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Home Health Care Quality Reporting Program Updates

Posted on Monday, December 9, 2019 1:51 PM

CMS has posted OASIS Considerations for Medicare PDGM Patients, to assist agencies with OASIS considerations during the PPS-to-Patient Driven Groupings Model (PDGM) transition. This provides guidance to providers on how to correctly complete the M0090 Date Assessment Completed for patients starts of care and recertifications from 12/27/2019 – 12/31/2019 as well as patients with resumptions of care at the end of calendar year 2019.

CMS is looking for input as part of the development process.  They have posted the Technical Expert Panel Summary Report: Development of Home Health Within-Stay Potentially Preventable Hospitalization Measure for Home Health Agencies and the Measure Specifications for the Home Health within-stay Potentially Preventable Hospitalization Measure for the public’s review.

Rehospitalization During the First 30 Days of Home Health measure has been removed from the HH QRP and will not be reported beginning January 1, 2020. 

Measure Specifications


Measure Title





Home Health Within-Stay Potentially Preventable Hospitalization Measure


Number of patients in the denominator with at least one potentially preventable hospitalization or observation stay during the HH stay.


All Medicare Fee-for-Service patients in the HH setting that do not meet the exclusion criteria.


-Patients younger than 18 years old at the start of the HH stay. -HH stays beginning with a Low Utilization Payment Adjustment (LUPA) claim. -Patients receiving services from multiple HHAs during the HH stay. -Patients not continuously enrolled in Part A FFS Medicare for the 12 months prior to the HH stay. -The patient is missing information needed for risk adjustment.

CMS is simplifying the Measures Management initiative, by reducing the number of measures reported to HHAs on the on-demand report.  Starting in January 202, CMS will be removing the following measures from the Tally report:

  • 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

Source: NAHC Report

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