ACHC Surveyor Oct. 2013 | Page 8

THE SURVEYOR I FALL 2013 PROGRAM UPDATES [ HOME HEALTH ] [ The Centers for Medicare and Medicaid Services (CMS) recently stated that the Home Health & Hospice Aide Plans of Care CANNOT use “PRN” or “per patient request” for ANY task, whether specifying personal care or non-personal care. Use of “PRN” or “per patient request” in a patient record must be cited as a def iciency during an on-site survey. Multiple types of care can only be used when it has been documented by the nurse that the patient/caregiver has the ability to functionally and cognitively make the choice. Aide Plans of Care must be individualized and refrain from using blanket statements like “patient is cognitively and functionally able to make the choice” for all patients and tasks. If patients are requesting a specific type of care as a result of changes in their condition, Aides must still contact their supervisor prior to administering care. For additional information about this update please see achc.org/CMS. [ HOSPICE ] The 2013 work plan released by the Office of the Inspector General (OIG) highlights two areas of focus to reduce fraudulent or inappropriate claims: Marketing practice and financial relationships with nursing facilities The OIG recently found that 82% of hospice claims for beneficiaries in nursing facilities did not meet Medicare coverage requirements. Accordingly, hospice facilities with a high census of patients whose care is provided in a nursing facility will be under close scrutiny. General Inpatient Level of Care The OIG reports that 27% of hospice organizations billing Medicare did not meet the Condition of Participation mandating that this type of care be provided. The OIG will be scrutinizing the appropriateness of hospice General Inpatient Level of Care claims. 8 I 855-YES-ACHC (855-937-2242) I achc.org achc.org PRIVATE DUTY ] MANDATORY ACCREDITATION FOR NC PRIVATE DUTY PROVIDERS By June 1, 2014 all Private Duty agencies providing skilled nursing services must be accredited to be in compliance with Clinical Coverage Policy No. 3G issued by the North Carolina Division of Medical Assistance for Private Duty Nursing. To assist NC Private Duty agencies in meeting this deadline, ACHC is offering a modified accreditation process to North Carolina agencies who fall under the guidelines of this new policy. To expedite the accreditation process, NC Private Duty agencies are not required to submit a Preliminary Evidence Report (PER) to ACHC. All agencies are still required to have all of the policies and procedures typically included in the PER; however, it is not required that these be submitted prior to the on-site survey. By waiving this requirement, an agency is only required to submit an application (indicating a survey readiness date) and deposit to begin the accreditation process. The survey readiness date only provides that an unannounced, on-site survey will not happen prior to that date. For more information on this policy, contact Mary Kane Ziegler at [email protected] or (855) 937-2242.