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What home health agencies need to know about OASIS-D changes

What home health agencies need to know about OASIS-D changes

Last year, the Centers for Medicare and Medicaid Services announced proposed changes to the Outcome and Assessment Information Set (OASIS). Though the official interpretive guidance manual won't be finalized until November, the changes are scheduled to go into effect in January 2019.

Home health agencies must plan for these changes in advance, or risk financial penalty. Here's what every HHA should know about the proposed changes:

Proposed changes could impact reimbursements

According to CMS, the overhaul to OASIS-D would affect 33 items, resulting in the collection of 235 fewer data elements within a home health episode. The proposal may also new items to support interoperability for the IMPACT ACT. Once these changes go into effect, agencies will need to ensure that staff enter data correctly or risk missing out on reimbursements.

Failure to fill out a field – or filling it out incorrectly – could result in a denial from CMS. HHA stakeholders should consider updating their policies and practices to ensure no mistakes are made when filling out OASIS forms. Policies may include provisions for training staff members on how best to collect information relevant to OASIS-D data elements. Incomplete or inaccurate assessments could leave money on the table. HHA's can protect their financial health by preparing for these changes well in advance.

Staff may require additional training

Any time changes are made to OASIS, HHA staff members need to be trained on the new measures. This year's proposed changes are extensive, but even a small adjustment would require additional training hours to ensure full compliance.

NDoc software includes a training module to help staff members become familiar with the new fields. Because the module is built into the existing platform, staff members should have little trouble accessing and engaging with the training session. Plus, individuals can review the materials at their convenience.

Because CMS won't implement the new rules until November, it doesn't leave much time for training. HHAs that already work with NDoc software will have the advantage of possessing a pre-existing solution so they can get up and on track as soon as possible.

A nurse bandaging a patient's  leg. Home health care providers will need additional training.

Compliance is a big concern

As with any new regulatory change, compliance should be top of mind for all HHA stakeholders. Not only could noncompliance put your organization at financial risk, but it could also place the company in legal peril. Again, NDoc software can help stakeholders understand what it takes to be compliant and work toward that goal.

NDoc doesn't rely on static fields, but actually uses a logic-based system for comprehensive results.

As an added failsafe, NDoc not only contains compliance alerts that ask care providers to fill in certain fields, but also performs internal checks to ensure providers actually filled them in.

Interoperability will become easier

One of the major goals of the OASIS-D overhaul is to make the interoperability of data easier than ever. Essentially, the new system will pave the way for standardization among all providers, not only those within the acute care field.

For example, if a patient gets his or her hip replaced and is discharged into rehab facility and then to a home health agency, his or her data will seamlessly transfer between electronic record keeping systems. This allows for easier patient movement throughout the continuum of care.

Award winning NDoc software can help your organization stay compliant and improve operations. HHAs should consider investing in a comprehensive solution before the Jan. 1 deadline. To learn more, schedule a free demo today.

Why caring for caregivers is important

Why caring for caregivers is important

Who cares for the caregivers? Taking responsibility for a family member in need can be a full-time job. Many adults in the U.S. informally take care of an ill spouse, disabled child or aging family member. These caregivers often miss out on self-care opportunities and may experience their own negative health consequences as a result.

Caregivers should take steps to make time for self care and they should not be afraid to ask for help when they need it.

How daily responsibilities impact caregiver well-being

Caregivers face a number of challenges every day, outside of their caregiving responsibilities. Essential tasks such as grocery shopping and house cleaning can fall by the wayside as other important responsibilities take up additional time and energy. Over the long term, these stressors can add up, to the detriment of the caregiver's mental and physical well-being.

In fact, research from the University of Pittsburgh found that caregiving spouses between the ages of 66 and 96 have a 63 percent higher mortality risk than non-caregivers within the same age bracket.

Furthermore, the Family Caregiver Alliance reports that, regardless of age or sex, caregivers often experience sleep deprivation, lack of exercise, poor dietary habits and postponement of their own medical appointments. Emotions can run high, causing further stress on the caregiver's body, negatively impacting the individual's health.

These issues are not limited to a small group of people. According to the Mayo Clinic, roughly 1 in 3 adults provide care as an informal caregiver. Many of these individuals do not classify themselves as caregivers, and therefore miss out on opportunities for support.

Caring for an aging family member can be a full time job. Caring for an aging family member can be a full time job.

Why self care for caregivers is important

One reason caregivers may fail to take responsibility for their own personal care is because they feel selfish for doing so. Often, thinking about one's own problems leads to even deeper fears, such as what will happen if one is no longer able to care for a family member. These fears are legitimate, but caregivers should address them, lest they risk damaging their own well-being.

According to the National Cancer Institute, caregivers experience a range of conflicting emotions, including anger, grief, guilt and loneliness. For many caregivers, the first step to dealing with these negative emotions is to understand that it is completely normal to feel them. Every caregiver experiences these emotions on occasion and it can help to explore them with the help of a counselor, therapist or trusted family member.

When caregivers feel overwhelmed by their responsibilities, they should know it's all right to ask for help. In fact, the American Society on Aging provides a comprehensive list of organizations that provide care for caregivers.

What friends and family can do to help out

Caregivers should feel comfortable asking friends and family for help. Not everyone will be able to provide help. However, there's a good chance that these individuals want to offer assistance, but don't know how. Asking for specific assistance is a good way for caregivers to receive the help they need.

For instance, caregivers can request friends and family to assist with simple tasks around the home, such as cooking, cleaning, yard work or shopping. Family members can also make phone calls and find information the caregiver needs to provide for their loved one. These small activities can add up, freeing the caregiver to take care of their own needs so they can feel energized, rested and ready to provide care.

To learn more about how to support caregivers, visit our resource center.

Hospice: Tracking family and caregiver goals

Hospice: Tracking family and caregiver goals

A terminal diagnosis does not have to put an end to a patient's plans. In fact, a comprehensive approach to hospice care makes it a priority to help patients achieve practical tasks and goals during end of life.

Noting, tracking and monitoring these goals within a hospice management solution helps caregivers and patients alike to follow through on those goals which are still practical and possible.

Addressing patient goals

Hospice patients nearing end of life have a number of practical goals that they would like to achieve in the time remaining to them. As noted by the National Institute on Aging, four factors influence a patient's comfort at the end of life: physical comfort, mental and emotional needs, spiritual issues and practical tasks.

A comprehensive approach to hospice care addresses each of these areas of concern in a holistic manner because each is intertwined with the others. For instance, a hospice patient who is able to complete important practical tasks may feel better emotionally as a result.

Consider this scenario: A hospice patient worries what will become of her pet cat when she is no longer able to provide for the animal. Therefore, the patient wants to ensure there is a plan in place for her beloved pet. Caregivers and family members can work with the patient to provide for the animal in the future, thus putting the family member's mind at ease.

Hospice patients may also have goals concerning events in which they want to participate. Examples could include seeing a grandchild's dance recital or visiting with a old friend. These goals may require special assistance or coordination among caregivers. Having a systematic method of tracking goal progress can make it easier to accomplish these important end-of-life goals.

A goal tracking solution helps patients achieve realistic goals during end of life. A goal tracking solution helps patients achieve realistic goals during end of life.

Setting family and caregiver goals

Family members and caregivers may also have their own goals regarding their loved one's end-of-life plans. In addition to wanting to spend more time with their family member, caregivers may feel the stress of their responsibilities becoming overwhelming. As noted by the Mayo Clinic, caregiver roles shift over time, which can increase stress levels.

It's important to develop related goals that allow caregivers to accomplish their own ambitions. However, caregivers may hesitate to put their own needs first. The National Cancer Association suggested that caregivers learn to recognize when they're feeling overwhelmed and have resources prepared for when they need an extra hand.

Again, a systematic approach to goal setting and tracking will not only help everyone stay on the same page regarding patient care, but also ensure caregivers stay on track with their personal objectives.

Tracking goals to create new opportunities

A robust hospice management solution allows providers, caregivers and patients to establish goals, track progress and measure success. Because patient mobility changes over the course of hospice care, goals may need to be modified over time. A tracking solution makes sure everyone is always up to date with patient and caregiver goals so that all parties can work together to bring about a desired outcome.

When this functionality is built into the broader EHR platform, it's easier for providers and caregivers to align patient goals with their current treatment plans. As with other important activities, interoperability is key. Connecting solutions into a holistic system ensures nothing slips through the cracks.

To learn more about patient goal tracking and discover the other beneficial features of our award-winning hospice management solution, schedule a conversation with one of our expert consultants today.

Why hospice benefits are underutilized in the U.S.

Why Medicare hospice benefits are underutilized

Recent data shows that many Americans who are entitled to receive hospice services through Medicare are either unaware of the availability of benefits or are unwilling to take advantage of them. Only by spreading awareness of the availability of these essential services will hospice groups be able to raise participation rates.

What the statistics show

The recent Facts & Figures report from the National Hospice and Palliative Care Organization shows that the majority of Medicare beneficiaries do not fully benefit from available hospice resources. In fact, 40.5 percent of patients who access hospice services through Medicare receive 14 days or less of care.

Such a short span of time is insufficient to maximize these services. NHPCO President and CEO Edo Banach noted that patient and family outreach needs to improve to spread awareness of all benefits available to those facing end of life.

"The hospice interdisciplinary team is ideally suited to provide care and support to patients and family caregivers throughout the last months of life, not just the last days," Banach said.

Overall, hospice participation among Medicare patients could be improved. According to the report, 48 percent of Medicare decedents were enrolled in hospice at time of death in 2016. Further, of the 4,382 Medicare-certified hospice centers operating in the U.S., the majority had an average daily census of fewer than 50 patients.

Improving hospice participation among Medicare beneficiaries depends on a two-pronged approach: 1) Understanding patient and family motivations for declining hospices services, and 2) disseminating accurate information concerning the availability and types of services.

Patients may not be aware of the services available to them. Patients may not be aware of the services available to them.

Why families hesitate to use benefits

Patients and families often view enrollment in hospice services as the end of the road, only to be utilized when a family member is very close to end of life. They may fail to understand that these benefits are not only available on a short-term basis.

One reason for this misunderstanding may lie in the initial rollout of the Medicare hospice benefit. When these services first became available to Medicare patients in 1983, the majority of participants had terminal cancer.

Today, a larger percentage of hospice patients have cardiovascular diseases and dementia. Speaking with HealthLine, NHPCO vice president and COO John Mastrojohn explained that physicians may hesitate to refer dementia patients to a palliative care organization.

"It is well documented that the prognostication for those patients with a noncancer diagnosis is more difficult and is a complicating factor for physicians and others who refer patients to hospice care," said Mastrojohn.

Another reason individuals may refuse hospice care is a worry about expense. Patients and their families may not know the extent of services which are fully covered by the program. Therefore, spreading awareness of the availability of hospice benefits should be a priority among hospice organizational leaders.

How to encourage hospice participation

Hospice agencies can play a role in increasing the utilization of their services by becoming a source of knowledge for patients and their families. End of life is an incredibly stressful time, and even patients who research their options may not fully understand the exact benefits available to them.

Hospice leaders should consider developing a strategy for reaching out to local Medicare beneficiaries to explain, in plain language, the services patients are entitled to.

To learn more about patient outreach and discover the best-in-class features of our award-winning hospice management solution, schedule a conversation with one of our expert consultants today.

Change is in the air - is your agency ready?

M&A activity, trust and the hospice market

Mergers and acquisitions in the home health care sector have seen an increase in activity in recent years, and that's got a lot of agencies and staff members worried.The hospice sector is also seeing a spike in M&A activity, particularly as more health care providers – in and outside of acute care – consider expanding their services to include palliative care

With providers giving hospice a more central role, there are likely to be some big changes for acute care organizations in the near future. Amid the turbulence it's critical that agencies have EHR software they can depend on to help them continue providing care and receiving payment. 

Hospice M&A activity on the rise 
Interest in the hospice sector is rising, with many companies, such as Amedisys Inc., expanding their focus on this area of care, Home Health Care News reported. 

"I don't know of any [provider] looking to remain exclusively as a home health provider," said Mark Kulik, managing director of advisory firm The Braff Group, in an interview with the news source. "If you're a provider of Medicare-certified services, traditional episodic home care, I can't think of anybody of size that's not trying to also provide hospice services, as well."

Costs are driving part of this growing focus on hospice, which is often less expensive than other care delivery methods, and CMS reimbursement has generally been more favorable and steadier for hospice care, as Home Health Care News noted. 

hospice More providers are focusing on hospice care.

Expanding palliative care 
There are other factors at play, too, that have pushed many providers to look more closely at hospice. CMS has restricted what can be considered outside of the hospice benefit while at the same time increasing compliance standards, squeezing agencies and in effect forcing them to do more with less. As a result, many providers are introducing palliative care programs that enable them to provide a more comprehensive continuum of care, letting them capture patients who aren't hospice-appropriate and effectively care for those who are. 

Trust amid change 
Reorganization within health care to place more focus on hospice can present challenges for acute care agencies. Mergers and acquisitions, while growth opportunities, can create internal turbulence. Staff members can become unhappy because they are forced to adopt a difficult-to-use EHR or follow confusing new workflows. The change can create gaps in administrative support, with calls going unanswered and follow-up care and appointments failing to be scheduled. The agency can face hefty costs to re-establish partnerships with hospitals, labs and other providers. And the new EHR vendor may not provide the transparency needed to help the transition go smoothly and ensure that patient care is not disrupted in the interim. 

"Weather the tides of change with confidence and minimal disruption to care."

That's where trust comes in. Acute care agencies need to have the dependable support from a trusted EHR vendor that can help them weather the tides of change with confidence and minimal disruption to care. 

Thornberry's NDoc® solution has been named Best in KLAS in the homecare segment for a record-breaking five years in a row. NDoc® is a logic-based EHR that is designed to anticipate and accommodate change, avoid downtime during transitions and ease burdens on staff. NDoc® is also fully optimized for hospice care, and can help your agency expand its current services or implement a new palliative care program. And NDoc® is backed by Thornberry's dedicated customer support team, which is ready to help you whenever you need. 

As acute care priorities evolve, achieve the trusting partnership you need by choosing the Thornberry team and its award-winning NDoc® solution. 

These six tips can help you attract top talent.

6 hiring tips for home health care

Delivering high-quality home health care depends on who's on your team. It's impossible to deliver high-quality care without the right people on board across all departments of your home health agency, from clinical to administration support. 

But the quality of your hires depends on your recruitment strategy. Make the best hires for your HHA with these six tips:

1. Create a great candidate experience
"Candidate experience" is one of the buzziest phrases of the year, and for good reason: Creating a seamless, stress-free application process makes a positive impression on candidates and is more likely to lead top talent to accept an offer at your agency. A bad candidate experience generates bad press, too, with 72 percent of job applicants sharing their negative experience on review sites such as Glassoor, according to a study by Future Workplace. 

Here are the hallmarks of a great candidate experience – let them guide your recruitment strategy:

  • Timeliness: Recruitment can be time-intensive, but if candidates are left waiting to hear from you they may be picked up by another agency. Keep the process moving. 
  • Communication: Regularly update candidates on their status and stay in regular communication with them throughout the recruitment process. 
  • Simplicity: If people have to jump through hoops to apply for a job at your organization, they're going to look elsewhere. Streamlined, intuitive application processes are best. 

2. Reach right-fit applicants 
Another key to making great hires in home health is effectively reaching right-fit candidates. Advertise postings on social media sites such as LinkedIn and health care job boards. Work with a recruiter who specializes in the home health field and ensure they're fully briefed on the scope and demands of the job. 

Make sure people can apply for jobs at your agency on their smartphones, too, as 78 percent of millennials and 73 percent of Generation Xers used mobile devices to search for jobs in 2016, according to findings from the Pew Research Center. 

application Creating a great candidate experience helps you keep top talent interested.

3. Offer competitive salary and flexible benefits 
To attract the most qualified clinicians and administrative support staff, you need to offer competitive salary and benefits packages. Ensure the standard elements are there – great health insurance and retirement savings plans, for example, but also consider offering other non-typical benefits that are growing in popularity, such as generous PTO days, student loan repayment assistance and financial advisory services. 

4. Look for soft skills 
Of course, any new hire to your HHA needs to have the right technical and medical skills for the job, but it's also important to hire for soft skills, especially in patient-facing roles. Soft skills to look for include:

  • Effective written and verbal communication.
  • Creative problem solving.
  • Collaboration and teamwork.
  • Time management.

5. Plan onboarding 
Onboarding may seem like the last thing to think about when it comes to recruitment, but it deserves front-and-center attention. A great onboarding process is part of creating a positive candidate experience, and a structured program can help new hires hit the ground running. A strong onboarding process is one that includes ample training time and familiarizes the new hire with the teams and workflows of your agency. 

6. Stay organized 
Staying organized throughout the recruitment process helps improve the experience for both employer and employee. An EMR like Thornberry's NDoc® solution can help you HHA keep things running smoothly while more resources and time are devoted to recruitment efforts. 

The success of your HHA depends on the quality of its hires. Follow the six tips above to attract top talent and keep them on board through great application experiences. 

When it comes to sepsis, prevention is the best medicine for this deadly condition.

5 things to know about sepsis

When healthcare providers are doing everything they can to help patients get back on their feet or manage chronic illnesses, infections can decimate their efforts in the blink of an eye. 

Unfortunately, at many hospitals across the country, sepsis may be doing just that. And that means big problems for home health agencies, who send and receive patients to and from hospitals and depend on low readmission rates to avoid financial penalties. 

Sepsis is characterized by a breakdown in the body's healthy immune system response to infection. It is one of the top causes of hospital deaths in the U.S., with more than 1.5 million people developing the condition each year, according to the Centers for Disease Control and Prevention. One in three patients who die in a hospital have sepsis, a sobering statistic. 

sepsis Hospitals are seeing a growing number of sepsis cases. 

In response to this growing threat, state legislatures and regulatory bodies are mandating stricter standards for infection control by healthcare providers. The most famous case of this is New York State, which now requires all healthcare agencies to adopt more detailed, evidence-based screening and treatment protocols. The Centers for Medicare & Medicaid Services followed suit, updating its conditions of participation to make it mandatory that all HHAs operate an infection control program. 

As the discussion around sepsis intensifies, here are five things home health agencies should know about this dangerous condition:

1. Older patients are at increased risk of developing sepsis 
While sepsis can develop in any patient, older individuals, who represent the bulk of home healthcare patients, are most at risk. A study published in the World Journal of Critical Care Medicine attributes the high incidence of sepsis in elderly patients to reduced immune system functions, high rates of co-morbidities and frequent and long hospital stays. Sepsis is the top reason for ICU admissions for elderly patients.   

2. Sepsis advances quickly 
The insidiousness of sepsis lies in its ability to progress rapidly. A study published in the New England Journal of Medicine of more than 49,000 patients at 149 hospitals in New York State found that for every hour clinicians don't engage in sepsis control protocols, mortality rates increase by between 3 percent and 4 percent, Stat News reported. 

3. Sepsis is becoming antibiotic resistant 
There is growing concern over antibiotic resistance in the treatment of sepsis, a challenging issue seeing as antibiotics are a key treatment for the condition, as the Sepsis Alliance Explained. One study of 76 patients in the North American Journal of Medical Sciences found that the six antibiotics used most often to to treat infections demonstrated an average resistance higher than 50 percent

4. We're probably noticing sepsis more 
While the number of cases of sepsis has more than tripled in recent years, health experts say that the explanation is more likely that the condition seems more prevalent today because clinicians have gotten better at identifying the signs of sepsis, according to Bloomberg. 

Clinicians are "actually recognizing a much more common condition than we realized in the past was actually there," said Dr. Greg Martin, a professor of medicine at Emory University, in an interview with the source. 

5. Prevention is the best medicine 
The facts above point to an important conclusion: Prevention is the most effective way of combating sepsis. More comprehensive infection control protocols can help clinicians mitigate risk factors and identify patients most likely to develop the condition. Take the example of New York State, which saw sepsis mortality rates decrease nearly 16 percent as a result of the new and improved infection control processes. 

An EMR with enhanced infection control protocols is an important ally in the fight against sepsis. HHAs should choose a platform that enables clinicians and staff to have greater visibility into infection stages and provide more detailed documentation. Thornberry's NDoc® solution now features enhanced infection control protocols that include expanded data-collection fields and agency-wide reports – learn more about NDoc®, sepsis and Medicare infection control compliance here

Home health spending is slated to increase more than any other health care category.

Home health spending to skyrocket

Now that spring has come – at least according to the calendar – it's a great time to scrub the floors, open the windows and let the fresh air in. But if you work in the home health industry, it's also an opportune time to reassess your agency's budget and strategic priorities. The seasons aren't the only things changing – so is home health spending. 

Recent findings from the Centers for Medicare & Medicaid Services Office of the Actuary predicts that home health spending will increase 6.7 percent by 2020, which is a higher growth rate than any other health care category, Home Health Care News reported. With spending set to compound over the next several years, HHAs should consider their future growth and resource needs today. 

Let's take a closer look at changing spending patterns in the home health industry and what they mean for your agency:

A growing market 
In addition to the 6.7 percent annual growth rate between now and 2020, the Office of the Actuary forecasted that home health spending will rise to $103 billion this year alone, representing a growth rate of 5.9 percent compared to 2017. Furthermore, industry spending is expected to increase to $173 billion by 2026. 

It's not just home health investment that is increasing, however, but total health care expenditure across the board. CMS predicts national health spending will display a 5.5 percent annual growth rate between 2017 and 2026, rising to a total spend of $5.7 trillion by 2026. This follows 4.3 percent spending growth in overall health care in 2016. 

Medicare and Medicaid spending in particular will also see an increase, rising 7.4 percent and 5.8 percent annually per year by 2026. Expenditures in these categories have already kicked off their forward momentum, with Medicaid spending growth anticipated to jump to 6.9 percent this year from the modest 2.9 percent growth seen in 2017. 

home health Home health spending is rapidly increasing – invest in the best technology so you don't fall behind.

Why the increases?
There are a number of factors that industry analysts attributed to the rise in home health spending. One main reason is an aging population – researchers say 20 percent of U.S. citizens will be age 65 and older by 2030, according to the Census Bureau. By 2050, there will be 83.7 million people age 65 and older, nearly double the amount in 2012.

The CMS Office of the Actuary cites higher incomes and more expensive medical goods and services as other reasons for the spending growth. 

So what do all these numbers mean to you?

It's time to invest 
Your HHA needs to be able to remain competitive with fellow agencies that are all spending more of their resources to improve quality of care. There are two key steps critical to doing this. 

First, your HHA needs to adopt a forward-looking approach to operations – what will you need to do now to set yourself up for success five years down the line? How will your agency capitalize on an accelerating market over the next decade, while navigating inevitable payment reform and downward pressure on reimbursement? Taking a long-term view of strategy can help you ensure the sustainability of care and remain agile.

Second, it's time to invest in the best home health technology. With competitors enhancing their platforms, you can't afford to skate by with a solely adequate system any longer. An innovative and responsive EMR like Thornberry's NDoc® solution can provide your agency with the dependable technological infrastructure it needs to grow productivity and manage and administer care seamlessly and efficiently.

With home health spending surging over the next several years, you need to make sure your HHA earns part of the pie. Invest in industry-leading home health technology to remain competitive and improve your quality of care. 

When it comes to reducing patient readmission rates and avoiding financial penalties, infections can be a home health agency's worst nightmare.

Improving infection control protocols to comply with CoPs changes

When it comes to reducing patient readmission rates and avoiding financial penalties, infections can be a home health agency's worst nightmare. One particularly dangerous type of infection, sepsis, has grown more prevalent in recent years and often leads to rehospitalization. 

What HHAs need today are robust infection control policies and procedures. While some agencies were previously not required to implement such programs, the new Medicare conditions of participation (CoPs) have made it mandatory that all HHAs have a comprehensive infection control protocol. 

Let's take a closer look at what this new mandate means for your organization:

Understanding infections in the home health – hospital relationship
Researchers from the Columbia University School of Nursing conducted a study of 199,462 patients at 8,255 home health care agencies. They found that 3.5 percent of patients developed infections during their stay, and that 17 percent of unplanned hospitalizations were due to infections.

The study was published in the American Journal of Infection Control in 2016. While it found a relatively small incidence of infections in HHAs, there has been a notable surge in sepsis in hospitals. As a referral partner, this increase presents a greater need for sepsis monitoring and vigilance in home health agencies. 

health Evidence-based protocols can improve infection control at home health agencies.

The rise of sepsis in hospitals
The number of sepsis cases in the U.S. has been rapidly rising in recent years. Between 2005 and 2014, the incidence of hospital stays due to sepsis nearly tripled, according to a report by the Healthcare Cost and Utilization Project published in June of last year. Sepsis is now the No. 1 reason for hospital stays, according to new data from the Agency for Healthcare Research and Quality, Bloomberg reported. 

To deal with the rise of sepsis, New York State now requires all health care agencies to implement new evidence-based screening and treatment protocols. As a result of the new processes, sepsis mortality has decreased nearly 16 percent in the past two years. Other states have followed suit, with Illinois, Wisconsin and Ohio implementing infection protocols modeled after the New York program. 

Thornberry Ltd. also updated its NDoc® solution to better address sepsis, adding additional patient screening questions and expanding the Signs and Symptoms table to capture more detailed information relating to the condition. With these tools, providers can institute more effective evidence-based treatment protocols. 

Changes to the Medicare CoPs
Infection control has always been a part of HHAs' provisions of care, as mandated by their state's requirements. Those that were accredited by the Joint Commission or CHAP already had to have infection control policies and procedures in place. However, CoPs changes have now made it mandatory that all HHAs have an infection control program. Read the release on the final rule here

"CoPs changes have now made it mandatory that all HHAs have an infection control program."

Enhanced infection protocols in EMRs
The sepsis protocols highlight a need for HHAs across the country to have more robust infection control programs in place. Many EMRs only give nurses the option to document Yes/No as to whether the patient exhibited signs of an infection, and reports simply gave the the option to show if the patient had a catheter and if they were on an antibiotic.There was no report to calculate the number and type of infection. 

However, Thornberry Ltd. has introduced enhanced infection control protocols. In NDoc®, clinicians can now fill out a new section that captures more information about current and potential infections and easily coordinate additional lab work and cultures. Then, they can run a report for the number and types of infections for all of the agency's patients to quickly get a better idea of infection risk and trends and determine whether the infection was likely agency-acquired. 

These new processes give a more detailed picture of what an agency has done to prevent and treat infection. This information can then be used for performance improvement initiatives and staff training. 

The number of documented sepsis cases has been increasing, but with improved infection control protocols now mandated for use by all providers by the new CoPs, HHA are better equipped to identify, treat and ultimately prevent infection. 

It's not pleasant to think about, but you need to have a plan in place for dealing with emergencies at your agency.

Complying with the new CoPs rule on emergency preparedness

Disaster striking your home health agency is not a pleasant scenario to imagine, but one that's necessary to think about. It's essential to have an emergency plan in place ahead of time so that you can quickly pivot operations and continue providing care to patients. 

Being prepared for a disaster is all the more relevant in the HHA industry at the moment because emergency preparedness is now a part of the Medicare conditions of participation (CoPs). HHAs are now required to have an emergency program. 

Here's what you need to know about developing emergency preparedness at your agency:

Understanding the CMS rule 
The Centers for Medicare & Medicaid Services now mandates that all agencies must have an emergency preparedness plan. Such a program should protect patient health in the event of an emergency that affects operations, and covers both natural and man-made events, according to CMS. 

CMS says the emergency plan should be based on four main areas:

  1. Risk assessment and emergency planning. 
  2. Policies and procedures. 
  3. Communication plan. 
  4. Training and testing. 

CMS requires that continuous testing of the plan is performed to see if it needs updating or changes from lessons learned. Read more about the rule here

Creating your plan 
Keeping these four guidelines in mind, your emergency plan should specify what steps to take in the event of a disaster. Think about potential scenarios, such as what should be done if there is a water main break, gas leak or shut off, blackout, fire or loss of power. How will you communicate with patients if a phone system is down? Are there steps you can take to prepare for an impending natural disaster, such as a hurricane or wildfire? What actions should be taken in the event of man-made event, such as a robbery or active shooter? How will the authorities be contacted? These and other questions need to be extensively explored. 

"Key to effective disaster preparedness is having constantly up-to-date information on patient needs."

Establishing a priority list 
Another important issue is determining how you will prioritize patient care in an emergency. How will you manage those patients whose care relies on electricity and water?

An EMR with disaster preparedness features will provide essential triage support. Using Thornberry's NDoc® solution, nurses can run a Priority List report which tells them which patients on oxygen need to be seen, those who can be called and those with support who do not need to be called or visited during that time. 

Having the information you need ready 
The key to effective disaster preparedness is having constantly up-to-date information on patient needs. In NDoc®, nurses can add to a patient's emergency plan at any time to specify what may be needed for the individual's care in a disaster. For example, the nurse can note that the patient needs bottled water, batteries, matches, flashlights, enough medications for two weeks and so on. This data then pulls to a report that can be instantly retrieved in an emergency. Reports can be run daily and weekly so staff and clinicians have the most updated information on patients. 

With an in-depth plan and an EMR enabling up-to-date patient priority reports, your home health agency can comply with the CoPs and be better prepared in the event of an emergency.