MICHIGAN ASSOCIATION FOR HOMECARE

CLINICAL OPERATIONS

January 15, 2015

9:30-11:00 a.m.

At the Okemos office

Minutes

I.Call to Order at 09:40 Sara Simonds

II.Introductions

III.Approved Minutes from November 2014 meeting.

IV.Executive Director’s Report

  • March 12th, Association’s Legislative Day in Lansing, Opportunity for issues, related to the industry, to be discussed with legislators; NAHC legislative day in Washington March 25– 26th. NAHC F2F lawsuit, regarding narrative issue, is going forward. Michigan Association for Home Care’s annual conference will be held May 13 – 15, 2015. Companionship law suite for personal services overturned the companionship exemption law. Michigan needs a definition of “live in” status. Long Term Care Support Services Committee is disbanding, Gov. Snyder announced office on aging will now coordinate policy and recommendations. Will be addressing education requirements for home health aides.

V.Announcements/Reports:

  1. Regulatory Update

1. MILARA –Meeting will take place later this month. Please send questions to the Michigan Association for Home Care office. A question did come up: Does CASPER report reflect discrepancies state by state (does the report that Michigan print, print by volume the highest citations for Michigan and Illinois might be different based upon their highest?) Current report only gives information on non-deemed status agencies (certified by the state).

2. BCBSM – If you have question send them to the Michigan Association for Home Care office to Mary’s attention.

3. Regulatory/QI Committee - Submitted comments on proposed changes to the home health COP's.

4. Education Committee - ICD-10 training scheduled in Feb.; OASIS workshop in March: Annual Conference in May, registration information will be available the end of January. Please encourage vendors to sponsor and/or exhibit at the annual conference. There is an opening for an RN and Social Worker members for the committee. Please contact Cindy Thelen; or Barry Cargill; , if you are interested in participating. The Home Health Aide training program is up and running and agencies are participating.

  1. MPRO–Yvette McKenzie-Turner– Continuing to recruit for Cardiac Program. Home Health agencies being asked to participate in HHQI measurers regarding cardiovascular initiative. MPRO will assist with data input. Readmission Data is being examined January 22. Stroke and Afib call with CE’s provided for nursing and social work. Email Yvette if interested in joining call. Care transitions work continues.

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VI. Sub-Committee/Task Force Reports:

A. IV Therapy/Infection Prevention– IV Manual will be available soon through the Michigan Homecare office for purchase.

B. Psych Home Care -No report

  1. Rehab Subcommittee- Will meet following Clinical Operations meeting. Patients being recertified in new year, fall under 30 day review.

VIII.New Business–

  1. Face to Face narrative requirement changes –committee agreed that we adopt the format provided by Massachusetts Alliance for Homecare for a letter for physicians, and acute care facilities about the changes and references statutes.
  2. Surveys-

One Joint Commission Survey –Aide Care Plans need to be very specific to each patient with no patient choice allowed. Amy will ask for clarification from MILARA on interpretation of rather a patient can make a choice of: example: what type of bath. Barry Cargill asked about surveyors asking questions about disposal of narcotics. No one has had any questions from a home health perspective. Hospice committee will have an attorney from Trinity at the next hospice meeting to discuss issues related to changes in drug disposal laws.

  1. Medicare Advantage/miscellaneous–Is F2F required for the advantage plans? No definitive rule, suggested that agencies obtain F2F on every Medicare and Medicaid patient (it is required for all Medicaid products). Question - Medicare Plus Blue patients need recertification but might not qualify, ABN is specific to Medicare patients, so what form does the agency use –no language in the Advantage NOMNC pertaining to this. What Forms are other agencies utilizing? It was suggested that a letter be drafted and sent regarding possible responsibility for payment. Also suggested forwarding question to reimbursement committee.

CERT audits for F2F - has anyone had any positive results? Mixed comments, however, narrative continues to create denials. Follow the appeals process. One agency had a Face to Face pass for the original cert period, however when the recertification chart was requested at a later date, that payment was denied for inadequate face to face documentation.

F2F narrative if provided to the physician by the homecare agency, also need to inform physicians of need to document in their medical records and D/C summary–documentation provided to the physician office alone will not be complete –physician's medical record must support homebound and skilled need as well. Some suggestions: include needed documentation in admit note and send to physician office for signature and return to agency. Recommendation is to continue current processes and document as completely as possible. Describe homebound status on an addendum attached to plan of care and obtain signature. Make sure physicians are placing in their office records.

  1. Meeting Adjourned
  2. Next meeting February 19, 2015.

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