Hospice Quality Reporting Update: June 2014

1. Hospice Quality Reporting Update: June 2014 Presented by: Anne Shelley, MBA, BSN, RN Susan Wallace, MSW, LSW

2. Objective • Discuss the updates to hospice quality reporting requirements.

4. Hospice Quality Reporting Program • Structural Measure & Comfortable Dying Measure • Concluded April 2014 • Hospice Item Set • July 2014 • Hospice Experience of Care Instrument/CAHPS • Early 2015

5. What is the HIS? • “Item Set” vs. “Standardized Assessment” • Based on seven NQF-endorsed measures • Treatment preferences (CPR, Hospitalization, Other life-sustaining treatments • Beliefs/values addressed • Pain screening and assessment (2) • Dyspnea screening and treatment (2) • Opioid and bowel regimen

12. What is the HIS? • Admission & Discharge • Completed for ALL patients • Submitted on a rolling basis • Completed: 14 days from admission, 7 days from discharge • Submitted: 30 days from admission/discharge • Linked to 2% market basket reduction

13. A NEW Alphabet Soup • QIES ASAP CASPER RTI QTSO HQRP NQF HIS HART MAP

15. Preparation • Research • Staff Assignment • Medical Records Evaluation, Reconciliation with the HIS • Organizational Communication Plan • Staff Education • Implementation

16. Research • http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Hospice-Item-Set-HIS.html • HIS Manual • Training Slides (2/4 & 2/5) • Fact Sheet • https://www.qtso.com/hospice.html • Registration announcement • Technical Training Modules • Other announcements • https://www.qtso.com/hart.html

17. Staff Assignment • Who needs to be involved in planning? • QAPI/Compliance • Executive Director • P&P Interdisciplinary Group • Care Managers • Administrative staff • Preliminary estimate of staff hours required • Paper: 40 minutes per patient • EMR: 15-20 minutes per patient

18. Medical Records Evaluation, Reconciliation with the HIS • Contact EMR vendor • Are assessments aligned with HIS items and language? • Will reporting mechanisms be fully functional by July? • Will reporting mechanisms match CMS expectations? • Crosswalk the HIS to your records • Time Study

19. Organizational Communication Plan • Leadership • Resource Allocation/Redistribution • Communication to Board • Initial Education Plan for Staff • Ongoing Education Plan for Staff • Orientation/Training • Annual Updates

20. Staff Education

21. Implementation

22. What is the Hospice Experience of Care Instrument? • Evaluation of the patient/family’s experience of care • Caregiver as proxy • Post-death • Similar to CAHPS surveys • Similar to the Family Evaluation of Hospice Care (FEHC) • Developed by Rand Corporation • Three versions based on place of death • Home, Inpatient, Nursing Facility

23. Hospice EOCS (CAHPS): Timeline • First quarter 2015: 1-month “trial run” for submission • April 1, 2015: Begin continuous usage

24. Vendors • Hospices must contract with CMS-approved vendor • Vendor applications: late 2014 • Home Health CAHPS Vendors: • https://homehealthcahps.org/GeneralInformation/ApprovedSurveyVendors.aspx

25. On the Horizon

26. NQF Endorsement Process • Call for Measures • Call for Nominations • Measure Review • Comment • Voting • CSAC Decision • Board Ratification • Appeals

27. Measures Application Partnership • Measure concepts: • pain • goal attainment • patient engagement • care coordination • depression • caregiver’s role • timely referral to hospice

28. April 2014: Call for TEP Nominations • Project Objectives Include: • Investigate the potential for expanding existing quality measures or measure concepts to the Hospice QRP. • Generate measure ideas/concepts that address gaps in the current Hospice QRP identified by stakeholders such as the Measures Application Partnership (MAP).

29. Questions?