You're receiving this email because of your relationship with the Office of Inspector General, Division of Health Care. Thank you for your continued commitment to serving the citizens of our Commonwealth!
Cabinet for Health & Family Services
Office of Inspector General
Division of Health Care
|
|
Home Health Agency Newsletter
December 2019
|
|
Obtain Access to iQIES Before December 23, 2019
The Quality Improvement and Evaluation System (QIES), which providers and vendors use to submit assessment data, is being upgraded to make the system more reliable, scalable, secure, and accessible. The enhancements will occur in phases (by provider type) and began with Long- Term Care Hospitals (LTCHs) in March 2019, followed by Inpatient Rehabilitation Facilities (IRFs) in October 2019 and Home Health Agencies (HHAs) in January 2020. The enhanced system is referred to as the Internet Quality Improvement and Evaluation System (iQIES).
The rollout of iQIES will not require providers or vendors to change current processes related to submission of data. However, iQIES will require a new user management system because virtual private network (VPN) and CMSNet are no longer needed to access this system.
All users will have to create an account and establish credentials
in the Healthcare Quality Information System (HCQIS) Access, Roles and Profile system (HARP). HARP is a secure identity management portal that the Centers for Medicare & Medicaid Services (CMS) provides.
Through HARP, the level of access for iQIES will be similar to the roles that exist in QIES but with the addition of a Provider Security Official (PSO). The individual designated as the PSO will be responsible for approving or rejecting iQIES user access requests for their respective organizations, including vendors. For your organization to receive access to iQIES, you must first identify a PSO. For instructions on obtaining access to iQIES, descriptions of the iQIES roles applicable to HHAs and important iQIES information, please refer to the following link:
https://qtso.cms.gov/news-and-updates/register-iqies-account-action-required-1
.
Please note that at this time, only certified Home Health Agencies will be onboarded to iQIES. For questions, please contact our service desk at:
help@qtso.com or by phone: 800-339-9313.
***Although onboarding for HHAs is in progress, iQIES assessment submission functionality for HHAs will not be available until January 1, 2020. Although this functionality will not be available immediately, we encourage HHA security officials to request access to iQIES as soon as possible. CMS advises that HHAs register two security officials, if possible, as doing so will allow for a smoother transition prior to the January go live date. Upon receiving access, security officials will have access to ‘My Profile’ and ‘Help’ in iQIES.
Please note that failure to obtain access to iQIES prior to December 23, 2019, will impact your ability to submit assessment data needed for payment purposes, as the system will have a scheduled downtime so that the data migration can occur in preparation for the January 1, 2020, release. Claims that cannot be matched to assessments will be returned to the HHA, preventing Medicare payment.
|
|
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.
|
|
OASIS Considerations or Medicare PDGM Patients - Transition
A resource to assist agencies with OASIS considerations during the PPS to PDGM transition is now available in the Downloads section of the
OASIS User Manuals webpage
.
This document
provides PDGM transition guidance including OASIS time point, data set version and M0090 Date Assessment Completed considerations for patients where resulting assessments must provide the Health Insurance Prospective Payment System (HIPPS) code for a PDGM payment period that begins January 1, 2020 or later.
|
|
Special offer for 2020! Purchase all four 2020 OASIS Update Quarterly Teleconferences and you'll receive a
FREE 2020 INSTANT OASIS Answers book for OASIS-D1
. Assure that you and/or your entire in-house staff are up to date on the latest OASIS data collection rules. Offer expires 1/22/2020. Free INSTANT OASIS Answers book is estimated to ship in December 2019.
|
|
Quarterly OASIS Q&As
October 2019 OASIS Q&A’s are available in the OASIS Quarterly Q&As section of the CMS
QTSO
webpage.
|
|
Home Health Quality Reporting Data Submission Deadlines
|
|
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
.
|
|
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)
|
|
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!
|
|
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
|
|
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.
|
|
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.
|
|
|
|
OASIS CONTACT INFORMATION
|
Chrystal Daugherty
Assessment/Coding Questions
Rhonda Littleton-Roe
Transmission or Technical Questions
Sam Crossfield
HHA Licensing or Regulation Questions
|
|
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.
|
|
OASIS Data Specifications
|
|
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
.
|
|
Click here
to visit the website or
click here
for guidance on how to verify and update home health demographic data.
|
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.
|
|
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.
|
|
CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
|
|
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.
|
|
ISTW: Integrated Surveyor Training Website
This CMS website provides training information to include the preceptor manual, the State Operations Manual and other documents. As always, the survey and certification process is a collaborative effort between CMS and providers. This website will allow providers the opportunity to take the same courses as surveyors.
|
|
|
|
Want to Know the Top 10 Citations for Home Health Agencies?
|
Sign Up for This Newsletter
If you have received a copy of this newsletter from a friend or co-worker, you can click on the Sign Up button to enter your information and join our mailing list.
|
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.
|
|
DHC Leadership Team:
Vacant
Inspector General
V
acant
Deputy Inspector General
Director
Assistant Director
Vacant
Assistant Director
|
|
Commonwealth of Kentucky | Office of Inspector General | 275 East Main St., Frankfort, KY 40621
|
|
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.
|
|
|
|
|
|
|
