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Welcome to Primaris…. With your host …. Care Coordination. OASIS. Avoiding ACH. Managing Meds. Fall Prevention. 100 pt. 100 pt. 100 pt. 100 pt. 100 pt. 200 pt. 200 pt. 200 pt. 200 pt. 200 pt. 300 pt. 300 pt. 300 pt. 300 pt. 300 pt. 400 pt. 400 pt. 400 pt. 400 pt.
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Care Coordination OASIS Avoiding ACH Managing Meds Fall Prevention 100 pt 100 pt 100 pt 100 pt 100 pt 200 pt 200 pt 200 pt 200 pt 200 pt 300 pt 300 pt 300 pt 300 pt 300 pt 400 pt 400 pt 400 pt 400 pt 400 pt 500 pt 500 pt 500 pt 500 pt 500 pt
Are Significant Changes in Condition (SCIC) OASIS required to be submitted after Jan. 1, 2008?
Yes. Submitting SCICs is required per regulation but there is no payment adjustment.
How is the Start of Care (SOC) determined?
It is the first billable visit, regardless of the discipline.
One clinician must complete it, but all disciplines may collaborate w/ the author.
Outcome and Assessment Information Set
What is a written, patient-centered plan with a range of symptoms to report first to the agency, rather than calling 911?
According to the HHQI BPIP for reducing ACH, what should be reviewed on every visit by every discipline before leaving the patient’s home?
What assessment other than OASIS is a part of a best practice to reduce ACH that is completed at the SOC?
What are the two most effective BPs that promote early ID of abnormal S&S, intensify patient/caregiver education, reinforce the patient emergency plan and initiate best practices for medication management?
True or False? Hospitalization risk assessment should be completed on SOC/ROC and may also be performed at recertification or with significant change in condition (SCIC).
Who defines a fall as “an unintentional change in position resulting in coming to rest at the ground or a lower level?”
True or False? “Timed up and Go” screening is an effective assessment to identify persons at risk for falls.
True. Use this assessment as a part of your hospital risk assessment.
Double Jeopardy Fall-related injuries accounted for 6%, 3% or 1% of all medical expenditures for people age 65 and older in the U.S. Double Jeopardy
Double Jeopardy 6% Double Jeopardy
What OASIS timeframes are suggested for doing a fall risk assessment?
What is the first step in the procedure for accurately assessing orthostatic hypotension?
This “Criteria for Potentially Inappropriate Medication Use in Older Adults: Independent of Diagnosis or Conditions” is otherwise known as:
MO 780 states, “Management of Oral Medications: Patient’s ability to prepare and take all prescribed oral medications reliably and safely, including administration of the correct dosage at the appropriate times/intervals.” The OASIS response selected should reflect the patient’s ability to:
Take a majority of daily doses correctly on the day of assessment
Name one element of medication review required by the Conditions of Participation.
Any of the following are appropriate answers: • Identify any significant side effects • Significant drug interactions • Duplicate drug therapy and noncompliance with drug therapy • A process is put in place to ensure that the patient’s medication regime is evaluated. The same process must be carried out for therapy-only patients.
To accurately assess the patient’s medications the clinician needs to use a combined approach of interview and __________.
Your patient had a stroke and is unable to open the medication bottles or open her pill box. To what discipline would you make a referral?
Name two care providers involved in patient care transition.
Any of the following: • Hospital to home health • Home health to self-care • Hospital to SNF • SNF to home, PCP or hospice
When you think of patient transition, what is the purpose of the handover?
Answers could include: • Exchange Vital Information • Communicate patient status • Exchange information and assume or pass on responsibility *** Transitional care-coordination should be the standard of care
Double Jeopardy True or False? Medication reconciliation only applies to medications and prescriptions ordered by a doctor. Double Jeopardy
Double Jeopardy False Reconciliation includes all medications taken by the patient including any OTC vitamins, supplements, pain meds, etc. Double Jeopardy
Name at least one piece of information that should be included in the Personal Health Record (PHR).