In The News

CMS Submits OASIS-E to OMB

By the National Association for Home Care (NAHC)

The Office of Management & Budget (OMB) has issued the information collection packet for the Outcome and Assessment Information Set (OASIS)-E, which includes three attachments and the Supporting Statement document outlining the burden estimate for both home health agencies (HHAs)  and the federal government.

The OASIS-E assessment tool is effective January 1, 2023.

Attachment A is an  OASIS-E change table that compares the changes made to OASIS-E from the OASIS-D . Attachment B includes all of the OASIS items, and Attachment C is an itemized list of the OASIS-E data elements.

As usual, in the supporting statement, the Centers for Medicare & Medicaid Services (CMS) underestimates the burden for HHAs to complete the OASIS-E data set. CMS projects that assessment items in the data set will take a range of 0.15-0.3 (9-18 seconds respectively) minutes of clinician time to complete.

  • Estimated time spent per each OASIS-E Start of Care (SOC) Assessment/Patient = 57.3 clinician minutes for 203 data elements
  • Resumption of Care (ROC) Assessment/Patient = 48 minutes for 172 data elements
  • Estimated time spent per each OASIS-E Follow-Up (FU) Assessment/Patient = 13.2 minutes for 4 data elements
  • Estimated time spent per each OASIS-E Discharge (DC) Assessment/Patient = 40.2 minutes for 146 data elements

This assumption provides that even the most complex assessment items ( e.g. the GG items and the new cognition items) will require, at most,18 seconds to complete.

CMS also reveals changes it plans to propose for Patient Driven Groupings Model (PDGM)  in the CY 2023 home health payment update rule.  Pending the adoption of these changes, CMS will add the following items to the FU assessment.

  • Shower/bathe self
  • Upper body dressing
  • Lower body dressing
  • Putting on/taking off footwear
  • Car transfer
  • Walk 150 feet
  • 12 steps
  • Wheel 150

CMS Stakeholder Call on Medicaid and CHIP Access

The Centers for Medicare & Medicaid Services (CMS) is seeking feedback on topics related to health care access in the Medicaid program. Specifically, CMS is interested in hearing from a broad array of stakeholders on topics relating to: enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates to encourage provider availability and quality.

This Request for Information (RFI) is part of CMS’  comprehensive access strategy in its Medicaid program and Children’s Health Insurance Program (CHIP).

CMS will hold a stakeholder call on the RFI on access in Medicaid and CHIP. This session will

  • provide additional information on the RFI,
  • review how to access the online form, and
  • outline the importance of providing feedback on this topic.

When: Tuesday, March 1, 2022, 3:30-4:00 PM ET

Where: Zoom link will be provided following registration.



Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States

The CDC has updated the Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States to indicate that the second dose of mRNA COVID-19 vaccines may be given up to 8 weeks after the first dose.  

The rationale for this change is that "Some studies in adolescents (ages 12-17 years) and adults have shown the small risk of myocarditis associated with mRNA COVID-19 vaccines might be reduced and peak antibody responses and vaccine effectiveness may be increased with an interval longer than 4 weeks." They also say that "an 8-week interval may be optimal for some people ages 12 years and older, especially for males ages 12 to 39 years."

 A 3-week interval for Pfizer and a 4-week interval for Moderna continue to be recommended for people who are moderately to severely immunocompromised, adults ages 65 years and older, and others who need rapid protection due to increased concern about community transmission or risk of severe disease.


Referral Rejection Rate for Hospice Reaches ‘All-Time High’ of 41%

By Robert Holly | February 18, 2022

Skyrocketing demand for post-acute care services has put providers in a pickle, often forcing them to turn away new hospital referrals due to limited labor capability.

This problem has been particularly pervasive for home health agencies, but it’s increasingly an issue in the hospice setting as well, according to the latest data from CarePort, a WellSky company.

Because of this supply-and-demand imbalance, hospice providers are rejecting new referrals at record levels, with hospital patients in need of end-of-life care having to wait in the acute care setting about a day longer.

“I would say that the story we are seeing across post-acute providers – skilled nursing facilities (SNFs), home health care and hospice – is very similar,” Tom Martin, director of post-acute care analytics at CarePort, told Hospice News. “I might just boil it down to: We are seeing very high demand for post-acute services. And we are now experiencing sort of this supply shortage of available post-acute beds and staff to care for people.”

On the demand side of the equation, referral volume for CarePort’s hospice clients reached 113% of pre-pandemic levels in January, after hitting 118% of pre-COVID levels at the end of last year.

In actuality, the only time CarePort’s hospice providers saw lower-than-normal volumes was in the spring of 2020. That didn’t last long, however, with home health agencies also experiencing a V-shaped volume recovery.

Due to rising demand and clinician burnout, hospice operators haven’t always been in a position to “say yes” to new referrals from the acute care setting.

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HCAOA Highlights 6 Key Policy Priorities for the Home Care Industry

Home Health Care News / By Joyce Famakinwa
Policy and regulations for home care haven’t kept pace with the growing demand for services and the overall increased visibility of the sector.
For policymakers looking to address industry challenges and ultimately increase access to home care, there are six policy priorities that should be considered, a new report released Wednesday by the Home Care Association of America (HCAOA) suggests.
“With the growth of the Medicare population projected to double from 40 to 80 million adults by 2040, addressing the shortfalls in care for older Americans must begin now,” Vicki Hoak, CEO of HCAOA, said in a statement.
Indeed, there are demographic shifts in the U.S. that point to the increasing need for more senior care services. Roughly 81 million people in the U.S. will be 65 years older by 2040, compared with 77 million under the age of 18.
Plus, an individual turning 65 today has nearly a 70% likelihood of needing long-term care and support, according to the U.S. Department of Health and Human Services (HHS).
In terms of the type of care seniors prefer, services that allow them to age in place for as long as possible are overwhelmingly popular.
In order to strengthen the home care sector and, in turn, fulfill the increasing demand for care, HCAOA urges policymakers to prioritize the establishment of an industry-coordinated set of standards at both the federal and state level. 
“Without standards on caregiver training, inconsistencies in types, levels and quality of service may hamper the ability of the industry to define itself as a trusted and sought-after service provider,” HCAOA wrote in the report. “This has implications for the safety of home care clients as well.”. . .

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