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In response to the COVID-19 crisis, several important updates from CMS and the Department of Health & Human Services were posted over the last weekend. HealthPRO Heritage’s COVID-19 Task Force immediately released a summary about these updates (i.e.: waivers of the 3-day stay & the 60-day break). 

March 18, 2020

MEMO TO:  All HealthPRO Heritage Professionals
FROM:         John Heller, Chief Executive Officer
RE:                Encouragement & Guidance for Our Staff 

As we all look to understand and respond to the growing complications related to COVID-19, it can become a challenge to balance our daily lives, concerns for family and friends and the responsibilities of our jobs. 

Amidst the COVID-19 crisis, HealthPRO Heritage has organized a multi-faceted approach to preparedness and promotion of safe treatments to our patients, and implementation of strict precautions to prevent the risk of the virus spreading. Our Physical, Occupational, and Speech Therapists remain available and ready to serve the immediate patient care needs of our agency partners, many of whom are reporting staffing challenges.

HealthPRO Heritage has summarized important updates from a memo released by the Department of Health & Human Services found here and a memo released by CMS found here.

Amidst the COVID-19 crisis, HealthPRO Heritage shares an important resource. 

This is information is updated as of 03/12/20

This is information is updated as of 03/12/20 at 1:00pm EST

In the unfortunate event that a resident or patient in your care is a confirmed COVID-19 case, please note special ICD-10 coding will be necessary. The CDC released official diagnosis coding guidance for encounters and deaths related to the 2019 novel coronavirus (COVID-19), effective February 20, 2020.

The Patient Driven Grouping Model (PDGM) was implemented January 1, 2020 and changed reimbursement models of Medicare home health services from therapy utilization driven to patient characteristics. While this has allowed for a focus from quantity to quality, some home health agencies are restricting therapy visits and placing their quality measures, Star Rating, and most importantly patient outcomes at risk. CMS calculates Star Ratings through several areas therapy may influence including, ambulation, bed transfers, bathing, discharge location, and rehospitalizations.

When it comes to clinical reimbursement opportunities, HealthPRO Heritage asks: “Is your clinical team leaving no stone unturned?” As national healthcare consultants with a progressive approach to PDPM, HealthPRO Heritage offers five simple (but not easy*) strategies to compliantly optimize clinical-based reimbursement.

"If it were easy….then everyone would do it!"