Code and Federal Register Requirements for Life Safety Code.
For additional information and to view the complete manual, please click here.
HB 138 passes Senate
Last week, the Ohio Senate passed HB 138 unanimously, with a 30-0 vote taken on Wednesday afternoon. HB 138 includes a long-awaited fix that would allow emergency responders to follow Do Not Resuscitate (DNR) orders signed by nurse practitioners (NPs) and physician assistants (PAs). Under Ohio law, NPs and PAs are permitted to sign DNR orders, but EMTs may only follow orders signed by physicians.
In addition to addressing this discrepancy in the Ohio Revised Code, the bill also includes a Senate-added amendment that would require a single licensed EMT– rather than two– to support non-emergency medical transports. This would alleviate some of the staffing pressure faced by medical transportation providers, and hopefully expand access for residents of nursing facilities, hospice patients, and others who require cot transportation for medical appointments.
The bill now heads back to the House for concurrence before going to the Governor’s desk. It will take effect 90 days following the Governor’s signature. Any questions related to HB 138 may be sent to Susan Wallace at swallace@leadingageohio.org.
Honoring Wishes Task Force networking call: Tomorrow at 8:30AM
Please mark your calendar for tomorrow's Honoring Wishes Task Force networking call on Wednesday, March 23 at 8:00AM, when the Honoring Wishes Task Force, a statewide coalition dedicated to improving the way Ohioans communicate and document healthcare wishes, will host Dr. Susan Hickman of the Indiana University College of Medicine. Dr. Hickman is a nationally-recognized expert on advance care planning research. Dr. Hickman will respond to the recent JAMA article questioning the value of advance care planning.There is no cost to attend, but registration is required. To register, click here.
LeadingAge Ohio has served as the convener for the Honoring Wishes Task Force since 2014.
REMINDER: LeadingAge Ohio Awards Program open for nominations, application period to close April 8
The LeadingAge Ohio Awards Program celebrates exemplary work of the individuals and organizations within our membership on an annual basis. COVID’s relentless impact makes honoring innovations by staff and volunteers more important than ever. Check out the 2021 award tributes here.
Nominations for this year’s awards are open now and include nine different categories. With many opportunities to recognize staff and volunteers, please spread the word about the Awards Program to get the nomination process started. The application period will close on April 8.
Visit the Annual Awards webpage on the LeadingAge Ohio website under the About header within the Recognition & Awards section to access the award descriptions/nomination forms by category.
Questions regarding the annual Awards Program can be directed to Patrick Schwartz, Director of Strategic Communications, pschwartz@leadingageohio.org.
Clark R. Law Executive Management Scholarship announced, application portal now open
The LeadingAge Ohio Foundation is funding $2500 for Clark R. Law scholarship awards in 2022. The Clark R. Law Executive Management Scholarship provides assistance for administrators-in-training or others furthering their career in senior services management, and is named in honor of past LeadingAge Ohio CEO Clark R. Law. Member employees may submit their applications now via the LeadingAge Ohio website.
The deadline for scholarship applications is May 1, 2022. To access the qualifications for this application and other application materials, click here. Awards will be announced in June. Awards will be presented during LeadingAge Ohio’s Annual Conference & Trade Show August 30 - September 1, 2022.
CDC’s Project Firstline offers IC resources
The Centers for Disease Control and Prevention’s (CDC) hosted the Project Firstline call for providers on March 16, where they announced that training resources have now been posted to the resources webpage. Training resources include videos, training toolkits, posters, social media graphics, Information on obtaining CEU’s can be found on the video’s webpage.
Project Firstline can help support healthcare workers in protecting themselves and their patients from infections in healthcare. CDC’s Project Firstline, launched in FY2020, is a collaborative of diverse healthcare and public health partners. The CDC’s factsheet notes that Project Firstline delivers comprehensive, transparent, and responsive training and education to the millions of frontline healthcare workers in the United States. Project Firstline is funded through American Rescue Plan investments for FY22-FY26.
LeadingAge Ohio welcomes Workforce Director Randi Hamill
Last week, LeadingAge Ohio welcomed Randi Hamill as Workforce Director. Randi joins LeadingAge Ohio on a part-time basis until April, when she will graduate with her Masters in Social Work from The Ohio State University and begin full-time work for LeadingAge Ohio. She comes to LeadingAge Ohio having worked several years in adult protective services in North Carolina, where she supported clients across the continuum including in facility settings. Here in Ohio she’s worked with the Age Friendly Innovation Center at the Ohio State University, supporting the development and evaluation of their Age Friendly Scholars program.
Randi will focus on developing and implementing programs that help LeadingAge Ohio members address the breadth of their workforce needs. She will work across the membership to aid in creating pathways to employment for in-demand jobs and in developing policies/practices to enhance recruitment/retention efforts into the aging services sector. Additionally, Randi will work alongside the advocacy team in advancing policy that supports workforce efforts in aging services.
“I am so excited to join the LeadingAge Ohio team in helping create momentum around our surmounting workforce needs and support LeadingAge members to create sustainable pathways and enthusiasm in the aging services field.” said Randi.
Susan Wallace, President and CEO of LeadingAge Ohio said:
“We are pleased to have someone of Randi’s caliber lend her talents to the critical needs of our sector. We know that we can no longer take a ‘business as usual’ approach to addressing our workforce needs, and look forward to the fresh, creative thinking Randi will bring to addressing these challenges.”
ODH shifts to weekly COVID-19 data reporting
Ohio Department of Health (ODH) Director Bruce Vanderhoff, MD, MBA, announced on Thursday, March 12, that the state of Ohio will transition from daily to weekly COVID-19 data reporting at www.coronavirus.ohio.gov beginning last Thursday.
A summary of key reporting changes:
- COVID-19 new and cumulative cases, hospitalizations, ICU admissions, and vaccinations that are currently updated daily at coronavirus.ohio.gov will be updated weekly on Thursdays starting Thursday, March 17. Cases will continue to be assigned to the appropriate illness onset date, and vaccinations to their appropriate administration date.
- Newly reported COVID-19 deaths (currently reported twice weekly on Tuesdays and Fridays) will be reported on Thursdays and will continue to be assigned to the appropriate date of death.
- Data about long-term care facilities, as well as the reports from partner agencies (Developmental Disabilities, Veteran’s Homes, Youth Services, Mental Health and Addiction Services and Rehabilitation and Corrections), will be published weekly on Thursdays.
- K-12 schools will no longer be required to report positive COVID-19 cases to their local health departments, unless the school tests a student for COVID-19 and the result is positive. In addition, the COVID-19 School Reporting dashboard will be archived.
For the first time since August 2021, the statewide average case number per 100,000 residents has dropped below 100, with an average of 78.2 cases per 100,000 people as of March 9. Nearly two-thirds of Ohio’s 88 counties are currently below 100 cases per 100,000 people.
This change also brings Ohio’s reporting system more in line with the Centers for Disease Control and Prevention (CDC), which recently introduced new benchmarks for assessing community risk, shifting away from using cases as the sole measure of risk. The new COVID-19 Community Levels assess data related to the proportion of hospital capacity devoted to caring for COVID-19 patients, the number of new patients with COVID-19 admitted to the hospital in the past week, and the number of new COVID-19 cases in a given county in the past week. These data tell us how much the virus is spreading in an area in the context of how many people in the area are getting sick enough to require hospitalization and the strain that’s placing on a community’s acute care safety net. This combination of factors determines the COVID-19 Community Level in a given county expressed in ranges of low, medium, or high. Layered prevention strategies are recommended for communities deemed high risk.
Staying up to date on COVID-19 vaccinations, including getting a booster dose when eligible, is the best form of protection against COVID-19. COVID-19 vaccinations are widely available throughout the state at no cost to Ohioans. Many providers offer walk-in appointments, or appointments can be scheduled using gettheshot.coronavirus.ohio.gov. Ohioans who want to learn more about the safety, efficacy, and side effects of COVID-19 vaccines should talk to their doctor, nurse, or pharmacist, or visit coronavirus.ohio.gov/vaccine.
ODH Life Safety Code meeting
The Ohio Department of Health (ODH) shared that the life safety code preventative maintenance manual has been updated and will be available this week on the ODH nursing homes publications webpage. The updated manual includes a section on Fire Safety Evaluation System (FSES), Temporary Construction Waivers/ Time Limited Waivers, and Continuing Waivers. A list of required documentation has also been included. ODH shared the following trends in citations:
- Lack of inspection documentation
- Alcohol-based hand sanitizers placed over a switch or receptacle
- Gas oven not chained to the wall
- Sprinklers obstructed with dust
- Specific gravity testing for non-maintenance free batteries
- Emergency preparedness not being updated
ODH confirmed facilities can use the pandemic for the emergency preparedness exercise. Facilities could use the implementation of the vaccine mandate as a table-top exercise to review what the facility did and how the implementation went. ODH reminds facilities to ensure they can print reports from any electronic system that contains the required documentation. During the facility tour surveyors are finding penetrations in smoke barriers, commonly due to contractors conducting work such as with computer cabling work. Isolation units were discussed and ODH reminds facilities to take them down when they are no longer needed and the facility is out of an outbreak, which allows corridor egress to be unobstructed. When isolation units are in service, facilities should attempt to have only the necessary number of items placed in the hallways such as doffing receptacles. The plastic barrier should not leave a portion of the unit without sprinkler coverage. Exit signs should be placed on the plastic partitions, possibly on both sides of the partition. ODH commended the work facilities did on constructing the isolation units.
What the Media Said about end of life care this week – March 22, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: March 15, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding hospice aide supervisory visits
- LeadingAge home health and hospice recap
- ODH shifts to weekly COVID-19 data reporting
- Honoring Wishes Task Force networking call: March 23
- CMS releases application request for third year of MA-Hospice demonstration
- CMS webinar: Medicare Advantage Value-Based Insurance Design Model – 2023 Hospice Benefit Component Overview: April 5
- Bill to expand HCBS for veterans introduced in congress
- Short time frame to complete application for High School Health Care Preceptor Pilot
- Ohio Assisted Living Association announces new Executive Director
- What the Media Said about end of life care this week – March 15, 2022
You asked... We answered regarding hospice aide supervisory visits
You Asked:
We realize the 14-day RN supervisory visits don't require the hospice aide to be present. How do the annual supervisory visits work?
We Answered:
According to the MLN article of September 2021, the hospice must make sure that the supervisory RN makes an annual on-site visit to the location where a patient is getting care to see and assess each aide while the aide is providing care. This way at least one in-person direct care observation occurs annually for each hospice aide. The Supervisory RN should document the annual on-site RN visit per the hospice’s own policies and procedures for monitoring and tracking. The annual on-site supervisory RN visit documentation should:
- Show the aide’s performance per the patient’s POC
- Show ability with assigned tasks
- Follow infection control policies and procedures
- Report changes in a patient’s condition
- Create successful relationships with the patient and family
According to the Hospice: CMS flexibilities to fight COVID-19 the annual hospice aide onsite supervisory visit is on hold until 60 days after the expiration of the PHE. See the flexibility below:
Training and Assessment of Aides: CMS is waiving the requirement at 42 CFR §418.76(h)(2) for Hospice and 42 CFR §484.80(h)(1)(iii) for HHAs, which require a registered nurse, or in the case of an HHA a registered nurse or other appropriate skilled professional (physical therapist/occupational therapist, speech language pathologist) to make an annual onsite supervisory visit (direct observation) for each aide that provides services on behalf of the agency. In accordance with section 1135(b)(5) of the Act, we are postponing completion of these visits. All postponed onsite assessments must be completed by these professionals no later than 60 days after the expiration of the PHE.
Onsite visits for Hospice Aide Supervision are also waived at this time: CMS is waiving the requirements at 42 CFR 418.76(h), which require a nurse to conduct an onsite visit every two weeks. This would include waiving the requirements for a nurse or other professional to conduct an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan, as this may not be physically possible for a period of time.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features a Home Health Advisory Group recap.
ODH shifts to weekly COVID-19 data reporting
Ohio Department of Health (ODH) Director Bruce Vanderhoff, MD, MBA, announced last Thursday that the state of Ohio will transition from daily to weekly COVID-19 data reporting at www.coronavirus.ohio.gov beginning today, March 17.
A summary of key reporting changes include the following:
- COVID-19 new and cumulative cases, hospitalizations, ICU admissions, and vaccinations that are currently updated daily at coronavirus.ohio.gov will be updated weekly on Thursdays starting Thursday, March 17. Cases will continue to be assigned to the appropriate illness onset date, and vaccinations to their appropriate administration date.
- Newly reported COVID-19 deaths (currently reported twice weekly on Tuesdays and Fridays) will be reported on Thursdays and will continue to be assigned to the appropriate date of death.
- Data about long-term care facilities, as well as the reports from partner agencies (Developmental Disabilities, Veteran’s Homes, Youth Services, Mental Health and Addiction Services and Rehabilitation and Corrections), will be published weekly on Thursdays.
- K-12 schools will no longer be required to report positive COVID-19 cases to their local health departments, unless the school tests a student for COVID-19 and the result is positive. In addition, the COVID-19 School Reporting dashboard will be archived.
For the first time since August 2021, the statewide average case number per 100,000 residents has dropped below 100, with an average of 78.2 cases per 100,000 people as of March 9. Nearly two-thirds of Ohio’s 88 counties are currently below 100 cases per 100,000 people.
This change also brings Ohio’s reporting system more in line with the Centers for Disease Control and Prevention (CDC), which recently introduced new benchmarks for assessing community risk, shifting away from using cases as the sole measure of risk. The new COVID-19 Community Levels assess data related to the proportion of hospital capacity devoted to caring for COVID-19 patients, the number of new patients with COVID-19 admitted to the hospital in the past week, and the number of new COVID-19 cases in a given county in the past week. These data tell us how much the virus is spreading in an area in the context of how many people in the area are getting sick enough to require hospitalization and the strain that’s placing on a community’s acute care safety net. This combination of factors determines the COVID-19 Community Level in a given county expressed in ranges of low, medium, or high. Layered prevention strategies are recommended for communities deemed high risk.
Staying up to date on COVID-19 vaccinations, including getting a booster dose when eligible, is the best form of protection against COVID-19. COVID-19 vaccinations are widely available throughout the state at no cost to Ohioans. Many providers offer walk-in appointments, or appointments can be scheduled using gettheshot.coronavirus.ohio.gov. Ohioans who want to learn more about the safety, efficacy, and side effects of COVID-19 vaccines should talk to their doctor, nurse, or pharmacist, or visit coronavirus.ohio.gov/vaccine.
Honoring Wishes Task Force networking call: March 23
Please mark your calendar for next week's networking call on Wednesday, March 23 at 8:00AM, when the HWTF will host Dr. Susan Hickman of the Indiana University College of Medicine, a nationally-recognized expert on advance care planning research. Dr. Hickman will respond to the recent JAMA article questioning the value of advance care planning. To register, click here. Please share this widely in your newsletters and network-- all are welcome on these monthly calls.
CMS releases application request for third year of MA-Hospice demonstration
On March 1, 2022, the Centers for Medicare & Medicaid Services (CMS) released the information for Medicare Advantage Organizations (MAOs) interested in participating in the Hospice Benefit Component of the VBID Model; the scope of the Hospice Benefit Component under the VBID model; specific quality, network, and payment policies being tested as part of the Hospice Component for CY2023; model requirements; an overview of the planned evaluation of the Hospice Component and the application process. Calendar year 2023 will be the third year of the model, which is expected to be conducted for a total of four years.
While the model has not undergone dramatic changes and the content of the CY2023 RFA closely tracks previous RFAs (i.e., the CY2021 and CY2022 RFAs), CMS has incorporated some notable changes. Of particular interest in the CY2023 RFA to stakeholders are the following:
- In keeping with CMS’ strategic priorities, the CY2023 RFA includes increased emphasis on advancing health equity under the model;
- Discussion of Medicare program waiver considerations to support the model;
- Additional clarity around the model’s goals related to the provision of palliative care outside of hospice care;
- A new Network Adequacy standard applicable to MAO Plan Benefit Packages (PBPs) with one year or more of experience under the model (mature-year PBPs); and
- A brief explanation of the “Learning System Strategy” (Section 5) under which CMS provides support for contracted hospices and participating MAOs under the model.
As has been the case in previous years, CMS has set a deadline of mid-April for MAOs to submit their applications to participate in the model. For the CY2023 model year, mature-year PBPs will be required to submit their provider networks for CMS review during the summer. Given the expectation that established MAOs will be required to establish networks by mid-year, an inquiry was sent to the CMS VBID staff to check as to when hospices should anticipate that mature-year PBPs and PBPs newly entering the program will likely be entering into contracts with hospices for the CY2023 model year.
To read the complete Medicare Advantage Organizations (MAO) release, please click here.
CMS webinar: Medicare Advantage Value-Based Insurance Design Model – 2023 Hospice Benefit Component Overview: April 5
The CMS Innovation Center will host an office hours session to discuss the Medicare Advantage Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component on April 5 from 3:00 - 4:00PM. Attendees will receive an overview of the Model and the CY 2023 application process and have an opportunity for questions and answers with the Model team.
Registration for this event is available here. The Office Hours Number for this call will be 2456 392 6777 and the password is Apphours405.
Bill to expand HCBS for veterans introduced in congress
Bipartisan legislation to ensure that veterans can receive care in their home for as long as possible has been introduced in the U.S. House of Representatives. The Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2022 (H.R. 6823) would expand and improve expand the home and community-based services (HCBS) programs within the Department of Veterans Affairs (VA), and align public policy with improved outcomes and patient choice, which is to stay in their own home.
This bill will make much needed improvements to the delivery of HCBS for veterans, enabling options in how and where they receive care, while also working to address workforce shortages and support family caregivers.
Specifically, this legislation would:
- Expand access to HCBS services for veterans living in US territories and to Native veterans enrolled in IHS or tribal health program.
- Raise the cap on how much the VA can pay for the cost of home care from 65% of the cost of nursing home care to 100%.
- Coordinate expanded VA home care programs with other VA programs.
- Establish a pilot project to address home health aide shortages.
- Providing respite care to caregivers of veterans enrolled in home care programs.
- Establish a “one stop shop” webpage to centralize information for families and veterans on programs available.
- Require the VA to provide a coordinated handoff for veterans and caregivers denied or discharged from the Program of Comprehensive Assistance for Family Caregivers into any other home care program they may be eligible for.
The legislation is led by Representatives Julia Brownley (D-CA) and Jack Bergman (R-MI). At introduction, Rep. Brownley stated, “Over half of all veterans that use VA are over the age of 65, age, combined with their unique health needs, makes many elderly veterans especially vulnerable to going into nursing homes and institutional care. Our nation’s veterans deserve the right to age comfortably and with dignity in their homes.
Short time frame to complete application for High School Health Care Preceptor Pilot
As shared in The Source last week, the Ohio Department of Education, in collaboration with the Ohio Department of Health, announced it will offer paid internships in health care fields to high school students via the High School Health Care Preceptor Pilot. These internships will provide mentors in the health care industry and create a career pathway for students to obtain CPR certification and industry-recognized credentials, such as STNA and the elder care certificate, as well as prepare students for health care education at the postsecondary level. The grant application will be available from March 7 to 21, 2022.
LeadingAge Ohio is aware that the application for this funding opportunity is not a simple one, and that this represents an extremely narrow window (March 7-21) to apply for this funding to support paid interns. If your organization has reviewed the application and is interested in participating but feels it may be a challenge to complete by next Monday, reach out to Patrick Schwartz at pschwartz@leadingageohio.org to discuss how LeadingAge Ohio might be able to assist in the process. LeadingAge Ohio aims to encourage partnerships between members and their local school systems, and to that end, lend administrative support to members wishing to pursue this grant, including research, writing and other tasks for preparing the grant.
The importance of aging services providers connecting to local schools, and to Business Advisory Councils (BACs) which support career education, cannot be overstated as we take on this historic workforce crisis together.
Details on the application process are provided here:
The application portal is now open available on the Ohio Department of Education's webpage. Targeted school districts include the following:
- Whitehall Local School District – IRN 045070;
- Groveport Madison School District – IRN 046979;
- Reynoldsburg City School District – IRN 047001;
- Ironton City School District – IRN 044149;
- Dayton City School District – IRN 043844;
- Toledo City School District – IRN 044909;
- Springfield Local School District – IRN 044818;
- Canton City School District – IRN 043711;
- Perry Local Schools – IRN 045781;
- Chillicothe City Schools – IRN 043745;
- Adena Local School District – IRN 049494;
- Federal Hocking Local School District – IRN 045914;
- Washington Court House City School District – IRN 045013;
- Cleveland Metropolitan School District – IRN 043786;
- Zanesville City School District – IRN 045179;
- Columbus City Schools District – IRN 043802.
The $380,760 in grant funding will be awarded to multiple entities to fund in-demand internship opportunities for high-risk, underserved ethnic minority and rural high school students in identified targeted districts. Each entity may be awarded between $10,000 and $80,000 maximum. Please be advised that providers do not need an IRN number to submit the completed application, letter of support, budget documents and appendices.
Eligible applicants include nonprofit health care organizations, health care providers (including community health centers - for example, federally qualified health centers), health care industry sector partnerships and career-technical planning districts. Applicants must identify and be willing to match students from a targeted school district with a preceptor.
Please follow instructions on the webpage to obtain a Unique Entity Identifier and to register as a supplier for the State of Ohio. This will be needed for reimbursement.
Interested applicants must be prepared to:
- Register for a Dun and Bradstreet number (DUNS) (Effective April 4, 2022 the US Government will transition from DUNS numbers to Unique Entity Idenditfiers (UEI)); and
- Register as a supplier for the State of Ohio.
Applicants may need to be prepared to:
- Obtain information retrieval numbers (IRN) from the Ohio Department of Education;
Register for an OH|ID account and a Department of Education Profile.
Ohio Assisted Living Association announces new Executive Director
Last Monday, the Ohio Assisted Living Association (OALA) announced Megan Kelley as the association’s new Executive Director. Megan will assume the role effective March 21.
Megan succeeds Jean Thompson, OALA’s first Executive Director, who provided excellent leadership and oversaw incredible membership growth until her recent retirement at the end of 2021. Jean will continue providing support and consultation to the Association.
Prior to her role as Executive Director, Megan spent nine years with National Church Residences, most recently serving as Vice President of Public Policy, Government Relations & Corporate Communications. In addition, Megan just completed a six-year term on the Ohio Ethics Commission. Prior to her work in senior living, she worked in private legal practice and in the Ohio legislature.
What the Media Said about end of life care this week – March 15, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Home Health and Hospice Newsletter: March 8, 2022
Home Health and Hospice Newsletter
In Today's Newsletter
- You asked... We answered regarding HB 138
- All Member Call: All things agency - TOMORROW at 11:30
- LeadingAge home health and hospice recap
- CDC proposes updates to controversial 2016 opioid prescribing guidelines
- Department of Labor announces $3.2M in grants for work safety, training on COVID, infectious diseases
- Department of Labor webinar to educate healthcare industry on wage laws: March 23
- PASSPORT, AL Providers get 59M in ARPA Funds
- LeadingAge Ohio Awards Program - Nominations Open!
- What the Media Said about end of life care this week – March 8, 2022
You asked... We answered regarding HB 138
You Asked:
Will HB 138 allow an EMS to follow a written DNR-CC and DNR-CCA orders from a nurse practitioner (NP) or physician assistant (PA)?
We Answered:
Yes. HB 138 has passed both the Ohio House and Senate, and is now back in the House to concur with Senate changes before it would go to the Governor for signature. Once signed, the bill would become law and would be effective in 90 days after signature. LeadingAge Ohio has been supportive of this bill and is encouraged that NP’s and PA’s may be able to sign DNRCC and DNR-CCA orders and have them honored soon. Please watch the LeadingAge Ohio Home Health and Hospice newsletter or the Source for additional updates.
All Member Call: All things agency - TOMORROW at 11:30
Join LeadingAge Ohio Chief Policy Officer Susan Wallace tomorrow, Wednesday, March 9 at 11:30AM in a discussion of high-level strategies to rein in staffing agency costs. She will review Ohio’s proposed HB466, a bill that would cap agency margins, require staffing agencies to be licensed, and implement quality and pricing controls. Aaron Barton of LeaderStat will share information about “Managed Services Provider” programs, a model for groups of provider to leverage their bargaining power in stabilizing agency rates.
The call is free to members but registration in advance is required. To have your question answered on the call, email it to COVID19@leadingageohio.org.
LeadingAge home health and hospice recap
Each week, LeadingAge provides a recap regarding home health and hospice. This week's edition features information on the Home Health Public Reporting Refresh that is coming this April.
CDC proposes updates to controversial 2016 opioid prescribing guidelines
On February 10, 2022, the Centers for Disease Control and Prevention (CDC) issued new proposed guidelines for prescribing opioids for acute, sub-acute and chronic pain. The clinical practice guideline updates and expands the CDC Guideline for Prescribing Opioids for Chronic Pain— United States, 2016, and provides evidence-based recommendations for clinicians who provide pain care, including those prescribing opioids, for outpatients age 18 years and older with acute pain (duration less than 1 month), subacute pain (duration of 1–3 months), or chronic pain (duration of 3 months or more).
The guideline explicitly EXCLUDES sickle cell disease-related pain management, cancer pain treatment, palliative care, and end-of-life care.
The clinical practice guideline includes recommendations for primary care clinicians (including physicians, nurse practitioners, and physician assistants) as well as for outpatient clinicians in other specialties (including those managing dental and postsurgical pain in outpatient settings and emergency clinicians providing pain management for patients being discharged from emergency departments).
This voluntary clinical practice guideline provides recommendations and does not require mandatory compliance; the clinical practice guideline is intended to be flexible so as to support, not supplant, clinical judgment and individualized, patient-centered decision-making.
As part of the guideline issuance, CDC is asking interested persons or organizations to submit written views, recommendations, and data. In order to be considered, written comments must be received on or before April 11, 2022. Instructions for submitting comments and various materials are available HERE; the revised guideline and other supporting materials are located in the “Enhanced Content” box in the lower right hand corner of the page.
A major area of concern associated with the 2016 guideline was the emergence of misapplication of the guideline by various state and local governments. In 2019, CDC issued a Media Statement on the 2016 guideline cautioning against:
- Misapplication of recommendations to populations outside of the Guideline’s scope;
- Misapplication of the Guideline’s dosage recommendation that results in hard limits or “cutting off” opioids;
- Abrupt tapering or sudden discontinuation of opioids; and
- Misapplication of the Guideline’s dosage recommendation to patients receiving or starting medication-assisted treatment for opioid use disorder.
These concerns, in part, led to issuance of the revised guideline that is currently under review.
Department of Labor announces $3.2M in grants for work safety, training on COVID, infectious diseases
The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) today announced the availability of $3.2 million in funds from the American Rescue Plan Act (ARPA) for Susan Harwood Workplace Safety and Health Training on Infectious Diseases, including COVID-19 grants.
The grants will fund training and education to help workers and employers identify and prevent work-related infectious diseases, including COVID-19. Training topics must focus either on COVID-19 specifically or infectious diseases broadly. The maximum awarded for each grant is $160,000 for a 12-month performance period.
This funding opportunity is separate from the fiscal year 2022 Susan Harwood training grants for Targeted Topic, Training and Educational Materials Development, and Capacity Building. Successful applicants may receive an FY 2021 and/or FY 2022 Harwood training grant (i.e., a Targeted Topic Training, Training and Educational Materials Development, or one of the Capacity Building grants) and a Workplace Safety and Health Training on Infectious Diseases, including COVID-19 grant in the same year.
The Harwood Training Grant program supports remote and in-person hands-on training for workers and employers in small businesses; industries with high injury, illness, and fatality rates; and vulnerable workers, who are underserved, have limited English proficiency, or are temporary workers.
Learn more about the funding and applying for grants by clicking here. Providers may submit applications for Harwood grants online no later than 11:59PM on May 6.
Submit applications for Harwood grants online no later than 11:59PM on May 6.
Starting April 4, the Data Universal Numbering System number will be replaced by a new, non-proprietary identifier requested in, and assigned by, the System for Award Management. This new identifier is called the Unique Entity Identifier.
OSHA awards grants to nonprofit organizations, including community and faith-based organizations, employer associations, labor unions, joint labor/management associations, Native American tribes, and local and state-sponsored colleges and universities to provide infectious disease workplace safety and health training.
Department of Labor webinar to educate healthcare industry on wage laws: March 23
Careworkers put in long hours tending to the vital needs of people in their homes and at health care facilities, yet they are among the nation’s lowest paid workers. Their jobs are made even more difficult when employers fail to pay them all their rightfully earned wages.
As part of U.S. Department of Labor efforts to build better jobs and increase pay equity, the department’s Wage and Hour Division regional office in Chicago will host a webinar on March 23 from 8:00 - 10:00AM titled, “Midwest Care Workers Summit 2022.” Registration is available by clicking here.
The virtual summit brings together industry stakeholders from Illinois, Indiana, Iowa, Kansas, Nebraska, Ohio, Michigan, Minnesota, Missouri and Wisconsin for an in-depth discussion about issues affecting federal labor law compliance within the health care industry in the Midwest.
“We want to hear directly from stakeholders in the healthcare industry about what the Wage and Hour Division can do to enhance their understanding of federal wages laws, provide resources and ensure essential healthcare workers are receiving the wages they are due,” said Wage and Hour Regional Administrator Michael Lazzeri in Chicago. “The healthcare industry has faced relentless challenges throughout the pandemic, and the Wage and Hour Division is committed to taking better take care of those who take care of us.”
Investigations by the Wage and Hour Division recovered more than $22.7 million for Midwest healthcare workers from 2019 to 2021 as a result of violations of worker protections under the Fair Labor Standards Act.
Building on the progress made with the Essential Workers - Essential Protections Initiative, the Wage and Hour Division embarked on a series of steps to increase communication between healthcare employers and the federal agency. They conducted more than 70 listening sessions with over 500 stakeholders across 50 cities nationwide.
For more information about the FLSA and other laws enforced by the Wage and Hour Division, contact the division’s toll-free helpline at 866-4US-WAGE (487-9243). Calls can be received confidentially in over 200 languages.
Learn more about the Wage and Hour Division, including a search tool to use if you think you may be owed back wages collected by the division.
PASSPORT, AL Providers get 59M in ARPA Funds
Story shared from Hannah News Service.
Home and community-based providers of long-term care services will begin receiving federal American Rescue Plan Act (ARPA) funds as early as this week, the Ohio Department of Aging (ODA) announced Monday.
The funding for the PASSPORT program and assisted living providers is intended to help them continue to respond and adapt to COVID-19 and ensure quality care for older Ohioans, ODA Director Ursel McElroy said in a news release. A total of $59 million is expected to be distributed for these services.
Gov. Mike DeWine officially signed an executive order making the funding available on March 1. The order is available at www.hannah.com >Document Collections>Legal>Executive Orders.
PASSPORT is an Ohio Department of Medicaid (ODM) waiver program operated by ODA that allows people with Medicaid who would otherwise require the types of care provided in a nursing home to receive that assistance in their homes at a fraction of the cost.
Assisted living providers with beds licensed by the Ohio Department of Health, including all providers participating in ODA’s Assisted Living Waiver program, are eligible for payments of $500 per bed. These payments are being distributed through a grant application process managed by the Ohio Office of Budget and Management (OBM) and supported by the ODA and ODM. On March 3, ODA and its partners hosted a webinar to give assisted living providers step-by-step instructions to apply for the payments. A recording of the webinar and additional information and resources are available on the department’s website at www.aging.ohio.gov/arpa-funding.
LeadingAge Ohio Awards Program - Nominations Open!
The LeadingAge Ohio Awards Program celebrates exemplary work of the individuals and organizations within our membership on an annual basis. COVID’s relentless impact makes honoring innovations by staff and volunteers more important than ever. Check out the 2021 award tributes here.
Nominations for this year’s awards are officially open and include nine different categories. With many opportunities to recognize staff and volunteers, please spread the word about the Awards Program to get the nomination process started.
Visit the Annual Awards webpage on the LeadingAge Ohio website under the About header within the Recognition & Awards section to access the award descriptions/nomination forms by category.
Questions regarding the annual Awards Program can be directed to Patrick Schwartz, Director of Strategic Communications, pschwartz@leadingageohio.org.
What the Media Said about end of life care this week – March 8, 2022
Throughout the pandemic, hospice and end-of-life care has been discussed across the country. LeadingAge Ohio reviews articles and media each week to share with our members.
Provider/Setting Specific
PROVIDER OR SETTING-SPECIFIC RESOURCES
Adult Day/PACE/Senior Centers
Affordable Housing
COVID-19 Update and Discussions for Affordable Housing Call Notes [Members Only]
September 23 | September 1 |August 19 |August 5 |July 1 |July 1 | June 24 | June 17 | June 10 | June 3 | May 27 | May 20 | May 13 | May 6 | April 29 (includes PPT and resource links) | April 22 | April 8 | April 1 | March 18
Assisted Living Communities
Home Health
Hospice
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Nursing Homes
You Asked... We Answered
You asked... We Answered
Can a facility request an 1135 waiver to use plastic barriers to mitigate the spread of COVID-19, since CMS has ended the COVID-19 waiver allowing for temporary barriers?
Read More >You asked... We Answered
Is there guidance on what type of eye protection can be worn? Our facility has several different types and we want to ensure we are only using what is recommended.
Read More >You asked... We Answered
Does a facility have to move a COVID-19 positive resident to a designated COVID isolation unit, or can a facility choose to shelter them in place? Our facility is not seeing large outbreaks like at the beginning of the pandemic and we feel we can staff better if we keep them in their current room versus re-opening an entire unit.
Read More >You asked... We Answered
Does a facility have to move a COVID-19 positive resident to a designated COVID isolation unit, or can a facility choose to care for them in place?
Read More >You asked... We Answered
Is an employee who has received two doses of their primary series vaccine but is not yet eligible for the booster considered up-to-date, or does the employee have to be routinely tested according to the routine testing schedule outlined in the CMS QSO-20-38-NH memo?
Read More >You asked... We Answered
Does the medical waste or general waste (trash) from healthcare facilities treating COVID-19 positive individuals have to be handled as if it is biohazardous waste?
Read More >You asked... We Answered
The Centers for Disease Control and Prevention (CDC) webpage has information on both the COVID-19 county level and community transmission level. Which one should I be following to determine universal source control, relaxing of restrictions, and testing?
Read More >You asked... We Answered
Has there been any additional clarification on how the HB 169 funds can be used by nursing facilities? Specifically, is there a timeframe within which we can use them? What is the definition of “direct care”?
Read More >You asked... We Answered
How long should a facility leave a resident room empty after a COVID positive resident leaves that room?
Read More >You asked... We Answered
I received our relief payment through MITS last week, and remember that there were restrictions requiring nursing facilities to spend the funds on direct care. Can you remind me what the rules were around how nursing homes could spend the relief funds through Medicaid?
Read More >You asked... We Answered
Are nursing facilities able to immediately stop using eye protection as universal source control once the community transmission level drops to a moderate to low level or do we have to wait two weeks as required for testing?
Read More >[Duplicate] You Asked... We Answered 2/10/22
After the phase 2 deadline of March 15, 2022, do new hires need to have their vaccination series completed before providing care or can just be starting?
Read More >You Asked... We Answered
Will a facility be cited if they are above the 90% threshold of staff vaccination but has a plan to achieve a 100% staff vaccination rate within 30 days of the March 15 phase two deadline?
Read More >You Asked... We Answered 3/8/22
Will HB 138 allow an EMS to follow a written DNR-CC and DNR-CCA orders from a nurse practitioner (NP) or physician assistant (PA)?
Read More >You Asked... We Answered 3/1/22
Have transmission-based precautions been reduced from 14 days to 10 days for individuals being cared for in healthcare settings, including home health?
Read More >You Asked... We Answered 3/1/22
Regarding our hospice inpatient unit (IPU), we have patients being transported to and from our IPU via ambulance. These are not emergency transports. I was initially told that we did not need to ensure compliance of the ambulance staff having COVID-19 vaccines as they fell under emergency services, but just this morning was told that we should have verification of the compliance of each ambulance staff member entering our hospice inpatient unit. What is your take on this?
Read More >You Asked... We Answered 2/22/22
We have been conducting our Interdisciplinary Group (IDG) meetings virtually since the beginning of the pandemic. I am wondering what ODH is requiring for proof of attendance at these virtual IDG meetings. Our team leaders overseeing the IDG meeting is documenting the names of the individuals in attendance at the meeting and then signing their name to attest to the fact the person was at the meeting. Is that good enough?
Read More >You Asked... We Answered 2/17/22
Are facilities required to maintain the vaccination records onsite for all contracted vendors?
Read More >You Asked... We Answered 2/15/22
Is the Election Statement Addendum and the Patient Notification of Hospice Non-Covered Items, Services and Drugs required for Medicaid like it is for Medicare?
Read More >You Asked... We Answered 2/10/22
After the phase 2 deadline of March 15, 2022, do new hires need to have their vaccination series completed before providing care or can just be starting?
Read More >You Asked... We Answered 2/3/22
Is there new guidance for testing residents during outbreak testing or new symptoms? Does this new testing guidance allow residents to be removed from quarantine sooner?
Read More >You Asked... We Answered 2/1/22
When there is a larger hospice patient, for safety reasons we need to send 2 hospice aides to the home at the same time to assist the patient with bathing or getting the patient out of bed. How should those visit frequencies be listed on the plan of care? Should visit frequency be listed as 1 visit 3 times a week (in other words, 3 visits a week) or 2 visits 3 times a week (in other words, 6 visits a week)?
Read More >You asked... We answered 1/27/22
We are trying to figure out when we can bring a healthcare worker that was exposed back to work. Is a healthcare worker considered up to date if they are fully vaccinated but not boosted? It has only been three months since this worker had their second vaccine dose, so they are not eligible yet to have their booster dose.
Read More >You Asked... We Answered 1/13/22
Is there guidance on when a facility can use mitigation staffing strategies?
Read More >You Asked... We Answered 1/6/22
Should nursing homes and assisted living facilities use the Regional Rapid Response Assistance Program (R3AP) for help accessing oral antiviral therapies, similar to the process for monoclonal antibody therapies?
Read More >You Asked... We Answered 12/22/21
We have a resident who wants to use a humidifier. Is there any guidance about humidifiers related to COVID-19?
Read More >You Asked... We Answered 12/9/21
Is health screening still required, and is it required to be handled by an individual such as a receptionist 24/7? We ask due to the relaxing of the visitation guidance.
Read More >You Asked... We Answered 12/7/21
I was reading the Ohio rules for hospice. The inpatient respite length of stay stood out to me. Ohio law states no more than seven consecutive days, where I understood respite to be no more than five nights and on day six would be paid at the routine homecare rate. Has something changed?
Read More >The Source Newsletter 2022
- The Source: Thursday, June 30, 2022: 2022-06-30
- The Source: Thursday, June 23, 2022: 2022-06-23
- The Source: Thursday, June 16, 2022: 2022-06-16
- The Source: Thursday, June 9, 2022: 2022-06-09
- The Source: Thursday, June 2, 2022: 2022-06-02
- The Source: Thursday, May 26, 2022: 2022-05-26
- The Source: Thursday, May 19, 2022: 2022-05-19
- The Source: Thursday, May 12, 2022: 2022-05-12
- The Source: Thursday, May 5, 2022: 2022-05-05
- The Source: Thursday, April 28, 2022: 2022-04-28
- The Source: Thursday, April 21, 2022: 2022-04-21
- The Source: Thursday, April 14, 2022: 2022-04-14
- The Source: Thursday, April 7, 2022: 2022-04-07
- The Source: Thursday, March 31, 2022: 2022-03-31
- The Source: Thursday, March 24, 2022: 2022-03-24
- The Source: Thursday, March 17, 2022: 2022-03-17
- The Source: Thursday, March 10, 2022: 2022-03-10
- The Source: Thursday, March 3, 2022: 2022-03-03
- The Source: Thursday, February 24, 2022: 2022-02-24
- The Source: Thursday, February 17, 2022: 2022-02-17
- The Source: Thursday, February 10, 2022: 2022-02-10
- The Source: Thursday, February 3, 2022: 2022-02-03
- The Source: Thursday, January 27, 2022: 2022-01-27
- The Source: Thursday, January 20, 2022: 2022-01-20
- The Source: Thursday, January 13, 2022: 2022-01-13
- The Source: Thursday, January 6, 2022: 2022-01-06
Regulations
Quality
Need Help?
Susan Wallace, MSW, LSW
President / CEO
614-545-9024
swallace@leadingageohio.org
- Staff oversight, fiscal & operations of organization
- Primary contact for policy priority development & advocacy
- Staff liaison to Advocacy Committee, Nursing Facility/Assisted Living Reimbursement, Billing/eligibility and Clinical/ Operations Subcommittees
Stephanie DeWees, HSE, LPN, LNHA, BS
Quality & Regulatory Specialist - Long Term Care
614-545-9034
sdewees@leadingageohio.org
- Supports planning and execution of the association's education initiatives for long term care
- Provides resources for quality and regulatory strategies
- Offers 911 survey support
- Facilitates networking opportunities through regional events
- Provides training on state and national trends, initiatives and enforcement
- Staff liaison to Professional Development Committee and SNF/AL Subcommittee
Anne Shelley, MBA, BSN, RN
Director of Home Health/Hospice Regulatory Relations
614-545-9030
ashelley@leadingageohio.org
- Reviews state and federal policies and regulations and provides technical and regulatory support to Home Health and Hospice members
- Works with state and federal agencies and regulatory bodies to develop policy and rules for the home health and hospice industry
- Provides education for hospice and palliative care providers related to regulatory and operational issues
2233 North Bank Drive, Columbus, OH 43220
Phone: (614) 444-2882 | FAX (614) 444-2974
info@leadingageohio.org