Health Facility Services

1. Health Facility Services A presentation for the HomeCare Association of Arkansas April 2019

2. Home Health and Private Care Agencies Content: • Early Intervention Specialists • Survey Data • Survey Process – Can you prepare? • Surveyor Round Table

3. Early Intervention Specialists! • Liz Davis, RNP • Kirk Gardner, RN • Rachel Rayl, RN • Carolyn Guth, RN • Paula Day, RN • Cecille Sperry, RN • Tim Simpson, RN

4. Liz Davis, RN

5. Kirk Gardner, RN

6. Rachel Rayl, RN

7. Carolyn Guth, RN

8. Paula Day, RN

9. Cecille Sperry, RN

10. Tim Simpson, RN

11. Dream • Arkansas Department of Health Mission: To protect and improve the health and well-being of all Arkansans. • CMS CQSOG Mission: assure basic levels of quality &safety for all patients, residents &clients receiving care from Medicare &Medicaid certified institutional providers

12. Home Health Agencies • A Home Health Agency is licensed to provide home health services in a patient’s residence. • For Medicare certification the agency must also meet the Medicare Conditions of Participation & the Medicare Administrative Contractor. • Class B Agencies must also be certified by the Arkansas Department of Human Services.

13. Private Care Agency • A Private Care Agency is defined by law as a provider that is certified by the Department of Human Services. • In order to be certified by the Department of Human Services, the Private Care Agency must be licensed by the Department of Health. • The Private Care Agency must enroll and meet regulatory requirements from both Departments.

14. Role of the Department of Health The Department of Health oversees the quality of care provided by Home Health & Private Care agencies by reviewing your compliance with the Conditions of Participation and/or the Rules and Regulations.

15. Quality of Care review & inspection. Your agency develops and implements your Policies and Procedures that demonstrate how your agency provides services and remains in compliance with the Rules and Regulations. Health Facility Services will conduct onsite inspections every 1-3 years to ensure compliance with the Rules and Regulations and/or Conditions of Participation.

16. Quality of Care review & inspection. Medicare Recertification Survey Letter of no deficiencies Form 2567 outlining problems with compliance. Licensure Survey Compliance Form delivered onsite

17. Home Health Survey Data Top 3 problems cited: • 484.55 (c)(3) Medication Review • 484.60 (e) Written Instructions to the patient • 484.75 (b) (3) Provide services in the Plan of Care

18. Private Care Survey Data Top 3 Problems cited: • Complete Personnel Records • Supervisory Aide Visits • In-service hours

19. Survey Process • Pre survey Preparation • Entrance Interview • Information Gathering • Information Analysis • Exit conference • Formulation of the Statement of Deficiencies OR Compliance Form (provided onsite)

20. Surveyors are in the House What are my next steps?

21. Key to an organized survey process • Prepare, Prepare, Prepare • Plan Ahead • On-going compliance with the regulation • Provide appropriate patient care

22. How to PREPARE • Develop a process for responding to the arrival of the Survey Team • Determine who is responsible for any task • Educate staff on this process • Staff members should know their expectations • Implement the process • Practice the process

23. Policies and Procedure • Acceptance of Patient • Plan of Care • Comprehensive Assessment • QAPI Program • Emergency Preparedness • Medication Management • Complaint Grievance Process • Transfer/Discharge • Coordination of Services • Infection Control • Significant Change in Condition • Aide Supervision

24. Survey Request • Provide the Survey Team a quiet and private place to work • Know what the Survey Team will request • Prepare these documents so anyone in the agency can access • Present only the documents requested • Typically request similar documents at all surveys • Standard Survey • Complaint Survey

25. Standard Survey • Overall assessment of the agency • Occurs at least every 36 months

26. Complaint Survey • Narrow focus into a particular area of care or service • These are completed as needed

27. Surveyor Request • Number of Unduplicated Admissions for recent 12 months • Current Census • Patient Name • Diagnosis • Discipline • Patient visit schedule for the week • Type of visit • Discipline making the visit • Diagnosis • Location – distance from the office

28. Surveyor Request • State License • CLIA Certificate, if applicable • QAPI Data • Complaint Data • AR Choices • Liability Insurance • Emergency Preparedness Information • Services offered • Policies and Procedures • Access to Electronic Medical Record

29. Home Visits • The visits will include: • Observations of skills • Patient/Caregiver Interviews • Agency staff will: • Schedule visit per Surveyor’s request • Obtain verbal consent • Provide a vehicle and driver • Surveyor will need: • Printed Plan of Care and Subsequent Orders • Policies/procedures specific to care being observed • Access to the complete record

30. Emergency Preparedness

31. REMEMBER: We have the same DREAM • We are in this together • Safe care • Quality care • Meeting the needs of patients

32. OASIS D • Effective January 1, 2019   • OASIS D Guidance Manual - Definitions • Go to CMS.Gov – Get the OASIS D Guidance Manual PDF • OASIS Education Coordinator • OASIS Automation Coordinator

33. OASIS D Training • OASIS D Training – FREE • Go to CMS.gov – Home Health Quality Reporting Program - Training • https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Home-Health-Quality-Reporting-Training.html

34. CONTACT Information • (501)661-2201 – office phone • 1-800-223-0340 Home Health Hotline • Email – Liz.Davis @ arkansas.gov