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How To Spot Signs Of Elder Abuse

According to The Elder Justice Roadmap, a report by the U.S. Department of Justice and the Department of Health and Human Services, five million Americans are affected by elder abuse every year. Abuse of the elderly can be difficult to pinpoint as its signs could appear to be symptoms of dementia or the natural results of frailty that come with growing older. It is important to know that elder abuse is not always physical and includes other categories, including sexual, psychological, and financial neglect.

Be on the lookout for the following common signs that abuse may be happening:

  • Frequent arguments between the caregiver and the patient
  • Changes in a senior’s personality or behavior
  • Unexplained injuries like burns, bruises, welts, cuts or scars
  • Broken bones, dislocations and sprains
  • Failure to take medication or overdose of medication
  • A caregiver’s refusal to let you see the patient alone
  • Appearing disheveled, in torn or soiled clothing, or not being appropriately dressed for the weather
  • Appearing hungry, malnourished, disorientated or confused
  • Unexplained charges or a suspicious drain of money
  • Unexplained weight loss

If you notice something strange, it is important to notify authorities or to report it to Adult Protective Services (APS).

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Attention Home Health Agencies: PEPPER Update Session Scheduled

The TMF Health Quality Institute is developing a new Program for Evaluating Payment Patterns Electronic Report (PEPPER) for Home Health Agencies (HHA). It will be available this July.

TMF Health Quality Institute has provided the following details regarding a PEPPER update session on April 30:

When: Thursday, April 30 at 11:00 a.m. to 12:30 p.m. Central Daylight Time

What: A WebEx presented by Kimberly Hrehor with TMF Health Quality Institute

Topic: An update on what is new/changed in the Q4FY14 PEPPER for Skilled Nursing Facilities (SNFs), Long-term (LT) Acute Care Hospitals, Inpatient Rehabilitation Facilities (IRFs) and Hospices, and a preview of the Home Health Agency PEPPER (coming in July 2015).

Registration is not required! Use this link to join the event:

https://tmfpepper.webex.com/tmfpepper/onstage/g.php?d=923918378&t=a

Event number: 923 918 378

Event password: lantana

This program is being brought to you at no charge.

Handout: Will be posted on the PEPPERresources.org website on the applicable Training and Resources pages by April 29, 2015.

Click here for more information.


CMS Corrects Inaccurate Info On The Home Health F2F Requirement

Earlier this month, CMS held a Special Open Door Forum for the voluntary electronic and paper clinical template for the home health Face-to-Face (F2F) encounter document. During this call, a presenter provided inaccurate information regarding what would be acceptable documentation within the physician’s medical record to support home health eligibility.

Several participants questioned the presenters about the CMS policy that allows a physician to sign information from an agency’s assessment and incorporate it into his or her medical record to support eligibility. CMS answered by comparing agency documentation to consultation notes that may be found in a physician’s record, saying that CMS does not actually consider these documents to be a part of the physician’s record, since they are not generated by that physician. CMS indicated it would only look for documentation the physician generated to support home health eligibility. However, this interpretation goes against what CMS has spelled out in the final rule for home health prospective payment system (HHPPS) rate update.

NAHC contacted CMS requesting clarification of this matter. On March 24, CMS released the following statement:

“In reviewing the transcript, CMS realizes that inaccurate information was provided related to HHA documentation to support certification for home health services.  Per 42CFR 424.22 (a) and (c), the patient’s medical record must support the certification of eligibility and documentation in the patient’s medical record shall be used as a basis for certification of home health eligibility. Therefore, reviewers will consider HHA documentation if it is incorporated into the patient’s medical record and signed off by the certifying physician. More guidance will follow regarding the review of home health claims shortly. CMS apologizes for the confusion.”

Click here to read more.


House Passes SGR Reform Bill

Yesterday, a majority passed Medicare legislation that reforms the physician payment formula also known as the Sustainable Growth Rate (SGR). H.R. 2 will now go to the Senate where it is expected to pass.

The bill includes the previously reported provisions that affect home health and hospice services:

  1. The annual payment rate update (Market Basket Index) is set at 1% in 2018. This represents an estimated 1 point reduction from what would otherwise be the update
  2. A two year extension of the home health rural add-on at 3%. Under the bill, the add-on would expire with episodes beginning January 1, 2018 and later.
  3. Modification of the home health surety bond requirements setting the bond minimum at $50,000 and allowing Medicare to scale the bond value up commensurate with the volume of Medicare revenue in the home health agency.

The Medicare beneficiary changes do not include a home health copay.

The bill “would institute a permanent fix in the physician payment methodology” which is good news for Medicare providers as there have been 17 previous “patches” that were financed by cutting provider payment rates.

Click here to read more.


Outsource Training to Transfer Knowledge

Take a look at our latest TCG CHEX eLearning blog post – Outsource Training to Transfer Knowledge – to learn more about an article covering recent trends in the utilization of outside education for staff.

While you are there, don’t forget to use the calculator to estimate the financial savings your organization could see when you implement TCG CHEX eLearning for your staff education!


TCG Webinar: Home Health Billing Essentials

Date: Tuesday, June 14, 2011

Time: 10 am PT/12 pm CT/1 pm ET

Presented by:
M. Aaron Little, BS, CPA
Senior Managing Consultant
BKD National Health Care Group

Medicare home health PPS refinements have significantly complicated the billing process. Other issues such as the face-to-face encounter and therapy changes have influenced billing practices.
This webinar will provide strategies for drilling into the details of your billing processes, and participants will take away valuable insights on available industry resources and processes
that can be implemented to help optimize efficiencies.

Features and Benefits:

After attending this webinar, the participant will be able to:

  • List typical Medicare home health billing challenges.
  • Apply suggested key billing performance measures.
  • Identify effective and efficient process management tools.

CEs available!

Click Here to Learn More


TCG Webinar: Building a Manageable Corporate Compliance Program

Date: Tuesday, June 7, 2011

Time: 10 am PT/12 pm CT/1 pm ET

Presented by:
Deborah A. Randall, Esq.
Healthcare, Compliance and Telehealth Legal and Consulting Services

In 1998 for home health agencies and in 1999 for hospices, the OIG issued guidance for compliance programs. This webinar will discuss the OIG guidance and what an organization can do implement a “manageable” corporate compliance plan and make it a part of the corporate culture.

Features and Benefits:

After attending this webinar, the participant will be able to:

  • Identify the seven elements that should be included in a comprehensive compliance program
  • Understand the necessity of a risk assessment as part of the plan to identify agency vulnerabilities
  • Develop the required policies and procedures and communicate them to staff

CEs available!

Click Here to Learn More