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Cabinet for Health & Family Services
Office of Inspector General
Division of Health Care
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Home Health Agency Newsletter
January 2020
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OIG Welcomes New Inspector General
Kentucky Cabinet for Health and Family Services (CHFS) Acting Secretary Eric Friedlander has announced that Adam Mather has been appointed the agency’s Inspector General. Friedlander said Mather is an excellent choice to serve in the job. “Adam brings leadership and attention to detail to the position of Inspector General, and he will ensure accountability and integrity throughout our regulatory operations,” he said.
Prior joining CHFS, Mather worked with several long-term care companies based out of Louisville. He is a graduate of Louisville’s Ballard High School where he played football. He received a Bachelor of Science in Nursing from Georgia State University and currently holds a registered nurse (RN) license. He will be attending Cornell University this spring to work on a Master of Health Administration degree.
Mather said he wants to ensure public confidence in his office. “The Cabinet’s Office of Inspector General (OIG) and all our staff across the state are crucial partners in protecting the health, safety and welfare of the citizens of the Commonwealth,” he said. “I am so pleased to join Secretary Friedlander and specifically this OIG team and to contribute to its mission of assuring the safety of all Kentuckians who use our all health care facilities.”
Click
HERE
for the official press release.
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Guide to Home Health Help Desks
A comprehensive 1-page guide to Home Health help desks is now available in the downloads section of the
Home Health Quality Reporting Program Help Desk
webpage. This document provides guidance to home health providers for questions related to a variety of topics such as compliance, Home Health Compare (HHC) star rating, iQIES and others and directs them to the help desk that will be most appropriate to answer their question. Contact information for each help desk is provided.
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OASIS 2.31.0 Details
iQIES incorporated the OASIS 2.31.0 data specifications that were effective January 1, 2020. The specification changes include updates to accommodate the new Functional Impairment Level Case-Mix Adjustment under the Patient Driven Groupings Model, or PDGM, as items that were previously inactive for Reason for Assessment 04 and 05 will now be active for assessments with a M0090 Completion Date of January 1, 2020 or greater. These two items are: M1800 Current Grooming, and M1033 Hospital Risk Items History of Falls through None of the Above. Also taken into account is the transition to PDGM for payment calculation; as a result, the Health Insurance Prospective Payment System (HIPPS) Group Code and HIPPS Version Code are no longer required for submission for assessments with a M0090 date of January 1, 2020 or greater. It is important to note that the transition period for accepting the Health Insurance Claim Number (HICN) or Railroad Retirement Board (RRB) number ended on December 31, 2019. After January 1, 2020, only the Medicare Beneficiary Identifier (MBI) will be accepted and providers will no longer be able to submit a HICN on assessment submissions or claims.
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Kentucky Health Survey Registry
(Annual Utilization Surveys)
The Kentucky Annual Utilization Surveys are being released on January 30, 2020. The deadline has been extended March 30, 2020. The delay is due to system and security upgrades. All licensed Long Term Care facilities and Home Health providers are required to report. These include Nursing Facility, Personal Care, Nursing Home, Alzheimer, Intermediate Care and ICF/IID beds. Additionally, MRI, PET, Megavoltage Radiation, Hospice, Hospital, Chemical Dependency and Psychiatric Residential Treatment Facility, services are required to report. Reporting of the data is required by 900 KAR 6:125.
Any request for an extension of the deadline must go through Elizabeth Tutt, Survey Administrator and Heatlhcare Data Analyst. You may contact her by
email
or by calling (502) 564-7940 Ext. 3156. For survey completion go to
https://prdweb.chfs.ky.gov/OHPSurvey/
to submit data. The facility license number is the login and the facilities should create their own password the first time they long in each year.
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OASIS Record Processing
The OASIS submissions portion of the QIES Assessment Submission and Processing (ASAP) system is no longer available. Effective January 1, 2020, all Home Health Agencies (HHAs) are required to submit OASIS records to the internet Quality Improvement and Evaluation System (iQIES) at:
https://iqies.cms.gov
.
Note: It is recommended that users access iQIES using Chrome or an Internet browser alternative to Internet Explorer.
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HHA Reports in iQIES
User
‐
requested HHA Provider and OASIS Quality Improvement reports will be iteratively available to users in iQIES as the reports are developed. The reports listed below are currently available for providers in iQIES:
- OASIS Agency Final Validation Report
- OASIS Submitter Final Validation Report (Note: this report can only be requested by the iQIES user ID who submitted the OASIS records to iQIES)
- OASIS Error Detail
- OASIS Error Summary By Agency
- HHA Discharges
- HHA Activity Report
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OASIS Quality Improvement Reports
There is currently one OASIS Quality Improvement report available in iQIES:
HHA Review and Correct Report:
- A calculation issue was identified with the “Application of Percent of Long‐Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function (NQF #2631)”measure on this report. A fix for this issue is underway.
- Patient‐level results for this report are available in the Comma Separated Values (CSV) file only; patient‐level results will be available in the Portable Document Format (PDF) in a subsequent release.
Three HHA Provider reports and all other OASIS Quality Improvement reports continue to be available in the CASPER Reporting application until the corresponding reports are available in iQIES. Once the reports are available in iQIES, the same reports in CASPER will no longer be available. Data in the HHA Provider reports in CASPER are reflective of OASIS submissions to the QIES ASAP system
through December 27, 2019.
Note: The iQIES OASIS Quality Improvement reports will support display of quality measure data with a reporting period end date of Q4, 2018 (October 1, 2018) forward. If users require quality measure data for older time periods, users are encouraged to request and download the reports while they are still available in CASPER.
The December 2019 HHA Provider Preview report for the April 2020 Home Health Compare Refresh and the HHA Quality Assessments Only (QAO) report are currently available in each home health agency’s shared folder in CASPER during the 30
‐
day provider preview period.
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New Regulation Changes for Private Duty Nursing Agencies
On December 9, 2019, the Health, Welfare, and Family Services committee approved several new changes to 902 KAR 20:370, the private duty nursing (PDN) agency regulation. A significant change was the addition of a new requirement for currently licensed home health agencies that are not Medicare-certified to convert to licensure as a PDN agency within 90 days of the effective date (12/9/19) of the administrative regulation.
This new change helps ensures compliance with the definition of “home health agency” as established by KRS 216.935(2), state law that requires federal certification for Kentucky-licensed home health agencies. A new certificate of need will not be required for home health agencies that convert to a PDN license. The Office of Inspector General will send a follow-up letter to all uncertified home health agencies affected by this change.
For a summary of other important changes to the PDN regulation, please refer to the following:
- Revised the definition of “private duty nursing services” and “skilled nursing services” so that in addition to continuous care, patients who are in need of part-time or short-term skilled nursing services may receive such services by a PDN agency.
- Eliminated the requirement for PDN services to be provided to patients at least four (4) hours per visit.
- Added a requirement for PDN services to be ordered and directed by the patient’s treating practitioner or specialist after a face-to-face evaluation, which may be a telehealth encounter.
- Replaced “medical director” with “clinical director” to allow for either a physician or an advanced practice registered nurse to serve as the PDN agency’s clinical director, and clarified that the clinical director is responsible for overseeing the clinical activities of the agency.
- Clarified that PDN agencies provide services only in community-based settings such as the patient’s temporary or permanent place of residence, including the patient’s home or outside the patient’s home, as necessitated by normal life activities.
- Added clarifying language to prohibit PDN agencies from seeking Medicare-certification.
- Eliminated the requirement for a description of linkages with inpatient facilities and other providers.
- Added clarifying language so that policies regarding the delivery and supervision of patient care must be developed by a group of professional health providers that includes at least one physician or one registered nurse instead of being developed by a group of providers that includes both a physician and a registered nurse.
- Added a prohibition against employment if a prospective employee is found on the nurse aide or home health aide abuse registry, caregiver misconduct registry, or child abuse/neglect registry, or has certain criminal convictions.
- Added a requirement for each licensed nurse to provide services that are commensurate with the nurse’s educational preparation and clinical competence, address the nursing needs of the patient, and are delivered in accordance with the patient’s plan of treatment.
- Added a requirement for compliance with HIPAA.
- Added a new Section 8 to require all new PDN agencies to become accredited within one year from the date of provisional licensure, and all currently licensed PDN agencies to become accredited within one year from the effective date of this administrative regulation, if the agency is not already accredited.
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Quarterly OASIS Q&As
October 2019 OASIS Q&A’s are available in the OASIS Quarterly Q&As section of the CMS
QTSO
webpage.
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Home Health Quality Reporting Data Submission Deadlines
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Home Health Quality Measures
As part of the Measures Management initiative, CMS announces that we they simplifying the number of measures reported to home health agencies (HHAs) in the on-demand Tally Reports. Beginning in January 2020, they will be removing the following the previously retired measures from the Tally Reports:
- Improvement in Grooming
- Improvement in Toileting Hygiene
- Improvement in Eating
- Improvement in Urinary Tract Infection
- Stabilization in Cognitive Functioning
- Improvement in Anxiety Level
- Stabilization in Anxiety Level
- Improvement in Behavior Problem Frequency
- Emergency Department Use with Hospitalization
- Depression Interventions Implemented During All Episodes of Care
- Treatment Of Pressure Ulcers Based On Principles Of Moist Wound Healing For All Episodes
- Drug Education on High Risk Medications Provided to Patient/Caregiver SOE
- Falls Prevention Steps Implemented For All Episodes
- Pressure Ulcer Prevention Implemented All Episodes
- Pain Interventions Implemented During All Episodes
Specifications for the quality measures and standardized patient assessment data elements for the HH QRP finalized through the CY 2020 HH PPS Final Rule are now posted. The specifications document provides detailed information on the new and updated measures: Transfer of Health Information to Provider–Post-Acute Care (PAC), Transfer of Health Information to Patient–Post-Acute Care (PAC), and Discharge to Community–Post-Acute Care (PAC) HH QRP. The standardized patient assessment data elements and evidence of support for these data elements are also detailed in the specifications document.
The new and modified sections of the OASIS, along with a change table, effective January 1, 2021, for the measures and standardized patient assessment data elements finalized for the HH QRP in the CY 2020 HH PPS Final Rule are also posted. The specifications, mockups and change table can be found in the Downloads section of the
HH Quality Measures webpage
.
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jHAVEN v1.4.1
jHAVEN (Home Assessment Validation and Entry System) v1.4.1, currently available under the Download section at the bottom of the
jHAVEN
webpage It is strongly recommended that you use Chrome to download the jHAVEN application. If using Internet Explorer, you may receive a pop-up message warning that the application you are about to install is “…an unrecognized app” and Windows has prevented the app from starting or that the signature is invalid. If you do receive a warning message like this, you can still complete the installation by either right-clicking on the jHAVENSetup…exe, or selecting “More info”, where you will have the option to “Run anyway”. Once you select to run, the install process will complete as usual.
jHAVEN v1.4.1 includes the following enhancements:
- v8219 of the Home Health PPS Grouper (effective 10/01/2019)
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OASIS Answers Home Health Training Webinars
The OASIS Answers, Inc. (OAI) "Just in Time" monthly home health training webinars are designed to provide the most innovative training to your clinicians, clinical leaders, quality improvement teams and auditors. These sessions will ensure that you are aware of and know how to apply the most recent, most relevant, and most accurate CMS home health information. Monthly topics are based on the issues that are most pertinent to agencies for the month and will be driven by CMS updates or changes that are critical to agency success.
Upcoming sessions are available in either a Live or Recorded format. Previously aired webinars are offered as a recording only. Take a peek and see how the OASIS Answers' webinar series can supplement your organization's training!
Click
HERE
for to reserve your spot!
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Interested in Serving on an IDR Panel?
Kentucky requires one member of the IDR panel to be "a person currently engaged in the provision of Home Health Agency services who has no affiliation with the provider disputing a deficiency." Typically, a Home Health Agency Director is on each IDR panel. There is no payment or travel reimbursement for a Director serving on a panel. Directors will be rotated. If a
Home Health Agency Director
is interested in serving on a panel, a confidentiality statement must be signed prior to the participation in the first IDR panel.
Chrystal Daugherty, IDR/IIDR Coordinator
Office of Inspector General
116 Commerce Ave.
London, KY 40744
Fax: (606) 330-2054
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Home Health Agency Questions and Answers
Home Health Agency (HHA) Providers can access the Home Health and OASIS Q&As and other reference manuals on the
HHA Providers Reference site
.
These Questions and their responses have been developed over many years of experience training OASIS coordinators and are currently used as part of the Home Health Agency Surveyor Training program. They can and should be used by home health agency providers in training new staff on the basics of OASIS and also as a refresher for existing staff.
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OASIS Answers, Inc.
is a team of experienced nursing and therapy professionals who concentrate their skills, experience and passion to meet the needs of clients at the state association, federal government, quality improvement organization, private industry, and individual provider levels.
Click here
for the latest information on their webinars.
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OASIS CONTACT INFORMATION
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Chrystal Daugherty
Assessment/Coding Questions
Rhonda Littleton-Roe
Transmission or Technical Questions
Sam Crossfield
HHA Licensing or Regulation Questions
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Please note:
Do not send any identifiable patient information through e-mail. This includes patient names, SSNs, dates of birth or any other data items considered identifiers or Protected Health Information (PHI) under HIPAA. Please redact any PHI prior to sending.
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OASIS Data Specifications
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KARES
To enroll in KARES voluntarily, please click the icon above and follow the self-directed enrollment process.
For additional information about the program, please contact the help desk at (502)564-2159 or
via email
.
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Click here
to visit the website or
click here
for guidance on how to verify and update home health demographic data.
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Reporting Complaints
Email addresses have been established for use by patients and the general public to report possible violations of regulatory requirements.
Click Here
for the email addresses and additional contact information based on the facility's location.
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Which Branch
is Serving You?
To provide the highest level of service, the Division of Health Care operates through four regional offices. Knowing the appropriate Branch to contact with questions and concerns will ensure you receive maximum service in minimum time. Review links below for detailed information.
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CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
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Medicare Learning Network
Let the Medicare Learning Network (MLN) be your home for Centers for Medicare & Medicaid Services (CMS) education, information, and resources.
Visit the
Medicare Learning Network
for free educational materials for health care professionals on CMS programs, policies, and initiatives.
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QSEP: Quality, Safety & Education Portal
The Centers for Medicare & Medicaid Services (CMS) Quality, Safety & Oversight Group (QSOG) Quality, Safety & Education Division launched the
Quality, Safety & Education Portal (QSEP)
on January 6, 2020. QSEP is a replacement of the Integrated Surveyor Training Website (ISTW), providing a user-centered, self-service training portal that makes it easier than ever to take control of surveyor training via training plans and improved reporting.
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Want to Know the Top 10 Citations for Home Health Agencies?
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Employment Opportunities
To search and apply for positions within the Office of Inspector General, please visit the Kentucky Personnel Cabinet's web page by clicking the sign above.
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DHC Leadership Team:
Inspector General
V
acant
Deputy Inspector General
Director
Assistant Director
Vacant
Assistant Director
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Commonwealth of Kentucky | Office of Inspector General | 275 East Main St., Frankfort, KY 40621
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The Office of Inspector General is the regulatory and licensing agency for all health care, day care and long-term care facilities and child adoption/child-placing agencies in the commonwealth.
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